Safety and efficacy of complementary medicines for eosinophilic gastrointestinal disorders in adults: a systematic review and exploration of candidate interventions.

Abstract

Eosinophilic gastrointestinal disorders (EGIDs) are a group of Th2-mediated antigen-driven conditions. The limitations of conventional management options (i.e. invasive monitoring, adverse effects of pharmacological treatments and challenges with maintaining dietary restrictions) may lead people with EGIDs to seek other treatment options, such as complementary medicine (CM). Although there is mounting evidence supporting the safety and efficacy of some complementary medicines (CMs) for the management of gastrointestinal diseases, the evidence of effectiveness of CMs for EGIDs has not yet been systematically reviewed. A systematic review of controlled clinical trials and randomised controlled trials, including cross-over trials, examining the safety and / or efficacy of any CM, against any comparator, was conducted to determine the safety and efficacy of CMs in adults with EGIDs and to explore potential candidate interventions. The search identified 4,304 references. After title and abstract screening, 4,297 studies were excluded. The 7 identified studies were retrieved as full-text and assessed for eligibility. All 7 studies were excluded due to wrong study design (n = 1; retrospective study), and wrong patient population (n = 6; e.g. patients with functional dyspepsia or heartburn). No studies met the eligibility criteria for inclusion in this review. While there is a paucity of clinical studies examining the effectiveness of CM for EGID, findings from observational and experimental studies highlight possible directions for future research. These studies point to a number of CMs (i.e. nutritional supplements and herbal medicines) that show promise as a treatment for EGID; the clinical safety and efficacy of these interventions therefore warrants further investigation. Identifying safe, effective and acceptable treatment options for people living with an EGID may help to reduce disease and treatment burden in this population, and in turn, improve quality of life.