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P488. Impact of complementary and alternative medicine on quality of life in IBD patients

S. Nahon1, P. Lahmek2, A. Buisson3, A. Olympie4, C. Poupardin5, S. Chaussade6, B. Lesgourgues5, V. Abitbol6, 1Groupe Hospitalier Le Raincy-Montfermeil, Gastroenterology, Montfermeil, France, 2Hôpital Emile Roux, France, 3Association François Aupetit, Paris, France, 4Association François Aupetit, France, 5GHI Montfermeil, France, 6Hôpital Cochin, Gastroenterology, France

Background

Complementary and alternative medicine (CAM) are widely used by IBD patients. However, only few data have been published concerning the impact of CAM on quality of life (QOL).

Methods

From December 2011 to March 2012, we have conducted an Internet survey of CAM through the website of the French association of IBD patients (AFA). Patients belonging or not to the association were invited to answer a questionnaire using the LimeSurvey application. The questionnaire contained four parts: 1) socio-demographics of IBD, 2) IBD treatment, 3) CAM type [a) naturopathy, b) manipulative and body-based practices, c) traditional medicine and homeopathy, d) herbal products or dietary supplements and e) meditation and spiritual approach], 4) socioeconomics data and small IBDQ (SIBDQ). Moreover, the patient had to note the impact of CAM on his disease's symptoms and on his quality of life on a scale from 0 to 100.

Results

767 (82.3%) patients completed the whole questionnaire. 503 (65.6%) reported using CAM, 172 (22.4%) had never used them and 92 (12%) had used CAM. CAM were based on naturopathy in 15.2% of the cases, on manipulative and body-based practices in 25.1% of the cases, on homeopathic or traditional medicine in 19.6% of the cases, on dietary supplements in 30.7% of the cases and on meditation in 9.1% of the cases. CAM users (compared with non users) were more likely to have a Crohn's disease (OR = 1.52, p = 0.02), to be in clinical remission (OR = 1.42, p = 0.06), to be member of the AFA (OR = 1.95, p = 0.0001), to have a high level degree (OR = 1.51, p = 0.02), to stop their treatment (OR = 9.3, p < 0.0001) and to have a higher rate of SIBDQ score >50 (OR = 1.64, p = 0.01).

Improvement of IBD symptoms and QOL by CAM is presented in Table 1. Their gastroenterologist was aware of CAM use by their patients in only 46% of cases.

Table 1
 Improvement of IBD symptomsImprovement of quality of life
 Median (IQR)Mean±SDMedian (IQR)Mean±SD
Naturopathy50 (20–71)47±30.360 (25–80)52.8±31.6
Manipulative and body-based practices60 (20–72)49.1±30.870 (41–80)60.1±29.6
Homeopathic or traditional medicine60 (20–76)50.4±32.268 (25–80)54.4±31.1
Dietary supplements63 (22–80)53.4±32.965 (25–80)55.5±32.6
Meditation or spiritual approach34 (0–70)38.7±35.750 (0–80)43.5±37.8

Conclusion

This study confirms that CAMs are widely used by IBD patients. CAM users seem to feel better, however, they tend to stop their treatment. All types of CAM except for meditation or spiritual approach seem to improve both QOL and IBD symptoms.