N11 Complementary and alternative methods to improve quality of life in patients with inflammatory bowel diseases: a systematic literature review

Abstract

\n \n \n Inflammatory Bowel Diseases (IBD) shoved an increasing incidence in the last decade. They can occur at any age, but especially between 15 and 30. They have multifactorial aetiology, including genetic, intestinal bacterial, immunological and environmental causes. These diseases present invasive and often disabling symptoms. Typically, patients complained of abdominal pain, diarrhoea and rectal bleeding, and frequently they present complications such as malabsorption, malnutrition, water and electrolyte imbalances accompanied by nausea and vomiting, and intestinal obstruction or stricture. Moreover, the effects of IBD extend to the systemic level, with extraintestinal manifestations generally located at the musculoskeletal apparatus, skin or eyes, as well as psychiatric complications, including depression and anxiety. There is no definitive cure for IBD, and the severity of symptoms affect patients’ well-being, compromising their quality of life (QoL) which is, in fact, generally lower as compared to healthy population. This leads patients to search for self-care methods that allow them to achieve greater control and management of the disease, i.e., complementary and alternative methods (CAMs).\n \n \n \n The purpose of the paper is to investigate the efficacy of mind-body CAMs in improving the QoL of patients suffering from IBD. Therefore, we focused on CAMs’ impact on the psychological and physical spheres of the subjects, considering outcomes such as anxiety, depression, stress, gastrointestinal symptoms and QoL. A systematic literature review was performed consulting the online databases PubMed, Cinahl, Cochrane, and Google Scholar regarding interventional studies performed in the last twenty years.\n \n \n \n 312 papers were identified and 21 of them were selected according to inclusion criteria applied to title and abstract. 8 of them were then excluded after full-text assessment according to exclusion criteria. The interventions described in the 13 papers included fell within the dimension of mind-body techniques in the sphere of mindfulness and relaxation. A quantitative synthesis was not performed because, among the identified evidence, the treatment effect is never reported for more than two studies. Overall, time-correlated positive developments were recorded in all the outcomes considered in patients with a greater degree of psychological stressors at the initial assessment, guaranteed an increase in the QoL or an avoidance of impairment of QoL during flare-ups.\n \n \n \n Mind-body CAMs have the potential to allow patients suffering from IBD to improve their compromised QoL. However, this area needs further investigation, carrying out more homogeneous studies, with larger samples and longer intervention and follow-up periods.\n