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P245. The use of complementary therapies in inflammatory bowel disease – Do we know what our patients are taking?

R.O. Butcher, T. Law, R.C. Prudham, J.K. Limdi

Pennine Acute Hospitals, Manchester, United Kingdom

Aim: There has been a paradigm shift in the attitudes and perceptions of patients with Inflammatory bowel disease (IBD) in relation to treatment over the last two decades. This coupled with an unprecedented expansion of information and technology has created an environment of increasing health consciousness with the potential for beneficial and detrimental effects to patients. Our study aimed at identifying the use of non prescription remedies or supplements and sources of such advice in patients with IBD.

Materials and Methods: We conducted a prospective questionnaire-based study of 104 consecutive patients attending IBD clinics at our hospital. Clinical data including patient demographics, disease characteristics, patient's educational level, access and use of information technology and other resources of information were recorded. Previous or current use of vitamins, herbal or alternative medicine and food/nutritional supplements were noted as was the source of such advice.

Results: Fifty-four of the 104 IBD patients were female. Ninety-four percent were Caucasian and the median age range was 45–64 years. Most patients were followed up for more than 6 years (range 6–10 years in 16; more than 10 years in 45). Highest educational level was high school/comprehensive in 48 (46.2%), sixth-form/technical college in 15 (14.4%), college/university graduate in 34 (32.7%) and postgraduate in 5 (4.8%) patients with a further 2 unspecified. Eighty-three patients had internet access and 51 (61.5%) of these used the internet to access health, nutrition and disease related information. Nineteen (18.3%) were members of Crohn's and Colitis UK.

Current or previous use of vitamins was noted in 36 (34.6%) patients, herbal medicine in 5 (4.8%), alternative medicine in 5 (4.8%) and food/nutritional supplements in 12 (11.5%) patients. Recommendations for vitamin therapy came from the Gastroenterologist (12), GP (5), other health professionals (3), Internet (3), family and friends (1) and other unspecified sources (1). Recommendations for food/nutritional supplements came from the Gastroenterologist (4), other health professionals (3), family and friends (3) and the internet (2). In contrast herbal medicines were recommended by other patients (3), family and friends in 3 and the internet in two patients, whilst alternative medicine was recommended by the Gastroenterologist (2), GP (1) and other unspecified sources in two patients.

Conclusion: The use of complementary therapies in inflammatory bowel disease may be increasing. Wider access to information resources sometimes from unreliable sources paralleled by increasing health consciousness and commercial promotion has outpaced scientific evidence for use of supplements. The popular notion that all natural remedies are safe is not entirely correct with the potential for severe harm in some instances. Clinicians must remain vigilant to the use of any non prescription remedies taken by patients and provide appropriate advice.