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....

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Bibliographic Details
Main Authors: Dipesh H Vasant, Nathan Quigley, Sandeep G Mistry, Sarju Vasani
Format: Article
Language:English
Published: BMJ Publishing Group 2023-12-01
Series:BMJ Open Gastroenterology
Online Access:https://bmjopengastro.bmj.com/content/10/1/e000883.full
Description
Summary: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.
ISSN:2054-4774