Complementary and Alternative Medicine Use in Brazilian Patients With Inflammatory Bowel Disease

Abstract

Background: The conventional treatment of inflammatory bowel disease (IBD) is based on drug therapy, but different studies have shown a progressive increase in the use of complementary and alternative medicine (CAM). The most used CAM comprises of acupuncture, traditional Chinese medicine, Ayurvedic medicine, homeopathy, and herbal medicine, as well as more modern practices, including aromatherapy and reflexology. Data from CAM use in Brazil has previously been scarce and there are no studies among Brazilian patients with IBD. Objective: The aim of the study was to evaluate the frequency of, and factors associated with the use of CAM among IBD patients in Brazil, in addition to estimating the satisfaction with CAM use. Methods: A cross-sectional study was performed in adult IBD outpatients from two Southeastern Brazilian referral centers, with a total a sample of 227 individuals. A semi-structured questionnaire was used containing CAM products - tea, probiotics, omega 3 or glutamine, homeopathy, and herbal therapy, and factors associated with CAM use and patient satisfaction. We used descriptive statistics, association tests (P<0.05) and logistic regression for statistical analyses. Results: In total, 126 patients with Crohn’s disease and 101 with ulcerative colitis were included. The mean age was 41.19±14.49 years and 57.27% were female. The time since diagnosis was 10.58±7.5 years, and most patients were in clinical remission. Twenty-nine patients (12.8%) reported having used CAM for IBD treatment, such as tea (5.29%), probiotics (5.29%), omega-3 or glutamine (1.76%), homeopathy (0.88%), and herbal therapies (0.44%). Despite the low frequency, patients were satisfied (>50%). There was no difference between CAM use in Crohn’s disease as compared to ulcerative colitis patients (P=0.1171). The factors associated with the use of CAM were regular or poor quality of life (odds ratio 2.084; 95% confidence interval 1.147-3.786, P=0.0159) and a shorter time since diagnosis (odds ratio 0.956; 95% confidence interval 0.918-0.995; P=0.0260). Conclusion: The prevalence of CAM use was low, but satisfactory among Brazilian IBD patients. The application of CAM has been associated with poor quality of life and shorter disease duration compared to patients with no use of CAM.

The Evolving Field of Hepatology in Brazil

“…It is therefore possible that non-adherence to strategies known to improve survival could be a plausible explanation for the suboptimal reported 6-week outcomes. One interesting report concerning high prevalence of CAM use in subjects with inflammatory bowel disease was also published in the present issue of Archives of Gastroenterology by several investigators from São Paulo and Rio de Janeiro (21) . It is well known that approximately 1/3 of those patients with inflammatory bowel disease (IBD) have abnormal liver enzymes at least once in their lifetime, mainly due to hepatotoxicity usually attributed to the use of azathioprine, mercaptopurine, mesalazine, methotrexate, immunobiologics and even steroids.…”

Toxicity and Anti-Inflammatory Activity of Phenolic-Rich Extract from Nopalea cochenillifera (Cactaceae): A Preclinical Study on the Prevention of Inflammatory Bowel Diseases

“…The current trend in treatments for IBD patients involves the use of medicines associated with complementary therapies, probably as a consequence of the lack of efficacy of conventional treatment or due to their side effects [ 4 , 5 , 6 ]. The combination of botanical extracts and approved medicines by IBD patients as an add-on therapy has shown a clinical improvement in the quality life of patients through a decrease in the disease activity index and the maintenance of remissive disease status [ 7 ].…”