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P357 Do you think that complementary and alternative medicine use is frequent amongst inflammatory bowel disease patients: Forget it!—results from a comparative study

M. Rutka*1, T. Ferenci2, F. Nagy1, Z. Szepes1, K. Farkas1, A. Bálint1, R. Bor1, A. Milassin1, Z. Lénárt1, T. Molnar1

1University of Szeged, First Department of Medicine, Szeged, Hungary, 2John von Neumann Faculty of Informatics of Óbuda University, Budapest, Hungary

Background

The use of complementary and alternative medicine (CAM) seems to be increasing in recent decades. The aim of this study was to examine the frequency and the predictors of the regular use of CAM in IBD patients and to compare with patients diagnosed with other chronic gastrointestinal diseases.

Methods

An anonymous questionnaire was distributed to outpatients who attended at the First Department of Medicine, University of Szeged between February 2015 and October 2015. Patients were categorised as suffering from inflammatory bowel disease (IBD) or any gastrointestinal disease (control group). The survey focused on the use of herbs and botanicals, lifestyle modification, and mind/body medicine. Penalised logistic regression was used to investigate the predictors of CAM usage, controlling for age, sex, and disease duration.

Results

In total, 424 IBD patients (207 Crohn’s disease and 184 ulcerative colitis; mean age 42 years; male/female ratio 192/216; disease duration 11 years) and 164 control patients (gastric acid–related diseases, premalignant and malignant colorectal diseases, diverticulosis, irritable bowel disease, lactose intolerance, coeliac disease, dysbacteriosis, and other; mean age 53 years; male/female ratio 40/124; disease duration 5 years) completed the questionnaire. Further, 25.6% of patients with IBD and 42.3% of the control subjects used herbal therapy (odds ratio [OR] 0.56; 95% confidence interval [CI] 0.37–0.86 p = 0.072). They were taking the prescribed medications in 84% and 74% simultaneously. After the diagnosis, 78.5% and 65 % of IBD and control patients modified their lifestyle (diet-based 91.5%, 90.4%; exercise 36.6%, 30.8%; smoking cessation 14.6%, 11.5%). In addition, 19.9% and 11.5% of the IBD and the control patients regularly use mind/body medicine. Prescribed medications were used in 84% and 74% of the patients. In the multivariate model, neither female gender (p = 0.0773) nor younger age (p = 0.4152) nor disease duration (p = 0.3859) predicted the usage of herbs and mind/body techniques (p = 0.6075, p = 0.3208 and p = 0.2534, respectively). Younger age, however, was found to be an independent predictor of lifestyle modification (OR 0.88 [95% CI 0.78–0.99] for 10-year increase in age, p = 0.0343). In an extended model that included disease phenotype, type of medication, and number of medication, neither was found to be associated with herbal therapy, lifestyle modification, or mind/body medicine in IBD group.

Conclusion

Based on our comparative complementary study, use of CAM in IBD patients did not prove to be more frequent–it was even lower than expected–than in patients with other gastrointestinal diseases. The low rate of CAM use in IBD may be explained by doctor-patient communication, and the patients’ education.