Paradigm Shift in Medicine: Integrating Naturopathic Care in the Treatment of Chronic Disease: Want to follow best practices in chronic disease treatment? Look to naturopathic physicians.

The current healthcare system too often relies on prescription drugs, leading to increased opioid use and addiction, despite major medical organizations recommending non-drug approaches as the primary treatment in many conditions. The importance of lifestyle changes to achieving whole-person health is increasingly recognized. Nature-based medicine, as routinely practiced by naturopathic physicians provide a valuable and noteworthy alternative approach featuring lifestyle intervention to chronic pain and disease management. These physicians undergo extensive training in holistic models of care and apply a systematic approach called the Therapeutic Order, which focuses on addressing the underlying cause of symptoms and using the least force necessary for treatment. Improved outcomes are realized with multifactorial personalized treatment plans including lifestyle, nutrition, stress management, and physical activity. Integrative medicine is on the rise and we support the shift to the inclusion of a patient-centered approach in the management of chronic pain and disease. Nothing in the practice of natural, holistic medicine precludes respect for science, and the reliance on evidence. Rather, medicine is at its best when practice can draw from the best offerings of all pertinent fields.

Naturopathic Management of Acute Pediatric Respiratory Infections: A Modified Delphi Study.

Objective: Both the United Nations and the World Health Organization have identified antimicrobial resistance as a significant threat to global health. The Centers for Disease Control and Prevention identified five pediatric respiratory conditions as requiring particular scrutiny in terms of antibiotic stewardship. This study sought to identify strategies used by experienced naturopathic practitioners to treat acute respiratory infections in children. The authors theorize that naturopathic strategies safely fill the gap between watchful waiting and antibiotic prescription, thus reducing the use of antibiotics. Methods: Naturopathic practitioners in Canada, the United States, and Australia with a minimum of 5 years of experience in clinical naturopathic care of children were recruited for a modified Delphi study. A 14-person panel of practitioners was selected to complete a series of four iterative surveys assessing agreement to statements in five domains of knowledge/attitudes, assessment/diagnosis, management, monitoring, and education. Items were deemed to have reached consensus if they reached a predetermined threshold of 70% agreement, or failed to reach a threshold of 40% agreement. Items between these boundaries were modified and retested until either consensus was reached or the four surveys had been completed. Results: Results yielded a large degree of agreement on core naturopathic approaches to the management of acute pediatric respiratory infections, especially lifestyle strategies, including adequate rest and dietary recommendations. The use of vitamins C and D was strongly supported, as were herbs, particularly echinacea and elderberry. Some hydrotherapy and topical applications specific to the individual focus on infection also reached consensus. Results suggested that most respondents, even if they have the authority to prescribe antibiotics, rarely deem it necessary to do so. Conclusion: Findings of this study provide (1) clarity on the role of naturopathic doctors in the management of pediatric health concerns and the stewardship of antibiotics; and (2) initial guidance to less experienced naturopathic practitioners. The findings also identify key priorities for research into the safety and effectiveness of naturopathic interventions to reduce the unnecessary prescribing of antibiotics.

Neutral douche: a hydrotherapeutic tool to manage pain and systemic symptoms in primary dysmenorrhea - a randomised controlled study.

BACKGROUND & OBJECTIVES: The douche, one of the hydrotherapeutic treatment modality is commonly used by Naturopathy physicians as a treatment of choice in the management of several ailments. This study was done to assess the effect of full body neutral douche in the management of pain and systemic symptoms in adult females with primary dysmenorrhoea. METHODS: 68 subjects of age 18-22 years with primary dysmenorrhoea were recruited for the study and were randomly divided into two groups: the experimental group (n = 34) and the control group (n = 34). The experimental group received whole body neutral douche, whereas the control group followed the routine as usual. Assessments for the pain, systemic symptoms and menstrual cramps were done by using McGill Pain Questionnaire, Verbal multidimensional scoring system and analog scale for severity of pain and menstrual cramps respectively at baseline, day 30 and day 60 of intervention. Two- way repeated measures of ANOVA was performed to understand the between group changes, adjusted for the respective baseline values and age. RESULT: Data was analyzed with SPSS (Version 21.0) package. Neutral douche resulted in significant improvement in pain [F(2,66) = 114.564, p < 0.0005, partial ?2 = 0.771], severity of pain [F(2,66) = 70.418, p < 0.0005, partial ?2 = 0.681], cramps [F(2,66) = 75.986, p < 0.0005, partial ?2 = 0.697] and systemic symptoms [F(2,66) = 14.64, p < 0.0005, partial ?2 = 0.307] as compared to the control group. CONCLUSION: Findings suggest that neutral douche can be used as a non-pharmacological intervention in the management of pain and systemic symptoms in primary dysmenorrhea.

