Patterns of complementary and alternative medicine use in pediatric patients with inflammatory bowel disease

Objectives: Inflammatory bowel disease (IBD) constitutes a challenging and long-lasting burden for pediatric patients. The management of IBD is multifaceted involving conventional medication but also dietary measures. An increasing number of patients are turning to complementary and alternative medicine (CAM) in their quest to alleviate IBD-related symptoms and improve their overall well-being. We therefore investigated the patterns of CAM use and associated patients' and disease characteristics to identify indicators of CAM use in pediatric IBD patients in Switzerland. Methods: Pediatric and adolescent patients enrolled in the Swiss IBD Cohort Study, a nationwide prospective cohort study, completed a questionnaire about CAM and supplementation use as well as dietary restrictions. Associations of CAM use with disease characteristics including conventional medication and patient-recorded outcomes were analyzed. Results: A total of 111 pediatric IBD patients (59 Crohn's disease, 41 ulcerative colitis, 11 IBD unclassified) answered the questionnaire. Sixty-five percent (72/111) of patients used at least one CAM since diagnosis, 73% (81/110) took vitamins and micronutrient supplements and 53% (59/111) followed dietary restrictions. The latter was in 68% self-imposed and significantly associated with CAM use in multivariable models (odds ratio [OR]: 4.48; 95% confidence interval [CI]: 1.84-10.92). CAM use was not associated with IBD subtype, need for biologicals or extraintestinal manifestations. Health-related quality of life (HRQOL) and disease activity did not differ between CAM and no-CAM users. Conclusion: CAM use as well as self-imposed dietary restrictions are frequent in IBD patients, whereby both are closely interrelated. While CAM users do not have higher HRQOL compared to no-CAM users, they subjectively report an improvement in health associated with CAM use.