Complementary therapies in inflammatory bowel diseases

Complementary and alternative therapies (CAM) are defined as therapies that are presently not considered part of conventional medical practice. They are termed "complementary" when used in addition to conventional therapies and termed "alternative" when used instead of conventional therapies. CAM includes many different practices, for example Ayurveda, acupuncture or traditional Chinese medicine (TCM), phytotherapy, homeopathy, probiotics and dietary supplements. While some evidence of benefit exists regarding some therapies, for most of these therapeutic approaches, the therapeutic efficacy and safety have not been proven in well-designed scientific studies. However, the use of complementary and alternative medicine among IBD patients is common, and physicians are frequently confronted with questions about their use. As most of the reported studies contain methodological problems, it is often difficult for physicians to inform their patients adequately. Nevertheless, the widespread use of CAM needs to be recognized. Some of these agents exert plausible biological effects in IBD patients and warrant further investigation. Controlled trials in IBD are warranted to show therapeutic benefits and safety of CAM. This review aims to give a brief overview on the current use of various complementary and alternative treatment options in IBD patients.