[The gut is where health begins : How gastroenterological diseases can be prevented].

Diseases of the digestive organs are among the most frequent diseases and at the same time diseases with the most severe consequences in Germany. They are widespread diseases in the proper sense. Around 2.5 million people are hospitalized annually due to gastroenterological diseases and approximately 140,000 deaths per year are directly attributed to them. In addition, there are substantial impairments in the quality of life, high periods of inability to work and an immense economic burden on the healthcare system with annual costs of over €60 billion. It is particularly relevant that a substantial proportion of these diseases could be avoided or at least the course could be favorably influenced. The gastrointestinal tract including the liver and pancreas undertakes a key management function for the whole organism. Disorders of the digestive organs not only have a local effect but also influence the metabolism, cardiovascular system, immune system and the brain. Therefore, prevention in gastroenterology always also means prevention of systemic diseases. A healthy gut is a prerequisite for a healthy life. Prevention in gastroenterology is also a success story. The introduction of screening coloscopy, the vaccination against hepatitis B, the introduction of hepatitis B and C screening and the eradication of Helicobacter pylori demonstrably reduce the morbidity and mortality risks and impressively show the potential of a consistently implemented preventive strategy. This article compiles the aims, evidence, success and current deficits in gastroenterological preventive measures, names potential improvements and provides a perspective of future developments.