Source:Heuschkel R, Afzal N, Wuerth A, et al. Complementary medicine use in children and young adults with inflammatory bowel disease.
Am J Gastroenterol.
2002
;
97
:
382
–388.

The authors from the United States and the United Kingdom reviewed complementary and alternative medicine (CAM) use in children and young adults (208 patients; median age 15 years; range 3.8 to 23) with a diagnosis of Crohn’s Disease (57%), ulcerative colitis (35%) or unstated or indeterminate colitis (8%). They evaluated prevalence and predictors of usage of CAM in patients with inflammatory bowel disease (IBD). Patients who modified their diets and/or consumed standard “One-a-Day” multivitamins were excluded from being considered “CAM” users. Only those patients using CAM therapy by historical questionnaires in the preceding 12 months were included as positives for statistical purposes.

CAM usage was 41% overall, excluding diet and multivitamin use. The prevalence of CAM use was similar in the United States and the United Kingdom centers in the study. The most common CAM use was megavitamin therapy (19%). Dietary supplements (17%), herbal supplements (14%), and environmental changes (eg, allergen reduction, music and aroma therapy, bioresonance, exercise, and prayer) at 10% were the next most common. Only 24% of the respondents in this survey had admitted to their physicians that they were using CAM. Two factors of significant importance in predicting CAM in children with IBD were: 1) parental CAM use (odds ratio 1.9); and 2) number of side effects experienced (odds ratio 1.3).

This study is the first to demonstrate the prevalence of CAM use in pediatric patients with IBD. CAM use has been shown in adults to be increased with chronic illnesses, particularly when patients have chronic pain, when compared to the general population.1 The prospect of life-long chronic illness and frequent medication use appear to result in a prevalence of CAM use in pediatric patients with IBD almost twice that seen in adults with IBD.2 Some of the common reasons given by responders for CAM use in this study were: 1) “wanting to feel better”; 2) “hope for a cure”; 3) “prescribed medicines didn’t work as hoped”; and 4) “side effects of prescribed medications.” Although only 41% of patients admitted to CAM use in the preceding 12 months, 35% of patients also used specific dietary modifications (which were not included in the overall data). Furthermore, all of the remaining 59% of patients expressed interest in learning more information about CAM. While admittedly most of the CAM usage in this survey was neutral to patient health, usage of certain herbal products may have adverse effects on patient health.3 Furthermore, CAM usage may result in decreased overall intake of what is believed by the patient to be toxic or ineffective medical therapy. Clearly, we need to take a detailed history of CAM use in our patients, particularly those with chronic illnesses. In addition, unless we provide a sympathetic environment for patients to express their desire for CAM use we may miss the opportunity to educate...

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