Australian Naturopaths' Approach to Caring for People with Cardiovascular Disease and Associated Risk Factors: A Qualitative Study of the Providers' Perspective.

Objectives: To date, no formal research has evaluated how naturopathic practitioners approach the care of people living with CVD and associated CVD risk factors. The primary aim of this research was to collect qualitative data from Australian Naturopathic practitioners about their clinical practices for CVD. Design: Semi-structured interviews were conducted, recorded, transcribed, and ultimately coded by three independent researchers using the Framework Approach. Subjects: 10 Australian Naturopathic practitioners. Results: The key emergent themes from the responses of naturopathic practitioners embodied the elements of patient-centered care (PCC). Numerous factors, including regulation, barriers to service access, and interprofessional communication, were cited as hurdles to additional effectiveness as PCC practitioners. Conclusion: Future research should assess whether the principles of PCC are reported directly from the patients who utilize naturopathy for CVD to determine if their experience mirrors the reports by practitioners.

AYUSH for COVID-19: Science or Superstition?

There is a lot of discussion on COVID-19 control strategies from the mainstream approaches, but it is also necessary to examine the contributions of the Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Riga and Homeopathy (AYUSH) sector, which is now being brought into public health interventions nationally. Although the AYUSH sector had previously joined the management of dengue and chikungunya outbreaks in some Indian states, its participation has remained contentious and there is reluctance in mainstream public health discourses to seriously examine their interventions. This is a commentary on the efforts made by the Ministry of AYUSH, state AYUSH directorates, AYUSH research institutions, and public hospitals, based on official documents as well as official statements reported in the media, with the aim of bringing out concerns in the process of adapting traditional textual knowledge and practices to public health requirements of the current age.

Effect of yoga and naturopathy-based lifestyle modification on left ventricular ejection fraction in a patient with severe triple vessel disease: A case report.

A 75-year-old, married man was diagnosed with coronary artery disease (CAD) [severe triple vessel disease (TVD)] in the 2nd week, June-2018. The physician advised him to undergo conventional medication and coronary artery bypass graft. Since the patient refused to undergo surgery he was admitted in our hospital and underwent yoga and naturopathy-based lifestyle modification (YNLM) along with conventional medicines for 16 weeks [12 weeks of intensive care at inpatient department and 4 weeks at outpatient department (OPD)]. After 16 weeks, the patient visited our OPD once/twice a month for 6 months. An increase in left ventricular ejection fraction from 35 to 48%; and a reduction in weight from 77.5 to 71-kg, and BMI from 26.60 to 24-kg/m2 were observed after 6 months of follow-up compared with baseline. Thus, YNLM might be considered as an adjuvant in reducing risk factor and in improving left ventricular systolic dysfunction in patients with CAD (severe-TVD). However, further studies are required to establish the efficacy of YNLM for CAD.

Use of Complementary and Alternative Medicines among Cancer Patients: A Single-Center Study.

PURPOSE: It is usual for cancer patients to use complementary and alternative medicines (CAMs) and yet the literature evaluating their efficacy in cancer patients is very limited. The objective of the present study was to report on the nature, frequency of use, and patient-reported outcome of CAMs in a single-center study. METHODS: All the consecutive patients treated between November 2017 and June 2018 at the Lucien Neuwirth Cancer Institute (France) were screened. Their reasons for using CAMs and their usage habits were collected. Patients evaluated their benefit. RESULTS: Of the 209 patients screened, 200 patients were included. CAMs ranged from osteopathy, homeopathy, acupuncture, healing touch, magnetism, naturopathy, suction cups, Chinese medicine, reflexology, to hypnosis. CAMs were widely used (n = 166, 83%), the first being osteopathy (n = 99, 49.5%), the second homeopathy (n = 78, 39.0%), and finally acupuncture (n = 76, 38.0%). Whatever the CAM, high satisfaction rates were reported (median satisfaction: 61-81%). CAMs were mainly used to prevent/treat side effects of anticancer treatments (81.2% for healing touch), increase well-being (55.4% for naturopathy), improve the immune system (16.9% for homeopathy), and treat cancer (n = 3, 5.1% for homeopathy). Patients could easily consider using CAMs, as up to 50.8% would have accepted a consultation. CONCLUSIONS: The reasons for using CAMs differed among patients. They praised CAMs and kept asking for more information although there is limited evidence about their efficacy in the literature. Thus, prospective randomized controlled trials exploring the safety and efficacy of CAMs in cancer patients are needed.

Evaluation and Comparison of the Effectiveness of Rehabilitation Procedures in the Area of ​Pain in the Lumbosacral Spine Performed in Sanatoria and Outpatient Conditions.

