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Complementary and Alternative Therapies

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Pediatric Inflammatory Bowel Disease

Abstract

Multiple studies confirm complementary and alternative medicine (CAM), or integrative therapy use is common among children with IBD. Pediatric prevalence rates are compatible with or exceed CAM use in adult IBD. Surveys indicate that biologically based therapies are the most frequently utilized modality among the pediatric IBD population. Concurrent use of biologically based CAM, such as herbals and supplements, and prescription medication is common and may cause untoward drug interactions. In this chapter, we review the available evidence for the safety and efficacy of the most commonly used biologically based therapies in IBD. Clinicians ought to appreciate the prevalence of CAM utilization in the pediatric IBD population, parent’s receptivity toward these modalities as adjuvant therapies, and the reticence to disclose utilization. We suggest that the maintenance of a cursory level of understanding and awareness of CAM modalities, including knowledge of efficacy, interactions, and contraindications, are essential to ensure patient safety.

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References

  1. Birdee GS, Phillips RS, Davis RB, Gardiner P. Factors associated with pediatric use of complementary and alternative medicine. Pediatrics. 2010;125:249–56.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hilsden RJ, Verhoef MJ, Rasmussen H, Porcino A, DeBruyn JCC. Use of complementary and alternative medicine by patients with inflammatory bowel disease. Inflamm Bowel Dis. 2011;17:655–62.

    Article  PubMed  Google Scholar 

  3. Rawsthorne P et al. An international survey of the use and attitudes regarding alternative medicine by patients with inflammatory bowel disease. Am J Gastroenterol. 1999;94:1298–303.

    Article  CAS  PubMed  Google Scholar 

  4. Hung A, Kang N, Bollom A, Wolf JL, Lembo A. Complementary and alternative medicine use is prevalent among patients with gastrointestinal diseases. Dig Dis Sci. 2015;60:1883–8.

    Article  PubMed  Google Scholar 

  5. Wong AP et al. Use of complementary medicine in pediatric patients with inflammatory bowel disease: results from a multicenter survey. J Pediatr Gastroenterol Nutr. 2009;48:55–60.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Markowitz JE et al. Patterns of complementary and alternative medicine use in a population of pediatric patients with inflammatory bowel disease. Inflamm Bowel Dis. 2004;10:599–605.

    Article  PubMed  Google Scholar 

  7. Langhorst J et al. Patterns of complementary and alternative medicine (CAM) use in patients with inflammatory bowel disease: perceived stress is a potential indicator for CAM use. Complement Ther Med. 2007;15:30–7.

    Article  PubMed  Google Scholar 

  8. Heuschkel R et al. Complementary medicine use in children and young adults with inflammatory bowel disease. Am J Gastroenterol. 2002;97:382–8.

    Article  PubMed  Google Scholar 

  9. Surette S, Vanderjagt L, Vohra S. Surveys of complementary and alternative medicine usage: A scoping study of the paediatric literature. Complement Ther Med. 2013;21:S48–53.

    Article  PubMed  Google Scholar 

  10. Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States (Number 343). Advance Data from Vital and Health Statistics. 2004;343:1–19.

    Google Scholar 

  11. Gerasimidis K, McGrogan P, Hassan K, Edwards CA. Dietary modifications, nutritional supplements and alternative medicine in paediatric patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2008;27:155–65.

    Article  CAS  PubMed  Google Scholar 

  12. Ceballos C et al. Complementary and alternative medicine use at a single pediatric inflammatory bowel disease center. Gastroenterol Nurs. 2014;37:265–71.

    Article  PubMed  Google Scholar 

  13. Day AS, Whitten KE, Bohane TD. Use of complementary and alternative medicines by children and adolescents with inflammatory bowel disease. J Paediatr Child Health. 2004;40:681–4.

    Article  CAS  PubMed  Google Scholar 

  14. Nousiainen P, Merras-Salmio L, Aalto K, Kolho K. Complementary and alternative medicine use in adolescents with inflammatory bowel disease and juvenile idiopathic arthritis. BMC Complement Altern Med. 2014;14:124.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hilsden RJ, Meddings JB, Verhoef MJ. Complementary and alternative medicine use by patients with inflammatory bowel disease: An Internet survey. Can J Gastroenterol. 1999;13:327–32.

    Article  CAS  PubMed  Google Scholar 

  16. Hilsden RJ, Scott CM, Verhoef MJ. Complementary medicine use by patients with inflammatory bowel disease. Am J Gastroenterol. 1998;93:697–701.

    Article  CAS  PubMed  Google Scholar 

  17. Cotton S et al. Mind-body complementary alternative medicine use and quality of life in adolescents with inflammatory bowel disease. Inflamm Bowel Dis. 2010;16:501–6.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Otley AR, Verhoef MJ, Best A, Hilsden RJ. Prevalence and determinants of use of complementary and alternative medicine in a Canadian pediatric inflammatory bowel disease (IBD) population. Gastroenterology. 2001;120:A213

    Google Scholar 

  19. Levenstein S et al. Stress and exacerbation in ulcerative colitis: a prospective study of patients enrolled in remission. Am J Gastroenterol. 2000;95:1213–20.

