camwatch

Chang FY, Lu CL. Treatment of irritable bowel syndrome using complementary and alternative medicine. J Chin Med Assoc. 2009 Jun;72(6):294-300. PMID: 19541564

A thoughtful and enlightened review of CAM practices used by patients with irritable bowel syndrome, by researchers at Taipei Veterans General Hospital and National Yang-Ming University School of Medicine in Taipei.

From the abstract:

"Unfortunately, none of the currently available drugs … are globally effective in treating all IBS symptoms, and the advanced receptor-targeted drugs are not always successfully and safely marketed. Consequently, more than half of patients may seek complementary and alternative medicine (CAM) to treat the annoying bowel symptoms. Physicians have considered these CAM measures to have an "enhanced placebo effect". For example, many herbal medicine and plant products are globally used to treat IBS, whereas their efficacies are often inconclusive because of small sample sizes, inadequate data analyses and lack of standardized preparations. Meta-analyses do not establish their true efficacy. Acupuncture has long been employed by patients themselves to treat functional gastrointestinal disorders with satisfactory response, but its effect on IBS does not seem to be promising. Peppermint oil, melatonin and clay-like materials are effective in treating some IBS symptoms, while their true pharmacology remains enigmatic."

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger).This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine irritable bowel syndrome

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Scott JG, Cohen D, Dicicco-Bloom B, et al. Understanding healing relationships in primary care. Ann Fam Med. 2008 Jul-Aug;6(4):315-22. PMID: 18626031

Healing relationships have not received a lot of attention in the published literature on primary care, considering they’ve been posited as an explanation of the large placebo effect observed in clinical trials. This theoretical model offers insights on a critical aspect of therapy.

From the discussion: 

"The interviews showed that both patients and clinicians had a common understanding of the nature of healing. Healing meant being cured when possible, reducing suffering when cure was not possible, and finding meaning beyond the illness experience."

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine

Comments and Links Appreciated!

A selection of open-access articles from NCBI "What’s New" results this month. Posts on individual papers to come.

• Little P, Lewith G, Webley F, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. BMJ. 2008 Aug 19;337:a884. doi: 10.1136/bmj.a884. PMID: 18713809
• Scott JG, Cohen D, Dicicco-Bloom B, et al. Understanding healing relationships in primary care. Ann Fam Med. 2008 Jul-Aug;6(4):315-22. PMID: 18626031

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine

Comments and Links Appreciated!

Kaptchuk TJ, Kelley JM, Conboy LA, et al. Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome. BMJ. 2008 May 3;336(7651):999-1003. PMID: 18390493

A fine benchmark study from investigators at Harvard Medical School. From the discussion:

In this large prospective study of placebo effects we found that such effects can be disentangled into three components that can then be recombined to produce incremental improvement in symptoms in a manner resembling a graded dose escalation of component parts. In the pairwise comparisons, we also found that an enhanced relationship with a practitioner, together with the placebo treatment, provides the most robust effect in terms of the four measures we used….

The magnitude of non-specific effects in the augmented arm is not only statistically significant but also clearly clinically significant in the management of irritable bowel syndrome…. the percentage of patients reporting adequate relief (62% and 61% at three and six weeks, respectively) is comparable with the responder rate in clinical trials of drugs currently used in the treatment of irritable bowel syndrome.

These results indicate that such factors as warmth, empathy, duration of interaction, and the communication of positive expectation might indeed significantly affect clinical outcome.

CAMWatch: Posts about free-access, peer-reviewed articles on aspects of complementary medicine theory, practice and policy (about the blogger). This blog is not a source for medical advice.

technorati tags: complementary and alternative medicine integrative medicine placebo effect

Comments and Links Appreciated!