Patient-Provider Interactions Affect Symptoms in Gastroesophageal Reflux Disease: A Pilot Randomized, Double-Blind, Placebo-Controlled Trial.

BACKGROUND: It is unclear whether the benefits that some patients derive from complementary and integrative medicine (CIM) are related to the therapies recommended or to the consultation process as some CIM provider visits are more involved than conventional medical visits. Many patients with gastrointestinal conditions seek out CIM therapies, and prior work has demonstrated that the quality of the patient-provider interaction can improve health outcomes in irritable bowel syndrome, however, the impact of this interaction on gastroesophageal reflux disease (GERD) is unknown. We aimed to assess the safety and feasibility of conducting a 2 x 2 factorial design study preliminarily exploring the impact of the patient-provider interaction, and the effect of an over-the-counter homeopathic product, Acidil, on symptoms and health-related quality of life in subjects with GERD. METHODS: 24 subjects with GERD-related symptoms were randomized in a 2 x 2 factorial design to receive 1) either a standard visit based on an empathic conventional primary care evaluation or an expanded visit with questions modeled after a CIM consultation and 2) either Acidil or placebo for two weeks. Subjects completed a daily GERD symptom diary and additional measures of symptom severity and health-related quality of life. RESULTS: There was no significant difference in GERD symptom severity between the Acidil and placebo groups from baseline to follow-up (p = 0.41), however, subjects who received the expanded visit were significantly more likely to report a 50% or greater improvement in symptom severity compared to subjects who received the standard visit (p = 0.01). Total consultation length, perceived empathy, and baseline beliefs in CIM were not associated with treatment outcomes. CONCLUSION: An expanded patient-provider visit resulted in greater GERD symptom improvement than a standard empathic medical visit. CIM consultations may have enhanced placebo effects, and further studies to assess the active components of this visit-based intervention are warranted. TRIAL REGISTRATION: ClinicalTrials.gov NCT01915173.

El efecto rebote de las drogas: un riesgo fatal para el tratamiento convencional y una base farmacológica para el tratamiento homeopático. / Rebound effect of drugs: fatal risk of conventional treatment and parmacological basis of homeopathic treatment

El modelo homeopático considera la acción secundaria o la reacción vital del organismo como un método terapéutico y, por lo tanto prescribe tratamientos por el principio de similitud; éste consiste en administrar a los individuas enfermos sustancias que han causado síntomas similares en individuas sanas. La reacción vital homeostática o paradójica de un organismo puede ser explicada científicamente en base al efecto de rebate de los medicamentos modernos, el cual puede causar eventos iatrogénicos fatales posteriores a la suspensión de un tratamiento antipático (un término utilizado en medicina alternativa para el tratamiento paliativo, también conocido como enantiopático). Aunque el efecto de rebate ha sido estudiado por la farmacología moderna, este ha sido poco difundido y discutido entre los profesionales de la salud, quienes en muchas ocasiones han sido privados de información crucial necesaria para el manejo seguro de los medicamentos actuales. En este artículo se presenta una revisión actual sobre el efecto de rebate de los medicamentos modernos que fundamentan el principio homeopático de curación y alerta a los médicos sobre este tipo de efecto adverso que usualmente no se notifica. EI efecto de rebate de los medicamentos modernos paliativos fue señalado por Hahnemann hace más de dos siglas, mencionando que éste puede causar efectos adversos fatales, los cuales pueden ser evidenciados como en el caso del ácido acetilsalicílico, los agentes antiinflamatorios, antidepresivos, broncodilatadores, las estatinas, los inhibidores de la bomba de protones, etc. Aunque el efecto de rebate solamente se presenta en una pequeña fracción de individuas (susceptibles) y puede ser evitado mediante una disminución gradual de los medicamentos antipáticos, este ha de mostrado una importancia epidemiológica significativa como resultado del uso masivo de tales drogas paliativas y la falta de conocimiento a este respecto. (AU)

