Organization of neurogastroenterology and motility units with a multidisciplinary, patient-centered perspective.

Neurogastroenterology and Motility is a subspecialty of Gastroenterology dedicated to the management of gastrointestinal (GI) motor diseases and disorders of gut- brain interaction (DGBI). Both types of conditions may impair the nutritional status of the patients. In the case of motility disorders, because a deficient gastrointestinal motility may impair the correct digestion and absorption of foods. In DGBI because development of gastrointestinal symptoms may impair the correct nutrition of the patient. In both cases, different studies have shown that patients start restrictive diets by their own, without supervision of a dietician, leading to nutritional deficits in many cases. Likewise, psychological factors like stress situations or anxiety may trigger gastrointestinal symptoms in these patients, mainly in those with DGBI. Recent studies comparing a patient-centered approach that includes medical treatment, dietary modifications, and behavioural interventions with the gastroenterologist-only standard care, have shown a greater proportion of symptom improvement, psychological state and quality of life, as well as reduced costs in patients allocated to the multidisciplinary treatment. In conclusion, there is growing evidence in favour of dietary and behavioural interventions by specialized professionals, coupled with an appropriate medical evaluation and treatment by a gastroenterologist. Hence, the importance to develop reference units in which comprehensive and individualized management can be offered. Multidisciplinary models improve clinical outcomes and patient satisfaction, which should result in a reduction of direct and indirect costs.  .