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P581 Complementary and alternative therapies for inflammatory bowel disease

A. M. Fennessy*1, C. Hanna1, N. Breslin1, D. Mc Namara1,2, S. Anwar1, A. O'Connor1,2, B. M. Ryan1,2

1Tallaght University Hospital, Department of Gastroenterology, Dublin 24, Ireland, 2Trinity College Dublin, School of Medicine, Dublin 2, Ireland

Background

Use of complementary and alternative medicines is common in patients with inflammatory bowel disease (IBD); with previous studies showing rates between 21–60%. Certain non-prescribed therapies have gained popularity in recent times in social and other media (cannabis oil) and we wished to explore the use of this, and other products in our patient population. The aim of this study was to evaluate the use of non-prescribed complementary therapies in patients with IBD in a tertiary setting.

Methods

Patients with ulcerative colitis (UC), Crohn’s disease (CD) and undetermined IBD (IBD-U) were recruited from out-patient gastroenterology clinics at Tallaght University Hospital over a six-week period. They completed a self-administered, anonymised survey. Participants were asked about supplement use (prescribed and non-prescribed) and to give a subjective assessment of the impact these had on their symptoms.

Results

Of 166 consecutively approached IBD patients, 150 completed the survey, giving a response rate of 90.3%. Thirty-five per cent of respondents were prescribed dietary or vitamin supplements. Thirty-nine per cent reported use of non-prescribed therapies. Of these, 32/58 (55%) felt these therapies had a positive impact on IBD symptoms. Thirty-four had used probiotics; 13 of these patients reported improved symptoms (Table 2). Cannabis-based products were the second most commonly used supplement for IBD symptom-control (9.3%). Respondents also confirmed use of aloe vera (12%) turmeric (11%), acupuncture (9%), aromatherapy (5%) and hypnosis (2%).

Table 1. Baseline patient characteristics.

Baseline characteristicsAll patients (n = 150)UC (n = 46)CD (n = 97)IBD-U (n = 7)
Sex, n (%)
Female84(56%)23(50%)59(61%)2(29%)
Male66(44%)23(50%)38(39%)5(71%)
Age (years), mean ± SD45.4 ± 15.150.1 ± 17.643.4 ± 13.542 ± 13.6
Duration of disease (n = 134), years11.8 ± 8.910.3 ± 8.312.9 ± 9.16.5 ± 8.6
Previous surgery (n = 148)49(33%)5(11%)43(44%)1(14%)
Regular analgesia (n = 150)74(49%)22(49%)48(49%)4(57%)
Prescribed supplement use52(35%)9(20%)40(41%)3(43%)
Non-prescribed medications58(39%)18(39%)37(38%)3(43%)

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Table 2. Use of alternative and complementary medicines in IBD.

Current or Previous UseUse for IBD SymptomsImprovement in IBD-related Symptoms
Probiotics34(23%)17(50%)13(38%)
Cannabis17(11%)14(82%)12(71%)
Aloe Vera18(12%)13(7%)4(22%)
Fish Oil34(23%)9(26%)7(21%)
Acupuncture13(9%)9(69%)5(38%)
Turmeric17(11%)6(35%)5(29%)
Hypnosis3(2%)3(100%)0(0%)
Aromatherapy8(5%)2(25%)2(25%)

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Conclusion

These results support previous studies which have shown that the use of complementary and alternative medicine is prevalent among IBD patients. Further studies are crucial to determine their role in IBD.