Chinese Journal of Integrative Medicine

, Volume 17, Issue 6, pp 403–409 | Cite as

Review on efficacy and health services research studies of complementary and alternative medicine in inflammatory bowel disease

Feature Article

Abstract

Objective

To assess the evidence of the use and efficacy for complementary and alternative medicine (CAM) in inflammatory bowel disease (IBD).

Methods

A systematic literature search in MEDLINE was performed for randomized controlled trials (RCTs) in Crohn’s disease and ulcerative colitis. Moreover, a selective literature search for health services research studies on the use of CAM in patients with IBD was performed.

Results

Health services research studies showed a high use of CAM in adult and pediatric patients with IBD worldwide. In contrast to the high use among IBD patients, there was a lack of high-quality data for many of the used CAM methods. Although most of the studies showed positive results, the methodological quality of most studies was rather low; therefore, the results had to be interpreted with caution. While there were many studies for probiotics and fish oil, RCTs for the highly used method homeopathy, for most herbal products, and for traditional Chinese medicine methods apart from acupuncture RCTs were completely lacking.

Conclusions

The lack of high-quality studies might be the consequence of the problems: associated with the funding of clinical trials involving CAM. However, having the high user rates in mind, high-quality studies assessing efficacy and safety of those methods are urgently needed. Furthermore, there is a quality need for better representation of CAM in undergraduate and postgraduate medical education.

Keywords

complementary and alternative medicine inflammatory bowel disease Crohn’s disease ulcerative colitis health services research 

