• Aucun résultat trouvé

Complementary and alternative medicine in inflammatory bowel disease


Academic year: 2021

Partager "Complementary and alternative medicine in inflammatory bowel disease"

En savoir plus ( Page)

Texte intégral


Invited Commentary

A. Buisson*,†,‡& L. Peyrin-Biroulet‡ *Department of Hepato-Gastroenterology, University Hospital Estaing of Clermont-Ferrand, Auvergne University, Clermont-Ferrand, France.

Microbes, intestine, inflammation

and susceptibility of the host, UMR Inserm/Université d’Auvergne U1071, USC-INRA 2018, Clermont Université Clermont-Ferrand, France.

Inserm U954 and Department of

Hepato-Gastroenterology, University Hospital of Nancy, Université Henri Poincaré 1, Vandoeuvre-lès-Nancy, France. E-mail: peyrinbiroulet@gmail.com doi:10.1111/j.1365-2036.2011.04991.x

Complementary and alternative medicine in inflammatory bowel disease

SIRS, We read with great interest the article by Weizman et al. on the use of

com-plementary and alternative medicine (CAM) and its impact on medication

adher-ence in inflammatory bowel disease (IBD).1

Over the past decade, the use of CAM has received increasing attention as reflected by the dramatic increase in the number of articles identified on

MED-LINE using the search terms “CAM” (Figure 1). A high rate (56%) of CAM use

was reported among IBD patients when compared to other chronic diseases such as cancers (40%), rheumatoid arthritis (38%), asthma (40%) and chronic renal

failure (25.2%).2–5 However, such discrepancy between these chronic conditions

may be partly explained by the fact that CAM defines a heterogeneous group of

medical practice. Accordingly, the European Crohn’s and Colitis Organisation (ECCO) recommended distinguishing complementary medicine (massage, relaxa-tion, meditation etc.…) from alternative medicine (Chinese medicine, herbal

products, probiotics etc.…).6

Even though CAM seems to have no impact on adherence to conventional therapy, limiting the use of costly and potentially life-threatening drugs should be a priority for all clinicians. Contrary to popular belief, natural therapies are not necessarily safe. Fatal hepatic and irreversible renal failure have occurred with

some preparations that may also interact with conventional medications.7

Fur-thermore, scientific evidence is usually missing regarding the efficacy of CAM,

even though herbal medicine appears promising in IBD.8

In this regard, the lack of information on safety and efficacy of CAM is a

major limitation to the study by Weizman et al.1 Rigorous randomised controlled

trials together with large prospective observational studies are needed to formally assess the benefit-risk ratio of CAM in IBD. Pending the results of these studies, the popularity of CAM among IBD patients challenges the physicians who should enhance their awareness and knowledge about this common practice to better advice their patients, especially the young women who were at increased risk of

using CAM referred to in the study by Weizman et al.1

AP&T invited commentary and correspondence columns are restricted to letters discussing papers that have been

pub-lished in the journal. A letter must have a maximum of 300 words, may contain one table or figure, and should have

no more than 10 references. It should be submitted electronically to the Editors via http://mc.manuscriptcentral.com/apt.

ª 2012 Blackwell Publishing Ltd 619



Declaration of personal interests: L. Peyrin-Biroulet has served as a speaker, a consultant and an advisory board member for Abbott and Merck. Declaration of funding interests: None.


1. Weizman AV, Ahn E, Thanabalan R, Leung W, Croitoru K, Silverberg MS, et al. Characterisation of complementary and alternative medicine use and its impact on medication adherence in inflammatory bowel disease. Aliment Pharmacol Ther 2012;35: 342–9.

2. Horneber M, Bueschel G, Dennert G, Less D, Ritter E, Zwahlen M. How many cancer patients use complementary and alternative medicine: a systematic review and meta-analysis. Integr Cancer Ther 2011; doi: 10.1177/1534735411423920 [in press]. 3. Knoeller GE, Mazurek JM, Moorman JE.

Complementary and alternative medicine use among adults with work-related and non-work-related asthma. J Asthma 2011; doi:10.3109/02770903.2011.637597 [in press].

4. Ernst E, Posadzki P. Complementary and alternative medicine for rheumatoid arthritis and osteoarthritis: an overview of systematic reviews. Curr Pain Headache Rep 2011;15: 431–7.

5. Nowack R, Birck R. Complementary and alternative medicine is popular among chronic renal failure patients – renal

teams must increase their competence to advise patients with respect to efficacy and safety. Evid Based Nurs 2012; 15: 29–30.

