1. Chronic pelvic pain.

Herbert B.

http://www.ncbi.nlm.nih.gov/pubmed/20085175

 

 

Source

Jefferson-Myrna Brind Center for Integrative Medicine, Integrative Pain Program, USA.

Abstract

Though there are myriad etiologies of CPP, common therapeutic targets include inflammation, somatic dysfunction, and psychological disturbances. Inflammation may be addressed not only with dietary changes including nutritional and botanical supplements but also with mind-body therapies. Somatic dysfunction may respond to manipulative therapies provided by osteopaths, naturopaths, chiropractors, and some physical therapists. Therapists may also offer visceral, craniosacral, myofascial, and other whole-body therapies, as can highly trained massage therapists and bodyworkers. Mental health care may be key in many cases. Integrative medicine heralds the return to a sense of the human being's intrinsic capacity for healing, incorporating the vitalism of many of the therapies' origins (traditional Chinese medicine, indigenous medicine, ayurveda, osteopathy, chiropractic, etc) with the gains made by a more reductionistic tradition. Given the complexity and wide variation of etiologies and symptoms of CPP, using an integrative approach may offer expanded therapeutic solutions. We must expand our capacity to listen to each patient-with ears, eyes, mind, heart, and hands. Each treatment plan may then be tailored to the unique history and perspective that lie within the individual. Doing so requires the essential elements of time, skill, and love.

Comment in

PMID: 20085175

[PubMed - indexed for MEDLINE]

 

2. Complementary and alternative medicine for treatment of irritable bowel syndrome.

Shen YH, Nahas R.        

http://www.ncbi.nlm.nih.gov/pubmed/19221071

 

Source

Department of Family and Community Medicine at University of Ottawa in Ontario.

Abstract

OBJECTIVE:

To review the evidence supporting selected complementary and alternative medicine approaches used in the treatment of irritable bowel syndrome (IBS).

QUALITY OF EVIDENCE:

MEDLINE (from January 1966), EMBASE (from January 1980), and the Cochrane Database of Systematic Reviews were searched until March 2008, combining the terms irritable bowel syndrome or irritable colon with complementary therapies, alternative medicine, acupuncture, fiber, peppermint oil, herbal, traditional, yoga, massage, meditation, mind, relaxation, probiotic, hypnotherapy, psychotherapy, cognitive therapy, or behavior therapy. Results were screened to include only clinical trials, systematic reviews, and meta-analyses. Level I evidence was available for most interventions.

MAIN MESSAGE:

Soluble fibre improves constipation and global IBS symptoms. Peppermint oil alleviates IBS symptoms, including abdominal pain. Probiotic trials show overall benefit for IBS but there is little evidence supporting the use of any specific strain. Hypnotherapy and cognitive-behavioural therapy are also effective therapeutic options for appropriate patients. Certain herbal formulas are supported by limited evidence, but safety is a potential concern. All interventions are supported by systematic reviews or meta-analyses.

CONCLUSION:

Several complementary and alternative therapies can be recommended as part of an evidence-based approach to the treatment of IBS; these might provide patients with satisfactory relief and improve the therapeutic alliance.

Comment in

PMID: 19221071

[PubMed - indexed for MEDLINE]

PMCID: PMC2642499

Free PMC Article

 

3. Complementary and alternative medicine use and cost in functional bowel disorders: a six month prospective study in a large HMO.

van Tilburg MA, Palsson OS, Levy RL, Feld AD, Turner MJ, Drossman DA, Whitehead WE.

http://www.ncbi.nlm.nih.gov/pubmed/18652682

 

Source

Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina, Chapel Hill, North Carolina, USA. tilburg@med.unc.edu

Abstract

BACKGROUND:

Functional Bowel Disorders (FBD) are chronic disorders that are difficult to treat and manage. Many patients and doctors are dissatisfied with the level of improvement in symptoms that can be achieved with standard medical care which may lead them to seek alternatives for care. There are currently no data on the types of Complementary and Alternative Medicine (CAM) used for FBDs other than Irritable Bowel Syndrome (IBS), or on the economic costs of CAM treatments. The aim of this study is to determine prevalence, types and costs of CAM in IBS, functional diarrhea, functional constipation, and functional abdominal pain.

METHODS:

1012 Patients with FBD were recruited through a health care maintenance organization and followed for 6 months. Questionnaires were used to ascertain: Utilization and expenditures on CAM, symptom severity (IBS-SS), quality of life (IBS-QoL), psychological distress (BSI) and perceived treatment effectiveness. Costs for conventional medical care were extracted from administrative claims.

RESULTS:

CAM was used by 35% of patients, at a median yearly cost of $200. The most common CAM types were ginger, massage therapy and yoga. CAM use was associated with female gender, higher education, and anxiety. Satisfaction with physician care and perceived effectiveness of prescription medication were not associated with CAM use. Physician referral to a CAM provider was uncommon but the majority of patients receiving this recommendation followed their physician's advice.

CONCLUSION:

CAM is used by one-third of FBD patients. CAM use does not seem to be driven by dissatisfaction with conventional care. Physicians should discuss CAM use and effectiveness with their patients and refer patients if appropriate.