    Article  CAS  PubMed  Google Scholar 

  20. Farhadi A et al. Heightened responses to stressors in patients with inflammatory bowel disease. Am J Gastroenterol. 2005;100:1796–804.

    Article  PubMed  Google Scholar 

  21. Anton PA. Stress and mind-body impact on the course of inflammatory bowel diseases. Semin Gastrointest Dis. 1999;10:14–9.

    CAS  PubMed  Google Scholar 

  22. Langmead L et al. Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis. Aliment Pharmacol Ther. 2004;19:739–47.

    Article  CAS  PubMed  Google Scholar 

  23. Ben-Arye E et al. Wheat grass juice in the treatment of active distal ulcerative colitis: a randomized double-blind placebo-controlled trial. Scand J Gastroenterol. 2002;37:444–9.

    Article  CAS  PubMed  Google Scholar 

  24. Tang T et al. Randomised clinical trial: herbal extract HMPL-004 in active ulcerative colitis - a double-blind comparison with sustained release mesalazine. Aliment Pharmacol Ther. 2011;33:194–202.

    Article  CAS  PubMed  Google Scholar 

  25. Sandborn WJ et al. Andrographis paniculata extract (HMPL-004) for active ulcerative colitis. Am J Gastroenterol. 2013;108:90–8.

    Article  PubMed  Google Scholar 

  26. Chen ZS, Nie ZW, Sun QL. Clinical study in treating intractable ulcerative colitis with traditional Chinese medicine. Zhongguo Zhong Xi Yi Jie He Za Zhi. 1994;14:400–2.

    CAS  PubMed  Google Scholar 

  27. Chen Q, Zhang H. Clinical study on 118 cases of ulcerative colitis treated by integration of traditional Chinese and Western medicine. J Tradit Chin Med. 1999;19:163–5.

    CAS  PubMed  Google Scholar 

  28. Ng SC et al. Systematic review: the efficacy of herbal therapy in inflammatory bowel disease. Aliment Pharmacol Ther. 2013;38:854–63.

    Article  CAS  PubMed  Google Scholar 

  29. Triantafyllidi A, Xanthos T, Papalois A, Triantafillidis J. Herbal and Plant therapy in patients with inflammatory bowel disease. Ann Gastroenterol. 2015;28:210–20.

    PubMed  PubMed Central  Google Scholar 

  30. Greenfield SM et al. A randomized controlled study of evening primrose oil and fish oil in ulcerative colitis. Aliment Pharmacol Ther. 1993;7:159–66.

    Article  CAS  PubMed  Google Scholar 

  31. Hanai H et al. Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2006;4:1502–6.

    CAS  Google Scholar 

  32. Lang A et al. Curcumin in combination with 5-aminosalycilate induces remission in patients with mild to moderate ulcerative colitis in a randomized controlled trial. Clin Gastroenterol Hepatol. 2015;1–7. doi:10.1016/j.cgh.2015.02.019.

  33. Holt PR, Katz S, Kirshoff R. Curcumin therapy in inflammatory bowel disease: A pilot study. Dig Dis Sci. 2005;50:2191–3.

    Article  PubMed  Google Scholar 

  34. Suskind DL et al. Tolerability of curcumin in pediatric inflammatory bowel disease: a forced-dose titration study. J Pediatr Gastroenterol Nutr. 2013;56:277–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Gupta I et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med. 2001;67:391–5.

    Article  CAS  PubMed  Google Scholar 

  36. Gerhardt H, Seifert F, Buvari P, Vogelsang H, Repges R. Therapy of active Crohn disease with Boswellia serrata extract H 15. Z Gastroenterol. 2001;39:11–7.

    Google Scholar 

  37. Holtmeier W et al. Randomized, placebo-controlled, double-blind trial of Boswellia serrata in maintaining remission of Crohnʼs disease. Inflamm Bowel Dis. 2011;17:573–82.

    Article  PubMed  Google Scholar 

  38. Omer B, Krebs S, Omer H, Noor TO. Steroid-sparing effect of wormwood (Artemisia absinthium) in Crohn’s disease: a double-blind placebo-controlled study. Phytomedicine. 2007;14:87–95.

    Article  CAS  PubMed  Google Scholar 

  39. Krebs S, Omer TN, Omer B. Wormwood (Artemisia absinthium) suppresses tumour necrosis factor alpha and accelerates healing in patients with Crohn’s disease - a controlled clinical trial. Phytomedicine. 2010;17:305–9.

    Article  CAS  PubMed  Google Scholar 

  40. Ren J, Tao Q, Wang X, Wang Z, Li J. Efficacy of T2 in active Crohn’s disease: a prospective study report. Dig Dis Sci. 2007;52:1790–7.

    Article  PubMed  Google Scholar 

  41. Tao Q et al. Maintenance effect of polyglycosides of Tripterygium wilfordii on remission in postoperative Crohn disease. Zhonghua Wei Chang Wai Ke Za Zhi. 2009;12:491–3.

