评估和管理不明原因慢性气消化症状患者的实用多学科框架。

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY BMJ Open Gastroenterology Pub Date : 2023-11-23 DOI:10.1136/bmjgast-2022-000883
Nathan Quigley, Sandeep G Mistry, Dipesh H Vasant, Sarju Vasani
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引用次数: 0

摘要

目的:出现不明原因的慢性咽喉症状(UCTS)的患者经常被转介到胃肠病学和耳鼻喉科门诊进行调查。通常,尽管进行了广泛的调查,但没有发现可识别的结构异常来解释这些症状。本文的目的是为目前评估和管理UCTS、其临床结果和相关医疗保健利用的方法提供简明的证据基础评估。设计:这篇多学科综述批判性地考察了目前对UCTS病因学理论和病理生理驱动因素的理解,并总结了支持各种诊断和管理方法的证据基础。结果:从综述中收集的证据表明,单一专业的UCTS方法不能充分捕捉临床特征和生物心理社会因素之间的实质性异质性和普遍重叠,因此需要一种更统一的方法。结论:借鉴当代胃肠文献对肠脑相互作用紊乱的见解,本文提出了一种全新的跨学科方法,其特点是积极的诊断框架和以患者为中心的治疗模式。这种方法的首要目标是改善患者的治疗效果,促进合作研究。
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Practical multidisciplinary framework for the assessment and management of patients with unexplained chronic aerodigestive symptoms.

Objective: Patients experiencing unexplained chronic throat symptoms (UCTS) are frequently referred to gastroenterology and otolaryngology outpatient departments for investigation. Often despite extensive investigations, an identifiable structural abnormality to account for the symptoms is not found. The objective of this article is to provide a concise appraisal of the evidence-base for current approaches to the assessment and management of UCTS, their clinical outcomes, and related healthcare utilisation.

Design: This multidisciplinary review critically examines the current understanding of aetiological theories and pathophysiological drivers in UCTS and summarises the evidence base underpinning various diagnostic and management approaches.

Results: The evidence gathered from the review suggests that single-specialty approaches to UCTS inadequately capture the substantial heterogeneity and pervasive overlaps among clinical features and biopsychosocial factors and suggests a more unified approach is needed.

Conclusion: Drawing on contemporary insights from the gastrointestinal literature for disorders of gut-brain interaction, this article proposes a refreshed interdisciplinary approach characterised by a positive diagnosis framework and patient-centred therapeutic model. The overarching aim of this approach is to improve patient outcomes and foster collaborative research efforts.

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来源期刊
BMJ Open Gastroenterology
BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.90
自引率
3.20%
发文量
68
审稿时长
2 weeks
期刊介绍: BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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