Complementary and alternative medicine use in adolescents with inflammatory bowel disease and juvenile idiopathic arthritis

Abstract

BackgroundThe use of complementary alternative medicine (CAM) is potentially prevalent among paediatric patients with chronic diseases but with variable rates among different age groups, diseases and countries. There are no recent reports on CAM use among paediatric patients with inflammatory bowel disease (IBD) and juvenile idiopathic arthritis (JIA) in Europe. We hypothesized that CAM use associates with a more severe disease in paediatric IBD and JIA.MethodsA cross-sectional questionnaire study among adolescent outpatients with IBD and JIA addressing the frequency and type of CAM use during the past year. The patients were recruited at the Children’s Hospital, University of Helsinki, Finland.ResultsOf the 147 respondents, 97 had IBD (Crohn’s disease: n = 46; median age 15.5, disease duration 3.4 years) and 50 had JIA (median age 13.8, disease duration 6.9 years). During the past 12 months, 48% regularly used CAM while 81% reported occasional CAM use. Compared to patients with JIA, the use of CAM in IBD patients tended to be more frequent. The most commonly used CAM included probiotics, multivitamins, and mineral and trace element supplements. Self-imposed dietary restrictions were common, involving 27.6% of the non-CAM users but 64.8% of all CAM users. Disease activity was associated with CAM use in JIA but not in IBD.ConclusionsCAM use is frequent among adolescents with IBD and JIA and associates with self-imposed dietary restrictions. Reassuringly, adherence to disease modifying drugs is good in young CAM users. In JIA, patients with active disease used more frequently CAM than patients with inactive disease. As CAM use is frequent, physicians should familiarise themselves with the basic concepts of CAM. The potential pharmacological interaction or the toxicity of certain CAM products warrants awareness and hence physicians should actively ask their patients about CAM use.

Complementary and alternative medicine (CAM) practices and dietary patterns in children with inflammatory bowel disease in Singapore and Malaysia

“…Previous studies in western populations reported CAM use of between 41% and 65% in pediatric IBD. 2,6,8,10,13,14 Although a recent study by Serpico et al 3 reported rates of use as high as 84% (or 100% if calcium and vitamin D are included in the definition of CAM) in their cohort of 104 pediatric patients with IBD. As noted in previous studies, the prevalence of CAM use varies and is dependent upon the working definitions of CAM.…”

“…The concept of CAM use in the present study included different medical practices or products that are generally considered not to be part of conventional medicine. 6 The face validity of the questionnaire was checked by two fellow healthcare professionals and three patients with IBD. Appropriate amendments to improve readability were then made to the questions before the construction of the final version of the questionnaire.…”

“…5 Moreover, it has also been noted that among the IBD patients, CAM users were more likely to be on a restricted diet such as the avoidance of dairy, fruits, and vegetables as compared to non-CAM users. 6 Certain dietary trends have also been associated with the prevalence of IBD. 7 Certain food such as fried potato which is high in glycoalkaloid has been found to disrupt the integrity of the gut epithelial barrier.…”

“…Of the few published studies on the use of CAM, most were based on Caucasian populations using different definitions of CAM, with differences in study design, respondents, and cultural specificities. 6,8,9 The main aim of this study was therefore to determine the prevalence and types of CAM use among these two Southeast Asian populations and the factors associated with its use. The secondary aim was to explore if particular dietary patterns/restrictions were practiced in those patients who used CAM.…”

Complementary and alternative therapies for inflammatory bowel diseases in children

“…Definicija varira i među zemljama i dijelova svijeta pa se tako primjerice u Aziji, za razliku od Europe, akunpunktura ne smatra dijelom KAM-ova. Najkorišteniji oblici KAM-ova u djece s UBC-om su ljekovite biljke (kurkuma, kanabis), probiotici, riblja ulja, akunpunktura, dijetne prehrane te multivitaminske terapije15 .…”