Complementary Medicine

Many IBD patients try complementary medicine to help manage their symptoms, in addition to their prescribed medication. We can help by breaking down the most common types of complementary medicines so that you and your healthcare team can discuss what options work best for you.

It’s important to discuss complementary medicine with your healthcare provider before starting treatments. Complementary medicine may be used in tandem with your prescribed medications, but are not advised to take the place of your doctor-recommended treatment plan.

What is Complementary Medicine?

Complementary medicine is an umbrella term that includes a vast array of treatment options, that are not considered conventional medicine.

Although more research is needed on complementary medicine in IBD, some studies have shown that complementary medicine may help to control symptoms and ease pain, contribute to a better quality of life, and  improve your mood and general attitude toward your health and well-being. Some therapies even have the potential to boost your immune system. Complementary medicine however, will not cure your disease.

Common complementary medicine therapies for IBD include:

  • Mind-Body Therapies

  • Chinese Medicine & Therapeutic Practices

  • Vitamins and Dietary Supplements

  • Probiotics and Microorganisms

  • Medical cannabis

It is important to weigh the risks and benefits of any treatment plan, including complementary medicine. There is generally less research on the safety and effectiveness of complementary medicine as compared with traditional medicine, though we are seeing an increasing number of scientific trials.

Choosing a Provider for Complementary Medicine

Most types of practices using complementary medicine have specific education requirements. It is important to be careful and thoughtful in choosing a provider.

When looking for a practitioner:

  • Research the requirements of the specific types of complementary medicines, including what education and accreditation is needed to practice a particular type of therapy

  • Look up and verify the provider’s license and check with your state’s regulatory board or agency

  • Get recommendations from your healthcare providers and look up reviews online

Mind-Body Medicine

Mind-body medicine focuses on the connection between your body, your emotional and mental well-being, and the social, spiritual, and behavioral factors that influence your health.

These connections are so important that some treatments once considered complementary medicine, including cognitive behavioral therapy and patient support groups, are now offered as conventional therapy.

Mind-body medicine also includes:

  • Prayer

  • Exercise

  • Hypnosis

  • Meditation

  • Relaxation/Mindfulness

  • Yoga

Chinese Medicine and Therapeutic Practices

Chinese herbs and acupuncture, the practice of  inserting small needles into specific points along the skin, may provide therapeutic benefits in IBD patients.

Chinese herbs can include:

  • Andrographis paniculata

  • Indigo naturalis

Vitamins and Dietary Supplements

There are many natural supplements that you may consider to  strengthen, heal, and balance your body.

Supplements can include:

Dietary supplements are often recommended for people with Crohn’s disease or ulcerative colitis, especially if you are at risk for vitamin and mineral deficiencies. These products can be marketed without approval from the U.S. Food and Drug Administration (FDA), unless they are made using a new dietary ingredient. That means manufacturers’ claims about effectiveness are largely unproven. The FDA does regulate dietary supplements to prevent adulterated or misbranded products. Claims on the label that the product is safe and effective may not be entirely accurate.

The regulation of dietary supplements is much more lax compared to prescription medication, which is subject to rigorous testing. The FDA requires proof that prescriptions are both safe and effective for the condition they are intended to treat before it will give approval.

Patients with Crohn’s disease or ulcerative colitis should not stop taking their prescribed medication even if they are using supplements.

Vitamins

People with IBD may develop vitamin or mineral deficiencies that require supplementation to stay nutritionally healthy. Deficiencies can be caused by certain medication and surgeries, or several other aspects of IBD, including Crohn’s disease that affects your small intestine.

Vitamins can include:

  • Vitamin B12

  • Folic acid

  • Vitamin D

  • Calcium

  • Iron

Fish Oil

Omega-3 fatty acids, often found in fish, are known to have anti-inflammatory properties and several other health benefits. Some people use omega-3 fatty acids to help relieve intestinal inflammation from Crohn’s disease and ulcerative colitis, though research has shown conflicting results regarding the effectiveness for maintenance or remission of Crohn’s disease.