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References

  1. 1.
    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;17:305–309.PubMedCrossRefGoogle Scholar
  2. 2.
    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.PubMedCrossRefGoogle Scholar
  3. 3.
    Langmead L, Feakins RM, Goldthorpe S, Holt H, Tsironi E, De Silva A, et al. Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis. Aliment Pharmacol Ther 2004;19:739–747.PubMedCrossRefGoogle Scholar
  4. 4.
    Gupta I, Parihar A, Malhotra P, Singh GB, Lüdtke R, Safayhi H, et al. Effects of Boswellia serrata gum resin in patients with ulcerative colitis. Eur J Med Res 1997;2:37–43.PubMedGoogle Scholar
  5. 5.
    Gupta I, Parihar A, Malhotra P, Gupta S, Lüdtke R, Safayhi H, et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med 2001;67:391–395.PubMedCrossRefGoogle Scholar
  6. 6.
    Gerhardt H, Seifert F, Buvari P, Vogelsang H, Repges R. Therapy of active Crohn’s disease with Boswellia serrata extract (H15). Gastroenterol (German) 2001;39:11–17.CrossRefGoogle Scholar
  7. 7.
    Ben-Arye E, Goldin E, Wengrower D, Stamper A, Kohn R, Berry E. Wheat grass juice in the treatment of active distal ulcerative colitis: a randomized double-blind placebo-controlled trial. Scand J Gastroenterol. 2002;37:444–449.PubMedCrossRefGoogle Scholar
  8. 8.
    Khan Z, Macdonald C, Wicks AC, Holt MP, Floyd D, Ghosh S, et al. Use of the ‘nutriceutical’, bovine colostrum, for the treatment of distal colitis: results from an initial study. Aliment Pharmacol Ther 2002;16:1917–1922.PubMedCrossRefGoogle Scholar
  9. 9.
    Kanauchi O, Mitsuyama K, Homma T, Takahama K, Fujiyama Y, Andoh A, et al. Treatment of ulcerative colitis patients by long-term administration of germinated barley foodstuff: multi-center open trial. Int J Mol Med 2003;12:701–704PubMedGoogle Scholar
  10. 10.
    Vernia P, Marcheggiano A, Caprilli R, Frieri G, Corrao G, Valpiani D, et al. Short-chain fatty acid topical treatment in distal ulcerative colitis. Aliment Pharmacol Ther 1995;9:309–313.PubMedCrossRefGoogle Scholar
  11. 11.
    Sang LX, Chang B, Zhang WL, Wu XM, Li XH, Jiang M. Remission induction and maintenance effect of probiotics on ulcerative colitis: a meta-analysis. World J Gastroenterol 2010;16:1908–1915.PubMedCrossRefGoogle Scholar
  12. 12.
    Kruis W, Fric P, Pokrotnieks J, Lukás M, Fixa B, Kascák M, et al. Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine. Gut 2004;53:1617–1623.PubMedCrossRefGoogle Scholar
  13. 13.
    Schultz M, Timmer A, Herfarth HH, Sartor RB, Vanderhoof JA, Rath HC. Lactobacillus GG in inducing and maintaining remission of Crohn’s disease. BMC Gastroenterol 2004;4:5.PubMedCrossRefGoogle Scholar
  14. 14.
    Marteau P, Lémann M, Seksik P, Laharie D, Colombel JF, Bouhnik Y, et al. Ineffectiveness of Lactobacillus johnsonii LA1 for prophylaxis of postoperative recurrence in Crohn’s disease: a randomised, double blind, placebo controlled GETAID trial. Gut 2006;55:842–847.PubMedCrossRefGoogle Scholar
  15. 15.
    Rolfe VE, Fortun PJ, Hawkey CJ, Bath-Hextall F. Probiotics for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev 2006:CD004826.Google Scholar
  16. 16.
    Turner D, Zlotkin SH, Shah PS, Griffiths AM. Omega 3 fatty acids (fish oil) for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev 2009:CD006320.Google Scholar
  17. 17.
    De Ley M, de Vos R, Hommes DW, Stokkers P. Fish oil for induction of remission in ulcerative colitis. Cochrane Database Syst Rev 2007:CD005986.Google Scholar
  18. 18.
    Joos S, Brinkhaus B, Maluche C, Maupai N, Kohnen R, Kraehmer N, Hahn EG, Schuppan D. Acupuncture and moxibustion in the treatment of active Crohn’s disease: a randomized controlled study. Digestion 2004;69:131–139.PubMedCrossRefGoogle Scholar
  19. 19.
    Joos S, Wildau N, Kohnen R, Szecsenyi J, Schuppan D, Willich SN, et al. Acupuncture and moxibustion in the treatment of ulcerative colitis: a randomized controlled study. Scand J Gastroenterol 2006;41:1056–1063.PubMedCrossRefGoogle Scholar
  20. 20.
    Mawdsley JE, Jenkins DG, Macey MG, Langmead L, Rampton DS. The effect of hypnosis on systemic and rectal mucosal measures of inflammation in ulcerative colitis. Am J Gastroenterol 2008;103:1460–1469.PubMedCrossRefGoogle Scholar
  21. 21.
    Langhorst J, Mueller T, Luedtke R, Franken U, Paul A, Michalsen A, et al. Effects of a comprehensive lifestyle modification program on quality-of-life in patients with ulcerative colitis: a twelve-month follow-up. Scand J Gastroenterol 2007;42:734–745.PubMedCrossRefGoogle Scholar
  22. 22.
    Elsenbruch S, Langhorst J, Popkirowa K, Müller T, Luedtke R, Franken U, et al. Effects of mind-body therapy on quality of life and neuroendocrine and cellular immune functions in patients with ulcerative colitis. Psychother Psychosom 2005;74:277–287.PubMedCrossRefGoogle Scholar
  23. 23.
    Keller W, Pritsch M, Von Wietersheim J, Scheib P, Osborn W, Balck F, et al. German Study Group on Psychosocial Intervention in Crohn’s Disease. Effect of psychotherapy and relaxation on the psychosocial and somatic course of Crohn’s disease: main results of the German Prospective Multicenter Psychotherapy Treatment Study on Crohn’s Disease. J Psychosom Res 2004;56:687–696.PubMedCrossRefGoogle Scholar
  24. 24.
    Schwarz SP, Blanchard EB. Evaluation of a psychological treatment for inflammatory bowel disease. Behav Res Ther 1991;29:167–177.PubMedCrossRefGoogle Scholar
  25. 25.
    Milne B, Joachim G, Niedhardt J. A stress management programme for inflammatory bowel disease patients. J Adv Nurs 1986;11:561–567.PubMedCrossRefGoogle Scholar
  26. 26.
    Hilsden RJ, Verhoef MJ, Rasmussen H, Porcino A, DeBruyn JC. Use of complementary and alternative medicine by patients with inflammatory bowel disease. Inflamm Bowel Dis 2011;17:655–662.PubMedCrossRefGoogle Scholar
  27. 27.
    Joos S, Rosemann T, Szecsenyi J, Hahn EG, Willich SN, Brinkhaus B, et al. Use of complementary and alternative medicine in Germany—a survey of patients with inflammatory bowel disease. BMC Complement Altern Med 2006;6:19.PubMedCrossRefGoogle Scholar
  28. 28.
    Bensoussan M, Jovenin N, Garcia B, Vandromme L, Jolly D, Bouché O, et al. Complementary and alternative medicine use by patients with inflammatory bowel disease: results from a postal survey. Gastroenterol Clin Biol 2006;30:14–23.PubMedCrossRefGoogle Scholar
  29. 29.
    Chen YC, Chen FP, Chen TJ, Chou LF, Hwang SJ. Patterns of traditional Chinese medicine use in patients with inflammatory bowel disease: a population study in Taiwan. Hepatogastroenterology 2008;55:467–470.PubMedGoogle Scholar
  30. 30.
    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;27:155–165.PubMedCrossRefGoogle Scholar
  31. 31.
    Wong AP, Clark AL, Garnett EA, Acree M, Cohen SA, Ferry GD, 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.PubMedCrossRefGoogle Scholar
  32. 32.
    Cotton S, Humenay Roberts Y, Tsevat J, Britto MT, Succop P, McGrady ME, et al. Mind-body complementary alternative medicine use and quality of life in adolescents with inflammatory bowel disease. Inflamm Bowel Dis 2010;16:2099–2108.CrossRefGoogle Scholar
  33. 33.
    Li FX, Verhoef MJ, Best A, Otley A, Hilsden RJ. Why patients with inflammatory bowel disease use or do not use complementary and alternative medicine: a Canadian national survey. Can J Gastroenterol 2005;19:567–573.PubMedGoogle Scholar
  34. 34.
    Langhorst J, Anthonisen IB, Steder-Neukamm U, Lüdtke R, Spahn G, Michalsen A, et al. Amount of systemic steroid medication is a strong predictor for the use of complementary and alternative medicine in patients with inflammatory bowel disease: results from a German national survey. Inflamm Bowel Dis 2005;11:287–295.PubMedCrossRefGoogle Scholar
  35. 35.
    Baars JE, Markus T, Kuipers EJ, van der Woude CJ. Patients’ preferences regarding shared decision-making in the treatment of inflammatory bowel disease: results from a patient-empowerment study. Digestion 2010;81:113–119.PubMedCrossRefGoogle Scholar

Copyright information

© Chinese Association of the Integration of Traditional and Western Medicine and Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Department of General Practice and Health Services ResearchUniversity Medical Hospital HeidelbergHeidelbergGermany

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