| Background:Gastrointestinal motility disorders,a series of diseases with abnormal gastrointestinal transmitting function,mainly manifest as gastrointestinal symptoms.These diseases are often thought to be equal to functional gastrointestinal disorders(such as functional dyspepsia,functional constipation and irritable bowel syndrome,ect.),while actually some organic GI diseases,systemic diseases,postoperative events(such as gastroesophageal reflux disease,peptic ulcer,systemic sclerosis,ect.)can also be accompanied with gastrointestinal dysmotility.Recently gastrointestinal motility disorders are becoming common public health issues with higher incidence worldwide.Sometimes,the uncleared pathogeny,diversified clinical manifestations,multiple systems involved,complications and comorbidities make it difficult to give a accurate diagnosis and individualized therapeutic schedule.That has made the disease great challenge for clinicians,bringing us into the realization that no single discipline or doctor has the ability to deliver the full range of knowledge when facing refractory gastrointestinal motility disorders.Multidisciplinary team(MDT)has been widely applied to tumor and other fields such as respiratory disease,metabolic disease,cardiovascular and cerebrovascular disease with significant effect.However,in addition to gastroesophageal reflux disease,MDT was rarely applied to gastrointestinal motility disorders systematically and the relevant studies were seldom referred.Aims:This study aimed to investigate the main forms,the major structure,the effect and value and viable system of MDT for patients with gastrointestinal motility disorders in out hospital,and to point out its existing problems,in order to provide new ideas for the diagnosis and treatment for this disease.Methods:807 patients who accepted MDT for their diagnosis and treatment were included in this study according to the criteria.They were divided into MDT Green Circle group(equal to or less than 3 disciplines were involved,n=786)and MDT Meeting group(equal to or more than 4 disciplines were involved,n=21).The clinical data of the patients enrolled were collected including general information,medical information(major symptoms,meeting form,discipline attended,the final diagnosis and therapic schedule),effect assessment and satisfaction survey,in order to observe the case characteristics and effect of two mode of MDT for gastrointestinal motility disease.In addition,a typical case was presented to show the specific process,the major structure and its effect.The statistical method of chi-square test,Mean ± standard deviation and t-test were used to the analysis(SPSS 22.0).Results:1.The number of the cases which accepted MDT Green Circle is much larger than that accepted MDT Meeting.2.Analysis of the characteristics of the cases in MDT Green Circle group(1)The number of patients with mainly upper gastrointestinal symptoms is 494(accounting for 63%);the number of patients with mainly lower gastrointestinal symptoms is 175(accounting for 22%);the number of patients with both upper and lower gastrointestinal symptoms is 117(accounting for 15%).(2)The ages of the patients with upper gastrointestinal disease were mainly distributed in 40-59 years old(accounting for 49%);the ages of the patients with lower gastrointestinal disease were mainly distributed in 60-79 years old(accounting for 45%);the ages of the patients with both upper and lower gastrointestinal symptoms were mainly distributed in 40-59 years old(accounting for 41%).(3)The disciplines involved in MDT Green Circle mainly include GI Medicine,Respiratory Medicine,Otolaryngology and Psychosomatic Medicine.(4)The final diagnosis of the diseases are mainly gstroesophageal reflux disease,functional esophageal disease and functional constipation.3.Analysis of the characteristics of the cases in MDT Meeting group(1)The ages of the patients were mainly distributed in 40-59 years old(accounting for 66%).(2)The disciplines involved in MDT Meeting mainly include GI Medicine,Gastrointestinal Surgery,Psychosomatic Medicine and Traditional Chinese Medicine.(3)The main purposes of the consultation were defecation difficulty,retrosternal burning sensation,while the most common diagnosis were functional constipation,refractory gastroesophageal reflux disease and malignant tumor.(4)The main therapeutic method include psychotherapy,drug therapy,life guidance,endoscopic therapy or interventional therapy and surgical treatment.4.Functional gastrointestinal diseases(FGIDs)are the most common diseases in this study.The proportion of patients with FGIDs in MDT Green Circle group was higher than that of MDT Meeting group(P<0.05).5.The total effective rate of the two multidisciplinary meeting modes for patients with gastrointestinal motility disorders was satisfactory.6.In the case report,the patient who was helped by MDT finally got a clear diagnosis and gradually restored normal bowel habits.Conclusions1.MDT plays a positive role in the diagnosis and treatment for patients with gastrointestinal motility disorders.2.MDT Green Circle is more acceptable and more widely used mode for patients.3.The typical case suggested that MDT can effectively solve patients' problems and improve their satisfaction. |
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