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P244 Use of complementary and alternative medicine in patients with inflammatory bowel disease in Germany

J. Klaus*1, M. Kretschmer1, J. Berthold1, L. Rauschek1, E. Rottler2, L. Schulte1, R. Eisele3, C. von Tirpitz4, M. Sularz1

1Ulm University Hospital, Department of Internal Medicine I, Ulm, Germany, 2Ulm University Hospital, Department of Psychosomatic Medicine and Psychotherapy, Ulm, Germany, 3Krankenhaus Blaubeuren, Innere Medizin, Blaubeuren, Germany, 4Krankenhaus Biberbach, Innere Medizin, Biberach, Germany

Background

Many patients ask to combine complementary and alternative medicine (CAM) with guideline-based state of the art medicine in inflammatory bowel disease (IBD). In line with this, the new German S3 Therapy Guideline for Ulcerative Colitis (UC) was published in 2018, with an update of how to use CAM in IBD. In our study, we asked our patients about their use of CAM to better understand their intentions and desires around CAMs.

Methods

298 IBD patients in 3 specialised IBD outpatient clinics in Germany (Ulm, Blaubeuren, Biberach) filled in an anonymous questionnaire including 88 questions on the underlying IBD itself, on CAM, socio-economic parameters and 6 psychological tests (HADS, STAI-S, STAI-T, F-Sozu, Neo-FFI, BL-R).

Results

In total, 139 (47.3%) male and 155 (52.7%) female patients, 185 (63.4%) with Crohn’s disease (CD) and 107 (36.6%) with UC completed the questionnaire. HBI in CD was 5.4 (± 4.6) and CAI was 2.29 (±2.4) in UC. 218 (73.9%) patients admitted to use CAM in the past or the present and only 80 (26.1%) patients did never use CAM at all. Eighty-nine patients used CAMs without being aware that the applied method was recognised as such. Phytotherapies (173 (61.3%)) were most frequently used, followed by probiotics (122 (45.7%)), relaxation techniques (121 (45.3%)), homeopathy (74 (29.5%)), and acupuncture (52 (19.9%)). The main reasons why patients would take CAM in the past, present, or future were, above all, concerns about the further course of the disease (112 (40.1%)), a desired holistic approach (92 (33.0%)) and on the recommendation of attending physicians (83 (29.7%)). 172 (58.9%) patients received or wanted to receive information about CAM preferably from their attending physician. The second most popular source of information was the Internet for 163 (56.0%) patients. 210 (72.9%) patients could imagine using CAM in the future. In addition, 220 (78%) patients would use CAM without further concerns about efficacy or safety.

Conclusion

German IBD patients widely use CAM. Although the Internet is often used as a source of information, patients like most to receive information about CAM from their attending IBD physician. Therefore, IBD specialists should become more involved with the subject to be able to help their patients with their best advice on CAM.