BACKGROUND: Low back pain is among the most frequent conditions of nowadays and due to its high prevalence, it is defined as a social and civilization-related disease.Today, increasingly young patients present with this condition affecting about 80% of the population. In Poland, 70% of the population complain of back pain and the prevalence rate increases with age. The treatment includes application of various procedures, both in outpatient conditions and in sanatoria. The aim of the study was to compare the effects of sanatorium treatment with those of outpatient treatment. MATERIAL AND METHODS: 240 patients with low back pain participated in the study. The sample was divided into two groups: 120 pa-tients undergoing treated in outpatient conditions and next, 120 patients undergoing sanatorium treatment. The research was based on survey in a form of a questionnaire, selected mobility tests and assessment of pain using thermal imaging camera and an algometer. RESULTS: The patients undergoing rehabilitation procedures in a sanatorium obtain improvement in terms of pain sensation (5.39 points in VAS scale) as compared with the patients undergoing rehabilitation in outpatient conditions (4.13 points in VAS scale) ; their results also indicate improvement in low back mobility (the obtained values, however, turned out statistically insignificant). Better results can be obtained by combining conventional rehabilitation with the approaches applied in sanatorium treatment, as confirmed by the assessment of each group of patients. CONCLUSIONS: 1. Rehabilitation of patients with lumbar spine pain conditions conducted in spa conditions is a more effective treat-ment method than in an outpatient clinic and should be used universally. 2. Research is indicated to determine the effect of rest in a sanatorium (the ambience) involving low back pain relief.

Naturopathic Oncology Care for Thoracic Cancers: A Practice Survey.

BACKGROUND AND OBJECTIVES: There is a lack of information on therapies recommended by naturopathic doctors (NDs) for lung and gastroesophageal cancer care. Study objectives were to: (1) identify the most common interventions considered for use by NDs; (2) identify interventions NDs recommend to support key therapeutic goals; and (3) identify potential contraindications between integrative and conventional therapies. METHODS: Oncology Association of Naturopathic Physicians (OncANP) members (n = 351) were invited to complete an electronic survey. Respondents provided information on interventions considered for thoracic cancer pre- and postoperatively across 4 therapeutic domains (supplemental natural health products, physical, mental/emotional, and nutritional), therapeutic goals, and contraindications. This survey was part of the development of the Thoracic Perioperative Integrative Surgical Evaluation trial. RESULTS: Forty-four NDs completed the survey (12.5% response rate), all of whom were trained at accredited colleges in North America and the majority of whom were Fellows of the American Board of Naturopathic Oncology (FABNO) (56.8%). NDs identified significantly more interventions in the postoperative compared to preoperative setting. The most frequently identified interventions included modified citrus pectin, arnica, omega-3 fatty acids, vitamin D, probiotics, exercise, acupuncture, meditation, stress reduction, low glycemic index diet, and Mediterranean diet. Potential contraindications with conventional treatment (surgery, chemotherapy, radiotherapy) differed across natural health products. CONCLUSIONS: These findings highlight naturopathic interventions with a high level of use in thoracic cancer care, describe and characterize therapeutic goals and the interventions used to achieve these goals, and provide insight on how practice changes relative to conventional cancer treatment phase.

Naturopathic Treatment and Complementary Medicine in Surgical Practice.

BACKGROUND: Many patients in Germany use naturopathic treatments and complementary medicine. Surveys have shown that many also use them as a concomitant treatment to surgery. METHODS: Multiple databases were systematically searched for systematic reviews, controlled trials, and experimental studies concerning the use of naturopathic treatments and complementary medicine in the management of typical post-operative problems (PROSPERO CRD42018095330). RESULTS: Of the 387 publications identified by the search, 76 fulfilled the inclusion criteria. In patients with abnormal gastrointestinal activity, acupuncture can improve motility, ease the passing of flatus, and lead to earlier defecation. Acupuncture and acupressure can reduce postoperative nausea and vomiting, as well as pain. More-over,aromatherapy and music therapy seem to reduce pain, stress and anxiety and to improve sleep. Further studies are needed to determine whether phytotherapeutic treatments are effective for the improvement of gastrointestinal function or the reduction of stress. It also remains unclear whether surgical patients can benefit from the methods of mind body medicine. CONCLUSION: Certain naturopathic treatments and complementary medical methods may be useful in postoperative care and deserve more intensive study. In the publications consulted for this review, no serious side effects were reported.

Nature Cure and Non-Communicable Diseases: Ecological Therapy as Health Care in India.

With rapidly increasing rates of non-communicable diseases, India is experiencing a dramatic public health crisis that is closely linked to changing lifestyles and the growth of the middle-class. In this essay we discuss how the practice of Nature Cure provides a way of understanding the scale and scope of the crisis, as it is embodied, and a way to understand key elements of a solution to problems that the crisis presents for institutionalized health care. As institutionalized in contemporary India, Nature Cure involves treatment and managed care using earth, air, sunlight, and water as well as a strict dietary regimen. In this regard, the essay shows how Nature Cure's bio-ecological orientation toward public health, which is grounded in the history of its modern incorporation into India, provides an expansionist, ecological model for holistic care that counters the reductionist logic of bio-medical pharmaceuticalization.

