Patterns of complementary and alternative medicine (CAM) use in patients with inflammatory bowel disease: perceived stress is a potential indicator for CAM use.

INTRODUCTION: The reasons for using complementary and alternative medicine (CAM) and the perception of stress in a group of patients with inflammatory bowel disease (IBD) who are actively interested in CAM were compared with those of a randomly selected group of IBD patients (controls). METHODS: Participants in a national lay workshop on CAM of the German Crohn's and Ulcerative Colitis Association (DCCV) (the study group) and a representative sample of the approximately 16,000 members and associates of the DCCV (the control group) were asked to complete a self-administered questionnaire that covered socio-demographic data, past medical history, stress perception, current conventional treatment, and interest in, and usage of, CAM. RESULTS: One-hundred and twelve (80%) of the approximately 140 participants of the lay workshop and 684 (68.8%) of the 994 IBD patients in the control group completed and returned the questionnaires. The duration of illness, taken as the time since diagnosis, was shorter for the participants of the lay workshop than for the control group (p=0.0035), and fewer workshop patients stated that their disease was currently "in remission" (p=0.0377). The two groups did not differ significantly in their experiences with CAM use. Among personal reasons given for CAM use, the "lack of success of conventional therapy" (p=0.014), the wish "to take a holistic therapeutic approach" (p=0.0008), and "a different point of view from that of my physician about the cause of, and treatment options for, IBD" (p=0.038) were chosen more often in the group of workshop participants than in the control patients. A total of 92% of the workshop patients perceived stress as having a negative effect on their IBD; this is a significantly greater percentage than in the control group (70.5%; p=0.0001). CONCLUSIONS: A group of IBD patients with an active interest in CAM showed distinct differences from a randomly selected group of IBD patients in their reasons for using CAM, particularly in their wish to take a holistic therapeutic approach. Patients who think that stress has a negative effect on their IBD appear to be more likely to use CAM.

Amount of systemic steroid medication is a strong predictor for the use of complementary and alternative medicine in patients with inflammatory bowel disease: results from a German national survey.

OBJECTIVES: Previous studies have suggested that inflammatory bowel disease (IBD) patients rank high among users of complementary and alternative medicine (CAM). To further elucidate this phenomenon, we sent questionnaires to a large sample of IBD patients in Germany to determine the patterns and predictors of their CAM use. METHODS: Pretested 73-item questionnaires were mailed to a randomly selected representative sample of 1000 IBD patients from the approximately 16,000 members and associates of the German Crohn's and Colitis Association. Predictors of CAM use were evaluated by logistic regression models. RESULTS: Completed questionnaires were returned by 684 patients (female patients, 61.4%; Crohn's disease patients, 58.3%; ulcerative colitis patients, 38.2%). Of the 671 adult respondents, 344 (51.3%) had experience with CAM, and significantly more of the ulcerative colitis patients (59.8%) than the Crohn's disease patients (48.3%) had experience with CAM. There was no difference by gender. Homeopathy (52.9%) and herbal medicine (43.6%) were the most commonly used types of CAM. The most frequent personal reasons for CAM use were the search for an "optimum treatment" (78.9%) and the wish to stop taking steroids (63.8%). Using logistic regression, we found that total cortisone intake (P = 0.0077), but not duration of disease, was a strong predictor of CAM use. Other predictors were experience with psychosomatic and psychotherapeutic support (P = 0.0029), relaxation techniques (P = 0.0284), an academic education (P = 0.0173), a diet utilizing whole grains (P = 0.0123), and a normal body weight (P = 0.0215). Although 80% of patients indicated that they were interested in using CAM in the future, only 24.7% felt sufficiently informed about it. CONCLUSIONS: More than 50% of a large group of German IBD patients had used CAM. Prolonged or intensive steroid treatment, an academic education, active ways of coping, and a health-conscious life-style are associated with CAM use. Given the potential side effects and interactions, the treating physician should focus on thorough information about the benefits and limitations of conventional and complementary treatment options, especially for IBD patients who have received prolonged or intensive steroid treatment.