Multidisciplinary Assessment and Management of Functional Dysphagia.

Area of Science:

• Gastroenterology and Neurogastroenterology
• Disorders of Gut-Brain Interaction (DGBI)
• Swallowing Disorders

Background:

• Functional dysphagia (FD) is defined by the Rome IV criteria as difficulty swallowing without identifiable esophageal disease.
• FD is classified as a functional gastrointestinal disorder (FGID) and a disorder of gut-brain interaction (DGBI).
• Pathophysiology involves complex gut-brain axis signaling, potentially leading to visceral hypersensitivity and CNS dysregulation.

Purpose of the Study:

• To provide a comprehensive overview of functional dysphagia, including its definition, epidemiology, pathophysiology, and clinical features.
• To detail a unique, multidisciplinary approach to managing FD patients.
• To highlight the collaborative roles of gastroenterologists, speech-language pathologists, and GI psychologists in FD care.

Main Methods:

• This narrative review synthesizes current knowledge on FD.
• It details a specific multidisciplinary assessment and treatment model from the University of South Florida's Center for Swallowing Disorders.
• The review covers FD definition, epidemiology, pathophysiology, clinical characteristics, associated disorders, and treatment.

Main Results:

• FD lacks standardized evaluation and treatment protocols, often being a diagnosis of exclusion.
• Management strategies are frequently adapted from other FGIDs.
• A multidisciplinary approach is essential for optimal patient care.

Conclusions:

• Functional dysphagia management necessitates a collaborative, multidisciplinary team.
• The described approach integrates expertise from gastroenterology, speech-language pathology, and GI psychology.
• Further research and standardized protocols are needed for FD evaluation and treatment.