Otolaryngology Department, Royal Brisbane and Woman's Hospital Health Service District, Herston, Queensland, Australia
Department of Ear Nose and Throat, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
BMJ Open Gastroenterol. 2023 Nov 23;10(1):e000883. doi: 10.1136/bmjgast-2022-000883.
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.
目的:经常有不明原因的慢性咽喉症状(UCTS)患者被转介到胃肠病学和耳鼻喉科门诊进行检查。尽管进行了广泛的检查,但仍未发现可解释症状的明显结构异常。本文的目的是简要评估当前 UCTS 评估和管理方法的循证依据、其临床结果和相关医疗保健利用情况。
设计:这项多学科综述批判性地检查了 UCTS 的病因理论和病理生理驱动因素的现有理解,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,单一专业方法不能充分捕捉到 UCTS 中临床特征和生物心理社会因素之间的大量异质性和普遍重叠,这表明需要一种更统一的方法。
结论:本文借鉴胃肠道文献中关于肠道-大脑相互作用障碍的当代见解,提出了一种新的跨学科方法,其特点是积极的诊断框架和以患者为中心的治疗模式。这种方法的总体目标是改善患者的预后并促进合作研究工作。
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