6. Van Assche G, Dignass A, Reinisch W, van der Woude CJ, Sturm A, De Vos M, et al. The second European evidence-based consensus on the diagnosis and

management of Crohn’s disease: special situations. J Crohns Colitis 2010;4: 63– 101.

7. Langmead L, Rampton DS. Review article: complementary and alternative therapies for inflammatory bowel disease. Aliment Pharmacol Ther 2006;23: 341–9. 8. Fukunaga K, Hida N, Ohda Y, Takeda N,

Iimuro M, Yoshida K, et al. A prospective randomised double blind placebo controlled trial to assess the efficacy of a Chinese herbal medicine“Xilei San” as remission induction and maintenance therapy in patients with refractory ulcerative proctitis. Gastroenterology 2011; 140: S261. 349 1827 4703 0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000

Before 2002 Before 2007 Before 2012

Number of articles published on


Figure 1 | Number of articles related to complementary and alternative medicine published on MEDLINE before 2002, before 2007, and until the end of 2011.

620 Aliment Pharmacol Ther 2012; 35: 619-620 ª 2012 Blackwell Publishing Ltd


Figure 1 | Number of articles related to complementary and alternative medicine published on MEDLINE before 2002, before 2007, and until the end of 2011.


Documents relatifs

En revanche, la propension des femmes à demander à être à temps partiel apparaît moins liée au caractère sexué de leur métier qu’à leur groupe socioprofessionnel (modèle [c])

In all cell lines tested, there was high endogenous production of VEGF, and ginger treatment resulted in inhibition of VEGF secre- Low concentrations of ginger have minimal effect

retrieved values resulting from InSb and MCT ranges, we recommend the use of the MCT microwindow for CH retrievals : the single CH 4 4 line selected in the MCT range indeed

Same patient: Recidivism of the colic adenocarcinoma with signet ring cell in the transverse colon: intense tumor infiltration of the mucosa and. submucosa corresponding of

VOCs detected through breath and faecal analysis hence serve as attractive, non-invasive biomarkers for diagnosing and monitoring irritable bowel syndrome (IBS) and inflammatory

Trace element partitioning between wollastonite and alkaline silicate magmas.. Céline Baudouin,

Type I training programmes cover the basic theories of traditional Chinese and allopathic medicine, as well as the knowledge and skills required for the

Upon completion of this subject, students are expected to be able to: describe at least 250 commonly used plants in Ayurveda (see Annex 3); and apply these herbs according

The World Health Organization (WHO) greatly appreciates the financial and technical support provided by the Regional Government of Lombardy, Italy, for the development and

Nuad Thai component The Nuad Thai component of a typical Type I Nuad Thai programme includes: • history, body of knowledge and application of Nuad Thai; • health benefits, values

One essential component of osteopathic health care is osteopathic manual therapy, typically called osteopathic manipulative treatment (OMT), which refers to an array

Upon completion of this subject, students are expected to be able to describe 350 commonly used Chinese Materia Medica, properly apply them according to TCM theory, particularly as

Professor Umberto Solimene, Director, WHO Collaborating Centre for Traditional Medicine, Centre of Research in Medical Bioclimatology, Biotechnologies and

ABSTRACT A cross-sectional study of knowledge, attitudes and practice of general practitioners (GPs) towards complementary and alternative medicine (CAM) was conducted in Doha,

Although there is a registry of traditional health practitioners, there are no official legislative or regulatory texts governing the practice of traditional medicine, no

Women aged 40–60 years (n = 814) were recruited at primary care centres in Qatar and completed a specially designed, pre-tested questionnaire. Overall, 38.2% of midlife women in

Ginseng Inconsistent; evidence found in 2 of 4 RCTs (level IIb) 26-29 No trials evaluate treatment Garlic (allicin) Evidence found in 1 RCT (level IIb) 30 No trials evaluate

Irritable bowel syndrome results in various functional gastrointestinal symptoms such as recurrent abdominal pain, changes in bowel habits, diarrhea or

Hypnotherapy  and  CBT  are  also  logical  therapeutic  choices,  and  enough  evidence  exists  to  consider  their  use  in  appropriate  patients. 

The high use of herbal therapies is related to Chinese  respondents’ beliefs about the therapies. We found that  66%  of  Chinese  respondents  believed  that 

is Project Manager in the Department of Community Health Sciences, and Dr Jones is a Professor and Associate Dean of Undergraduate Medical Education, all in the Faculty of

intestinal biopsies of microbiomes of CD and UC patients; these are associated with frequent relapses and poor responses to treatment with anti-TNF-α therapeutic antibodies. Changes

- La réutilisation non commerciale de ces contenus est libre et gratuite dans le respect de la législation en vigueur et notamment du maintien de la mention de source.. -