    PubMed  Google Scholar 

  42. Liao N et al. Efficacy of polyglycosides of Tripterygium wilfordii in preventing postoperative recurrence of Crohn disease. Zhonghua Wei Chang Wai Ke Za Zhi. 2009;12:167–9.

    PubMed  Google Scholar 

  43. Lal S et al. Cannabis use amongst patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol. 2011;23:891–6.

    Article  PubMed  Google Scholar 

  44. Izzo AA, Camilleri M. Emerging role of cannabinoids in gastrointestinal and liver diseases: basic and clinical aspects. Gut. 2008;57:1140–55.

    Article  CAS  PubMed  Google Scholar 

  45. Izzo AA, Sharkey KA. Cannabinoids and the gut: New developments and emerging concepts. Pharmacol Ther. 2010;126:21–38.

    Article  CAS  PubMed  Google Scholar 

  46. Borrelli F et al. Beneficial effect of the non-psychotropic plant cannabinoid cannabigerol on experimental inflammatory bowel disease. Biochem Pharmacol. 2013;85:1306–16.

    Article  CAS  PubMed  Google Scholar 

  47. Naftali T et al. Treatment of Crohn’s disease with cannabis: an observational study. Isr Med Assoc J. 2011;13:455–8.

    PubMed  Google Scholar 

  48. Naftali T et al. Cannabis induces a clinical response in patients with Crohn’s disease: a prospective placebo-controlled study. Clin Gastroenterol Hepatol. 2013;11:1276–1280.e1.

    Article  CAS  PubMed  Google Scholar 

  49. Feagan BG et al. Omega-3 free fatty acids for the maintenance of remission in Crohn disease: the EPIC Randomized Controlled Trials. JAMA. 2008;299:1690–7.

    Article  CAS  PubMed  Google Scholar 

  50. Fernández-Bañares F et al. Randomized clinical trial of Plantago ovata seeds (Dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Am J Gastroenterol. 1999;94:427–33.

    Article  PubMed  Google Scholar 

  51. Salvatore S et al. A pilot study of N-acetyl glucosamine, a nutritional substrate for glycosaminoglycan synthesis, in paediatric chronic inflammatory bowel disease. Aliment Pharmacol Ther. 2000;14:1567–79.

    Article  CAS  PubMed  Google Scholar 

  52. Tsujikawa T et al. Supplement of a chitosan and ascorbic acid mixture for Crohn’s disease: a pilot study. Nutrition. 2003;19:137–9.

    Article  CAS  PubMed  Google Scholar 

  53. Onken JE, Greer PK, Calingaert B, Hale LP. Bromelain treatment decreases secretion of pro-inflammatory cytokines and chemokines by colon biopsies in vitro. Clin Immunol. 2008;126:345–52.

    Article  CAS  PubMed  Google Scholar 

  54. Kane S, Goldberg M. Use of bromelain for mild ulcerative colitis. Ann Intern Med. 2000;132:680.

    Article  CAS  PubMed  Google Scholar 

  55. Wang B, Ren S, Fend W, Zhong Z, Qin C. Kui jie qing in the treatment of chronic non-specific ulcerative colitis. J Tradit Chin Med. 1997;17:10–3.

    CAS  PubMed  Google Scholar 

  56. Zhang F, Li Y, Xu F, Chu Y, Zhao W. Comparison of Xilei-san, a Chinese herbal medicine, and dexamethasone in mild/moderate ulcerative proctitis: a double-blind randomized clinical trial. J Altern Complement Med. 2013;19:838–42.

    Article  PubMed  Google Scholar 

  57. Fukunaga K et al. Placebo controlled evaluation of Xilei San, a herbal preparation in patients with intractable ulcerative proctitis. J Gastroenterol Hepatol. 2012;27:1808–15.

    Article  PubMed  Google Scholar 

  58. Khan Z et al. Use of the ‘nutriceutical’, bovine colostrum, for the treatment of distal colitis: results from an initial study. Aliment Pharmacol Ther. 2002;16:1917–22.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Jennifer Panganiban MD

  2. The Children’s Hospital of Philadelphia, Division of Gastroenterology, Hepatology and Nutrition, Philadelphia, PA, USA

    Jessi Erlichman MPH & Maria Mascarenhas MBBS

Authors
  1. Jennifer Panganiban MD
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  2. Jessi Erlichman MPH
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  3. Maria Mascarenhas MBBS
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Corresponding author

Correspondence to Jennifer Panganiban MD .

Editor information

Editors and Affiliations

  1. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Petar Mamula

  2. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Andrew B. Grossman

  3. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Robert N. Baldassano

  4. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Judith R. Kelsen

  5. Division of Pediatric Gastroenterology & Nutrition, University of South Carolina School of Medicine - Greenville, Greenville, South Carolina, USA

    Jonathan E. Markowitz

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Panganiban, J., Erlichman, J., Mascarenhas, M. (2017). Complementary and Alternative Therapies. In: Mamula, P., Grossman, A., Baldassano, R., Kelsen, J., Markowitz, J. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-49215-5_39

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  • DOI: https://doi.org/10.1007/978-3-319-49215-5_39

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49213-1

  • Online ISBN: 978-3-319-49215-5

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