According to the World Health Organisation, non-conventional therapies are those that apply their own therapies based on a specific diagnostic process and have a different philosophical basis to conventional medicine. The portuguese government recognises the following modalities: acupuncture, homeopathy, osteopathy, naturopathy, herbal medicine, chiropractic and traditional Chinese medicine (laws 45 of 2003 and 71 of 2013). The applicable laws require, among other things, that therapists have higher education in the area, a professional licence, provide correct and adequate information about the type of treatment, duration and the favourable and adverse effects that can be expected from it, and that they have civil liability insurance.
In recent decades, the search for complementary options to pharmacological therapy has increased, especially in chronic diseases. In the particular case of inflammatory bowel disease, it is estimated that between 30 and 60% of patients have already tried some kind of non-conventional therapy aiming to improve their general condition and reduce their symptoms. This interest in a more holistic approach stems from the desire to have more self-control over the disease, but probably also from the misconception that these therapies are safer than pharmacological and/or surgical treatment. It should be noted that some approaches can be associated with adverse effects and even have interactions with the drugs they are taking, making it essential for the patient to be open with the hospital team (nurses, doctors and nutritionists) so therapeutic decisions can be made safely and together.
Although unconventional therapies are widely used, studies of their effectiveness are scarce, heterogeneous and difficult to extrapolate to real life. To date, no clinical trial has shown that any unconventional therapy is systematically more effective than placebo. In other words, there is no scientific evidence to say that unconventional therapies reduce inflammation or help control the disease. However, these therapies can contribute to improve the quality of life of IBD patients by promoting physical, social and spiritual well-being, taking advantage of the mind-body connection.
Regarding phytotherapy, some authors have suggested that certain plants, such as aloe vera and turmeric, may help with the management of symptoms associated with mild-to-moderate forms of IBD. However, these conclusions derive from work carried out on animal models or clinical studies using laboratory-purified extracts, which are not always available on the market. With regard to food supplements, such as omega-3 and essential amino acids, there are no studies that clearly support the existence of a benefit from their use.
It's essential to remember that the studies that support the use of drugs in IBD are solid, reproducible and widely validated, and are at the basis of the protocols and recommendations that steer clinical management of IBD at a global level.
The decision to complement pharmacological treatment with a non-conventional therapy - but never as its substitute - should be discussed between the patient and the attending hospital team, but always with the caveat that many alternative therapies lack uniformity of procedures official regulation and control.
Authors
Young GEDII: Paula Sousa, Joana Roseira, Maria Manuela Estevinho, Sónia Bernardo
Ana Catarina Carvalho (Centro Hospitalar Tondela-Viseu),
Sofia Ventura (Centro Hospitalar Tondela-Viseu),
Francisco Pires (Centro Hospitalar Tondela-Viseu),
Cláudio Rodrigues (Centro Hospitalar Tondela-Viseu),
João Correia (Centro Hospitalar Vila Nova de Gaia/Espinho),
Edgar Afecto (Centro Hospitalar Vila Nova de Gaia/Espinho),
Juliana Serrazina (Hospital Santa Maria – Centro Hospitalar Universitário Lisboa Norte),
João António Cunha Neves (Centro Hospitalar Universitário do Algarve),
Viviana Alexandra Sequeira Martins (Centro Hospitalar Universitário do Algarve)
For more information, you can visit the Portuguese and European pacient associations' sites:
