Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases.

Researchers conducted a comprehensive review of complementary and alternative medicine (CAM) treatments for inflammatory bowel diseases (IBD), which include Crohn's disease and ulcerative colitis. These chronic conditions cause inflammation in the digestive tract, leading to pain, diarrhea, and other uncomfortable symptoms. The study examined various alternative therapies including herbal medicines, mind-body interventions like meditation and hypnotherapy, and acupuncture.

The researchers analyzed 26 randomized controlled trials and 3 controlled trials testing herbal remedies such as aloe vera, cannabis, curcumin, and wormwood. They also reviewed 7 studies on mind-body therapies and 2 studies specifically on acupuncture. The quality of these studies varied considerably, with some being more rigorous than others.

The findings showed promising evidence for several treatments. For acupuncture specifically, the review found positive results for both ulcerative colitis and Crohn's disease, suggesting it may help reduce symptoms and inflammation. Certain herbal therapies also showed benefits, particularly curcumin and plantago ovata for maintaining remission in ulcerative colitis, and wormwood for Crohn's disease. Mind-body interventions demonstrated effectiveness for ulcerative colitis patients.

What this means for patients: If you're living with IBD and considering acupuncture or other complementary therapies, this research suggests these approaches may offer real benefits alongside conventional treatment. However, the authors emphasize that more high-quality research is needed before definitive recommendations can be made. These therapies should complement, not replace, standard medical care. If considering acupuncture for IBD, seek a licensed acupuncturist with experience treating digestive conditions.

This systematic review evaluated CAM interventions for IBD through March 2014, searching Cochrane Library, PubMed/Medline, PsychINFO, and Scopus databases. Researchers assessed 26 RCTs and 3 CTs for herbal medicine, 7 RCTs for mind-body interventions, and 2 RCTs for acupuncture using the Cochrane risk of bias tool. Methodological quality was heterogeneous across studies.

Key findings identified best evidence for: plantago ovata and curcumin in UC maintenance therapy; wormwood in CD; mind-body therapy and self-intervention in UC; and acupuncture for both UC and CD. The acupuncture trials, though limited in number (n=2), demonstrated therapeutic potential for symptom management and inflammatory markers in both IBD subtypes.

Clinical takeaway: While evidence suggests acupuncture and select CAM modalities may provide adjunctive benefit for IBD patients, the limited number of trials and variable methodological rigor necessitate cautious interpretation. Practitioners should consider these modalities as complementary to conventional IBD management while advocating for more rigorous, adequately-powered clinical trials to establish definitive treatment protocols and mechanisms of action.