The Use of Complementary and Alternative Medicine Is Less Frequent in Patients with Inflammatory Bowel Disease Than in Patients with Other Chronic Gastrointestinal Disorders.

BACKGROUND AND AIMS: Complementary and alternative medicine (CAM) is commonly used among patients with inflammatory bowel diseases (IBD), but evidence about its real-life use is limited. We aimed to assess and compare CAM use in outpatients with IBD and other gastrointestinal diseases. MATERIALS AND METHODS: The use of herbs and botanicals, lifestyle modifications and mind/body therapies, patient satisfaction, and continuous use of conventional medicine were assessed with an anonymous questionnaire at a tertiary IBD unit in Hungary. 396 IBD patients (207 with Crohn's disease, 185 with ulcerative colitis, and 4 with indeterminate colitis) and 164 patients with gastric acid-related diseases, premalignant and malignant colorectal diseases, lactose intolerance, celiac disease, dysbacteriosis, and so on were included. RESULTS: IBD patients reported significantly lower usage of herbs than did controls (25% versus 42%, p < 0.001). More than 90% of responding IBD patients continued conventional medication besides herbal remedies (83% in unaltered doses). IBD patients were more likely to implement lifestyle modifications (77% versus 63%, p = 0.0011), but not body/mind therapies (20% versus 15%, p = 0.1516). Younger age was a significant predictor of lifestyle modifications (p = 0.0246). CONCLUSIONS: CAM use (especially that of herbal remedies) in IBD is less frequent than that in other gastrointestinal diseases. It is more a complementary than an alternative to conventional medicine in IBD. There is no significant difference between CAM use in patients with Crohn's disease and that in patients with ulcerative colitis, although the latter tend to choose herbs; the benefit of which is supported by scientific evidence. This study is registered at the Medical Research Council, Hungary. This trial is registered with 3769/2010/1018EKU.

[Surgical treatment of gastric cancer: new methods and longstanding difficulties]. / Gyomorcarcinoma sebészi kezelése: új lehetôségek és régi gondok.

UNLABELLED: The incidence of gastric carcinoma has been declining and the same tendency is observed in Hungary. The five-year survival rate has been improved due to the fewer postoperative deaths and the more radical operations (e.g. extended lymphadenectomies). METHODS: The authors analyzed the clinical data of 183 patients with gastric carcinoma. Age, sex, histology reports, TNM staging and the surgical interventions are presented. RESULTS: Potentially curative resection could be performed in about half of the patients (92/182). A large proportion of the patients belonged to the locally advanced cancer group (112/182). The ratio of the different TNM stages remained the same year by year in the investigated period despite the improving endoscopic facilities. CONCLUSION: Early diagnosis of gastric cancer is crucial and continuous effort should be made by the surgeons, the gastroenterologist and the general practitioners to identify high risk patients with the use of new, sensitive screening methods.