Sources of omega-3 fatty acids include:

  • Fatty fish, such as salmon, mackerel, and herring

  • Sardines

  • Nuts

  • Some green vegetables

Probiotics and Microorganisms

There are differences in the intestinal microbiota in patients with IBD, compared to those without IBD. Those with IBD have less microbial diversity and a loss of beneficial and anti-inflammatory bacteria.

Probiotics are defined by the World Health Organization as “live microorganisms, which when consumed in adequate amounts confer health and benefit to the host.” Your gut is home to several different types of perfectly normal bacteria. The good bacteria is beneficial because it keeps the harmful bacteria in check. If the balance between the two is thrown off, harmful bacteria may overgrow, causing diarrhea and other digestive problems.

Probiotics are generally safe and any side effects, such a gas or bloating, are usually mild. Talk to your doctor about before starting probiotics, especially in patients that are young children, older, or those with compromised immune systems.

Sources of probiotics include:

  • Dietary supplements, including capsules, tablets, and powders

  • Yogurt

  • Fermented and unfermented milk

  • Miso

  • Tempeh

  • Certain juices and soy beverages

Medical Cannabis

There is debate in the medical community about using medical marijuana as a complementary medicine for inflammatory bowel disease since there has been no direct scientific evidence that marijuana decreases intestinal inflammation.

Small research studies have found that a significant proportion of patients with IBD have reported smoking marijuana to relieve their IBD symptoms, particularly patients who have had abdominal surgery, suffer from chronic abdominal pain, and/or report having a low quality of life. Studies also show improvement of quality of life symptoms associated with IBD, including reduced pain, decreased nausea, and improvement in appetite and sleep.

Endocannabinoids, or molecules in your body that closely resemble cannabis compounds, may play a role in limiting intestinal inflammation that decreasing the intestinal motility that can lead to diarrhea. But there is conflicting evidence about changes to the expression of endocannabinoid receptors in patients with IBD.

There are also concerns that medical cannabis could cause an increased risk of cognitive, neuromuscular and respiratory side effects.

Read our position statement for more information about medical cannabis and IBD.

Video Length 00:18:12

Medical Cannabis in IBD- Part 1 Dr. Arun Swaminath provides an overview of medical cannabis, including research study findings, and policies around use in inflammatory bowel disease.

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Considerations for Medical Cannabis Use

  • Patients and providers need to be aware of your state laws pertaining to the prescription and use of medical cannabis.

  • Medical cannabis and marijuana are still considered controlled substances by the Drug Enforcement Administration (DEA).

  • Patients should be aware of and understand their employer’s drug and drug testing policies prior to obtaining and using medical cannabis.

Video Length 00:10:50

Practical Considerations of Medical Cannabis in IBD Part two of this webinar reviews practical considerations of medical cannabis in IBD, including travel, school, work, and important considerations on use, and special populations.

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Read more about the role of cannabis in the management of inflammatory bowel disease. 

 

Talking to Your Doctor About Complementary Medicine

Even the most innocent-looking supplement might contain ingredients that could interact with your medication. It’s important to talk to your healthcare team about any complementary medicines you are considering or already using.

While unconventional therapies and products may help control symptoms, ease pain, and increase your quality of life, there are still many questions about their safety and effectiveness.

Questions to Ask Your Doctor

  • Are there complementary therapies you would recommend?

  • Have these methods been studied and, if so, where can I find relevant research?

  • What benefits can I expect from this therapy?

  • How will I know if the therapy is working or not?

  • Is there a risk this will interfere with my standard IBD treatments?

  • Are there potential side effects? What should I look out for?

  • Do you offer complementary medicine as part of your practice? If not, can you refer me to a licensed practitioner in the area?

  • Are there specific therapies you would advise against?

 

Fact sheet

Complementary and Alternative Medicine (CAM)...

Complementary and Alternative Medicine (CAM)