Integrative medicine in gastrointestinal disease: evaluating the evidence

Abstract

Current Western therapies for many gastrointestinal diseases are suboptimal and potentially toxic. The majority of patients with digestive diseases are turning to complementary and alternative medicine for symptom relief and improved quality of life, due to dissatisfaction with conventional medical therapies. There is emerging evidence that many of these complementary and alternative medicine modalities are highly effective in modulating the immune system, disrupting the proinflammatory cascade and restoring digestive health while improving patients’ quality of life. We present evidence to support the potential utility of complementary and alternative medicine modalities for irritable bowel syndrome and inflammatory bowel disease. For each condition, we detail the proposed mechanisms of action and explore the current data for the prevention and/or treatment of disease.

Keywords::

• anti-inflammatory
• complementary and alternative medicine
• essential fatty acids
• immunomodulating
• inflammatory bowel disease
• integrative medicine
• irritable bowel syndrome
• polyphenols
• probiotics

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

The use of CAM in patients with inflammatory bowel disease has been well studied. The usage of CAM varies from 21 to 68%, but it is commonly accepted to be 50% in patients with inflammatory bowel disease [1–3].

CAM: Complementary and alternative medicine.

*Herbal preparations demonstrating efficacy in inflammatory bowel syndrome.

Probiotics have been shown to modulate the ability of Tregs to rebalance cytokines in the mucosal immune system. Tregs induce anti-inflammatory cytokines such as IL-10, to antagonize Th1 proinflammatory processes mediated by IFN-γ and IL-12 by stimulating Th2 function. Probiotics also downregulate the expression of NF-κB and stabilizing inhibitors of NF-κB (IkB), which results in a dampened inflammatory response.