New Development in Traditional Chinese Medicine: Symbolism-Digit Therapy as a Special Naturopathic Treatment.

Traditional Chinese medicine (TCM) grew out of traditional Chinese culture. For example, the eight-diagram symbol is composed of the Yang and the Yin. According to oriental philosophy, everything in the universe has a two-sided property, namely an image (or symbol) and a number (or digit). This paper introduces the new concept and historical background of symbolism-digit therapy (SDT), which is a natural therapy for the treatment of various kinds of diseases. SDT is of TCM heritage, which can be traced back to the ancient publications such as Yi Jing, and this heritage has been incorporated into modern development and practices. The successful treatments using SDT presented in this paper use formulas and/or prescriptions in accordance with TCM. All materials presented in this paper come from first-hand clinical observations, which are supported by TCM theories. Effects of SDT treatments are straightforward and worthy of broader and deeper investigation. SDT and other relevant therapies motivate the further exploration of the essence of TCM to improve the understanding of TCM principles.

Naturopathic Oncology Modified Delphi Panel.

UNLABELLED: Naturopathic oncology is a relatively new and emerging field capable of providing professional integrative or alternative services to cancer patients. Foundational research is critical to identify topics in the clinical and research development of naturopathic oncology for future growth of the field. STUDY DESIGN: This study implements a modified Delphi protocol to develop expert consensus regarding ethics, philosophy, and research development in naturopathic oncology. METHODS: The modified protocol implements a nomination process to select a panel of 8 physicians and to assist in question formulation. The protocol includes an in-person discussion of 6 questions with multiple iterations to maintain the concept of the Delphi methodology as well as a postdiscussion consensus survey. RESULTS: The protocol identified, ranked, and established consensus for numerous themes per question. Underlying key topics include integration with conventional medicine, evidence-based medicine, patient education, patient safety, and additional training requirements for naturopathic oncologists. CONCLUSIONS: The systematic nomination and questioning of a panel of experts provides a foundational and educational resource to assist in clarification of clinical ethics, philosophy, and research development in the emerging field of naturopathic oncology.

[Irritable Bowel Syndrome treatment: a multidisciplinary approach].

Irritable Bowel Syndrome affects 9-23% of the general population. This diagnosis contributes to more frequent doctor visits and multiple consultations by patients. The current approach to treating IBS is symptomatic and consists of a regimen of first line pharmacological treatment options; the use of anti-depressant drugs is also common. The efficiency of complementary medicine in the treatment of IBS has been studied in the last few years. Qualitative multidisciplinary approach studies, using personalized medicines with complementary therapies are needed. We present the case of a 39-year-old woman with a diagnosis of IBS since 2009, who complained about gastrointestinal symptoms since the age of 13 and severe episodes of spasmodic stomach aches in the last year self-ranked as 10, on a 0-10 scale; 3-4 episodes a month, which last for 5 days, accompanied by severe flatulence and bloating. In addition, she has constipation (one bowel movement every 10 days), alternating with multiple diarrheic bowel movements (6 times a day). Using a multidisciplinary approach, including medicinal care, Chinese medicine, reflexology and naturopathy resulted in significant improvement in symptoms and quality of life, as well as gradual reduction of drugs, approved by her physician. Stomach ache self-ranked now as 1, on a 0-10 scale; and flatulence and bloating self-ranked as mild. Bowel movement frequency increased and is now every other day. She no longer has diarrheic and/or multiple bowel movements. This case report emphasizes the importance of integrative treatment in IBS and its benefit in improving patients' quality of life.

Molecular targets of naturopathy in cancer research: bridge to modern medicine.

The relevance of naturopathy (defined as the practice of medicine for the treatment of human diseases with natural agents) in human cancer is beginning to be appreciated, as documented by renewed interest in nutraceutical research, the natural anticancer agents of dietary origin. Because of their pleiotropic effects and the ability to modulate multiple signaling pathways, which is a good attribute of natural agents, nutraceuticals have frequently been demonstrated to re-sensitize drug-resistant cancers. The effectiveness of nutraceuticals can be further enhanced if the tools for the relative assessment of their molecular targets are readily available. Such information can be critical for determining their most effective uses. Here, we discuss the anticancer potential of nutraceuticals and the associated challenges that have interfered with their translational potential as a naturopathic approach for the management of cancers. In the years to come, an efficient screening and assessment of molecular targets will be the key to make rapid progress in the area of drug design and discovery, especially focusing on evidence-based development of naturopathy for the treatment of human malignancies.