Use of Complementary Medicine in Pediatric Patients With Inflammatory Bowel Disease: Results From a Multicenter Survey

Abstract

Objectives We examined the use of complementary and alternative medicine (CAM) at 3 US pediatric medical centers, comparing a group of children with inflammatory bowel disease (IBD) with children presenting with chronic constipation. Materials and Methods Surveys were administered by postal mail and at pediatric IBD centers in San Francisco, Houston, and Atlanta from 2001 to 2003. A comparison group consisting of pediatric patients with chronic constipation also was surveyed. Data were analyzed by t tests and by exact tests of contingency tables. Results In all, 236 surveys were collected from the IBD group; 126 surveys were collected from the chronic constipation comparison group. CAM therapies were used by 50% in the IBD group and 23% in the chronic constipation group. The overall regional breakdown of CAM use in IBD revealed no differences, although the types of CAM therapy used varied by site. The most commonly used CAM therapies in the IBD group were spiritual interventions (25%) and nutritional supplements (25%). Positive predictors for CAM use in IBD include the patient's self-reported overall health, an increase in the number of side effects associated with allopathic medications, white ethnicity, and parental education beyond high school. Conclusions This is the first US study to characterize CAM use in pediatric patients with IBD with another chronic gastrointestinal disorder. CAM use was twice as common with the IBD group compared with the chronic constipation group. Regional variations exist with the types of CAM therapy used. Practitioners should know that half of their pediatric patients with IBD may be using CAM in conjunction with or as an alternative to other treatments and that certain predictors can help identify those using CAM therapies.

Complementary and alternative medicine use by Japanese children with pediatric surgical diseases

“…Several large studies in the pediatric population have demonstrated that CAM is used for symptom management, and healthmaintenance or prevention, rather than treatment of specificconditions [3,4,6,21]. Moreover, many studies have found a higher CAM use among children with chronic conditions such as cerebral palsy [11,15], asthma [22], cancer [15,17,23,24], sicklecell anemia [25], IBD [10,15,16,18,20], and emergent illness [14,21]. The present study demonstrated that 27% of pediatric surgical patients had an experience of using CAM and the rate of CAM use in IBD patients was significantly higher compared with that in non-IBD patients.…”

“…The present study demonstrated that CAM use in Japanese patients who had un-dergone operation for pediatric surgical disease had no relationship with sex, age, duration of disease, parents' use, and associated disorders. It has been previously reported that factors associated with pediatric use of CAM are a higher age [4,6], the patient's self-reported overall health [10], white ethnicity [10], higher education in the parent's career [4,6,10,14], use of prescribed medication [4], and use of CAM by a parent [4,6,15].…”

Fecal Bacteriotherapy for Ulcerative Colitis; Patients Are Ready, Are We?

“…Studies have shown that knowledge and use of complementary and alternative medicine correlates with level of education. 6,24 We report findings from the first study to examine key ethical and social issues regarding fecal bacteriotherapy as a treatment for IBD. Participants perceived FB as "natural" and similar to probiotics.…”

“…3 As such, patients with ulcerative colitis frequently embrace alternative therapeutic options such as probiotics. [4][5][6] Fecal bacteriotherapy (FB) is an alternative microbiome-based therapy, also known as "human probiotic infusion", "stool transplant", "fecal transfer", or the more recently proposed term, "fecal microbiota transplantation" (FMT). Fecal bacteriotherapy involves collecting stool from healthy pre-screened donors, preparing it, and administering it to an individual with disease.…”

“…Reports from as early as 1958 suggest that FB is safe and may be effective for a variety of gastrointestinal conditions including inflammatory bowel disease. [7][8][9] Recognizing the immense interest in complementary and naturalistic therapies for ulcerative colitis, [4][5][6] as well as recent work demonstrating the potential of fecal bacteriotherapy, 9,10 we undertook a qualitative study to explore the attitudes, interests, and concerns of adult patients and parents of children with UC, regarding fecal bacteriotherapy as a treatment for ulcerative colitis.…”