PMID: 18652682

[PubMed - indexed for MEDLINE]

PMCID: PMC2499988

Free PMC Articl

 

4. Integrative approaches to childhood constipation and encopresis.

Culbert TP, Banez GA.

http://www.ncbi.nlm.nih.gov/pubmed/18061784

 

Source

Integrative Medicine Program, Children's Hospitals and Clinics of Minnesota, 2525 Chicago Avenue South, Minneapolis, MN 55404, USA. timothy.culbert@childrensmn.org

Abstract

Constipation and encopresis (fecal soiling) are common childhood disorders that may lead to significant functional impairment. The etiology and course of constipation and encopresis are increasingly conceptualized from a broad biopsychosocial perspective, and therefore a holistic approach to assessment and treatment is indicated. Many children experience symptoms of chronic constipation and/or encopresis that are only partially responsive to conventional medical therapy. Complementary/alternative therapies can often help in the treatment of constipation/encopresis and are well accepted by patients and families.

PMID: 18061784

[PubMed - indexed for MEDLINE]

 

5. Methods used to eliminate colic in infants in the eastern parts of Turkey.

Ciftçi EK, Arikan D.

http://www.ncbi.nlm.nih.gov/pubmed/17973727

 

Source

Department of Child Health Nursing, Atatürk University Erzurum Health School, Erzurum, Turkey.

Abstract

OBJECTIVE:

Infant colic is a common problem characterized by excessive crying and fussing. There is not a consistent treatment method used to eliminate colic. Mothers make use of various models together to eliminate colic in their infants. This study was carried out to delineate the methods used by mothers to eliminate colic in their infants and to determine the efficacy of the various methods.

DESIGN:

Descriptive study.

METHODS:

The study was performed by visiting the homes of 186 babies (1-3 months of age) whose mothers had previously registered at a health center in Eastern Turkey between January 1 and February 28, 2005. Questionnaires and Wessel's criteria were used to obtain the data. The methods used by mothers to eliminate colic were classified as behavioral, natural, and drug treatments and were examined accordingly.

RESULTS:

According to mothers' statements, 75.8% of the babies had colic, while according to the Wessel criteria, 51.1% had colic symptoms. One hundred percent of the mothers used behavioral treatments, 66% used drug therapies, and 64.5% used natural treatment methods to eliminate colic.

CONCLUSIONS:

Mothers indicated that they achieved the most benefit from behavioral interventions, followed by natural therapies, and the least from drug treatments.

PMID: 17973727

[PubMed - indexed for MEDLINE]

 

6. Predictors of alternative and complementary medicine use in inflammatory bowel disease: do measures of conventional health care utilization relate to use?

Burgmann T, Rawsthorne P, Bernstein CN.

http://www.ncbi.nlm.nih.gov/pubmed/15128356

 

Source

Department of Internal Medicine, and University of Manitoba Inflammatory Bowel Disease Clinical and Research Center, Winnipeg, Manitoba, Canada.

Abstract

OBJECTIVE:

Alternative and complementary therapies (ACM) have gained increasing attention in the past few years. It was our purpose to determine whether increased ACM use is associated with increased use of conventional health care resources. Additionally, demographics of use, subjective benefit, and cost were analyzed.

METHODS:

We enrolled 150 inflammatory bowel disease (IBD) patients from a tertiary care center and performed a phone survey of their ACM use in the past year. A population-based administrative database was accessed to extract data regarding use of conventional medicine (hospitalizations, doctor visits, and GI specific doctor visits). Patients were divided into three groups: (i) no ACM (n = 60) (ii) users of exercise, diet, and prayer (EDP) exclusively (n = 47) (iii) other ACM use (n = 43) which included those who may have used EDP as well as any of acupuncture, chiropractic, homeopathy, naturopathy, herbology, massage, relaxation, reflexology, hypnotherapy, aromatherapy, meditation, or support group.

RESULTS:

ACM was used by 60% (EDP 31%, other ACM 29%). There were no significant differences in use between the three groups by disease diagnosis, education level, employment status, use of IBD medications, number of hospitalizations, doctor visits, or GI specific doctor visits. The EDP group was more likely to be married (p = 0.006) and female (p = 0.04) compared to no ACM. The EDP group tended to be older than the no ACM (p = 0.001) and other ACM (p = 0.01). The other ACM had shorter disease duration than EDP (p = 0.04) and no ACM (p = 0.04). The most commonly used therapies were diet (45%), herbal (17%), exercise (15%), prayer (11%), and relaxation (10%). ACM was sought for pain/cramps (64%), diarrhea (60%), and gas/bloating (21%). Seventy-three percent of EDP interventions incurred no cost compared to 33% with other ACM (p < 0.0001). The median annual amount spent on other ACM was $56 (range $0-$4800). Subjectively, patients felt helped by trials of EDP 95% of the time whereas other ACM helped 67% of the time (p < 0.0001).

CONCLUSIONS:

ACM use could not be predicted by either greater or less hospitalizations, conventional doctor visits, or GI specific visits. ACM was sought mostly to palliate pain or diarrhea. Those using EDP are more likely to be older married women. Subjectively other ACM is of less benefit (67%) than EDP (95%). If doctor visits or hospitalizations represent degree of increased disease activity then this too is not predictive of using ACM.

PMID: 15128356

[PubMed - indexed for MEDLINE]