Use of complementary medicine in pediatric patients with inflammatory bowel disease: results from a multicenter survey

Abstract

Objectives: We examined the use of complementary and alternative medicine (CAM) at 3 US pediatric medical centers, comparing a group of children with inflammatory bowel disease (IBD) with children presenting with chronic constipation.

Materials and methods: Surveys were administered by postal mail and at pediatric IBD centers in San Francisco, Houston, and Atlanta from 2001 to 2003. A comparison group consisting of pediatric patients with chronic constipation also was surveyed. Data were analyzed by t tests and by exact tests of contingency tables.

Results: In all, 236 surveys were collected from the IBD group; 126 surveys were collected from the chronic constipation comparison group. CAM therapies were used by 50% in the IBD group and 23% in the chronic constipation group. The overall regional breakdown of CAM use in IBD revealed no differences, although the types of CAM therapy used varied by site. The most commonly used CAM therapies in the IBD group were spiritual interventions (25%) and nutritional supplements (25%). Positive predictors for CAM use in IBD include the patient's self-reported overall health, an increase in the number of side effects associated with allopathic medications, white ethnicity, and parental education beyond high school.

Conclusions: This is the first US study to characterize CAM use in pediatric patients with IBD with another chronic gastrointestinal disorder. CAM use was twice as common with the IBD group compared with the chronic constipation group. Regional variations exist with the types of CAM therapy used. Practitioners should know that half of their pediatric patients with IBD may be using CAM in conjunction with or as an alternative to other treatments and that certain predictors can help identify those using CAM therapies.

FIG. 1

Specific complementary and alternative medicine therapies were categorized as spiritual interventions, nutritional supplements, herbal remedies, and alternative practices, and the mean percentage of use in inflammatory bowel disease subjects is shown for each category at each of the 3 sites.

FIG. 2

Treatment choices were determined for both the inflammatory bowel disease (IBD) and constipation groups and reported as mean percentages, categorized as prescription (RX) only, complementary and alternative medicine (CAM) only, both RX and CAM, or neither RX nor CAM.