The homeopathic model considers the secondary action or the organism vital reaction of the body as a therapeutic method and therefore prescribes treatments by the principle of similarity, which consists to administer to the sick person substances that have caused similar symptoms in healthy individuals. The vital homeostatic or paradoxical reaction of an organism may be explained scientifically based on the rebound effect of modem drugs, which can cause fatal iatrogenic events after discontinuation of the antipathic treatment (a term used in alternative medicine for palliative, also known as enantiopathic). Although the rebound effect has been studied by modem pharmacology, this was not widely known and discussed among health professionals, who have often been deprived of crucial information necessary for the safe handing of current medications. This article presents a current review on the rebound effect of modem medicines as a fundament of homeopathic healing, and alert doctors about these side effects usually are not notified.The rebound effect of modem palliative drugs, which was pointed out by Hahnemann more than two centuries ago, might cause fatal adverse events, which might be illustrated with the examples of acetylsalicylic acid, anti-inflammatory agents, bronchodilators, antidepressants, statins, proton-pump inhibitors, etc. Although the rebound effect is expressed by a small fraction of (susceptible) individuals and might be avoided by gradual tapering of antipathic drugs, it exhibits epidemiologic importance as a function of the massive use of such palliative drugs and lack of knowledge in its regard. (AU)

El efecto rebote de las drogas: un riesgo fatal para el tratamiento convencional y una base farmacológica para el tratamiento homeopático / Rebound effect of drugs: fatal risk of conventional treatment and parmacological basis of homeopathic treatment

El modelo homeopático considera la acción secundaria o la reacción vital del organismo como un método terapéutico y, por lo tanto prescribe tratamientos por el principio de similitud; éste consiste en administrar a los individuas enfermos sustancias que han causado síntomas similares en individuas sanas. La reacción vital homeostática o paradójica de un organismo puede ser explicada científicamente en base al efecto de rebate de los medicamentos modernos, el cual puede causar eventos iatrogénicos fatales posteriores a la suspensión de un tratamiento antipático (un término utilizado en medicina alternativa para el tratamiento paliativo, también conocido como enantiopático). Aunque el efecto de rebate ha sido estudiado por la farmacología moderna, este ha sido poco difundido y discutido entre los profesionales de la salud, quienes en muchas ocasiones han sido privados de información crucial necesaria para el manejo seguro de los medicamentos actuales. En este artículo se presenta una revisión actual sobre el efecto de rebate de los medicamentos modernos que fundamentan el principio homeopático de curación y alerta a los médicos sobre este tipo de efecto adverso que usualmente no se notifica. EI efecto de rebate de los medicamentos modernos paliativos fue señalado por Hahnemann hace más de dos siglas, mencionando que éste puede causar efectos adversos fatales, los cuales pueden ser evidenciados como en el caso del ácido acetilsalicílico, los agentes antiinflamatorios, antidepresivos, broncodilatadores, las estatinas, los inhibidores de la bomba de protones, etc. Aunque el efecto de rebate solamente se presenta en una pequeña fracción de individuas (susceptibles) y puede ser evitado mediante una disminución gradual de los medicamentos antipáticos, este ha de mostrado una importancia epidemiológica significativa como resultado del uso masivo de tales drogas paliativas y la falta de conocimiento a este respecto.

The homeopathic model considers the secondary action or the organism vital reaction of the body as a therapeutic method and therefore prescribes treatments by the principle of similarity, which consists to administer to the sick person substances that have caused similar symptoms in healthy individuals. The vital homeostatic or paradoxical reaction of an organism may be explained scientifically based on the rebound effect of modem drugs, which can cause fatal iatrogenic events after discontinuation of the antipathic treatment (a term used in alternative medicine for palliative, also known as enantiopathic). Although the rebound effect has been studied by modem pharmacology, this was not widely known and discussed among health professionals, who have often been deprived of crucial information necessary for the safe handing of current medications. This article presents a current review on the rebound effect of modem medicines as a fundament of homeopathic healing, and alert doctors about these side effects usually are not notified.The rebound effect of modem palliative drugs, which was pointed out by Hahnemann more than two centuries ago, might cause fatal adverse events, which might be illustrated with the examples of acetylsalicylic acid, anti-inflammatory agents, bronchodilators, antidepressants, statins, proton-pump inhibitors, etc. Although the rebound effect is expressed by a small fraction of (susceptible) individuals and might be avoided by gradual tapering of antipathic drugs, it exhibits epidemiologic importance as a function of the massive use of such palliative drugs and lack of knowledge in its regard.

Terapias alternativas; la Montmorillonita-bentonita como antiacido

La farmacopea de las culturas nativas bolivianas contienen productos con actividad farmacologica, como es el caso de la Montmorillonita-bentonita (Phasa), arcilla que a traves de analisis quimicos se ha demostrado que contiene silicatos, hidroxido y carbonatos, principalmente de aluminio y calcio analoga a los tradicionales antiacidos del arsenal terapeutico facultativo.