title: The usage of complementary and alternative medicine in gastrointestinal patients visiting the outpatients' department of a large tertiary care centre-views from Pakistan.
abstract: BACKGROUND
  The use of complementary and alternative medicine (CAM) has increased over the last few years, and an emergent data suggests that some CAM modalities may be helpful in addressing gastrointestinal (GI) conditions. Our aim was to find out the prevalence of such practices for GI condition amongst patients visiting an OPD of a large tertiary care centre of Karachi, Pakistan.
  
  
  METHODS
  Patients visiting outpatient department of Hepatogastroenterology department at SIUT, Pakistan from March 2014 to March 2015, were included in this cross sectional study. A pre designed questionnaire was used that included the demographic data, primary disease of the patient, CAM modality used, reason for the use of CAM therapy and reasons for stopping it. Frequencies of different variables were computed using SPSS version 18.
  
  
  RESULTS
  906 patients were interviewed, out of which 52% (471) were males. The mean age at presentation was 39.81±12.4 years. 234 (25.8%) of the participants used one of the CAM modalities; Herbal medicine being most common one, seen in 122 (52.13%) followed by spiritual 61 (26%), and homeopathy 33 (14%). The duration of therapy was limited to six months in 161(68%), whereas 7 patients (2.9%) had prolonged duration of use of more than five years. Reasons for using CAM therapy included advice by family and friends in 66 patients (28%), personal will in 42 (17.94%), no benefit from allopathic treatment in 34 (14.5%), while high cost was the reason of use in 3(5%) of the patients. The most common reason for discontinuation of CAM was no benefit, seen in 113 patients (48.30%), followed by physician's advice in 32 (17%) patients, and side effects in 19 (8%). On the other hand 44 patients (18.80%) reported benefit from the therapy while 14 (5.9%) were still continuing with CAM modality. Among the CAM users 140 (60.09%) were un-educated or had primary education while CAM nonusers had 328 (47%) were either uneducated or had primary education only correlation reveals P value 0.004.
  
  
  CONCLUSIONS
  Significant numbers of patients used CAM therapy. A lower level of education was associated with increased usage of CAM while cost had no major impact on its usage.
authors: Department of Hepato-gastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
authors: Ghulamullah
authors: G
authors: Lail
authors: Department of Hepato-gastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
authors: Nasir
authors: N
authors: Luck
authors: Department of Hepato-gastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
authors: Abbas Ali
authors: AA
authors: Tasneem
authors: Department of Hepato-gastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
authors: AyeshaAslam
authors: A
authors: Rai
authors: Department of Hepato-gastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
authors: Syed Mudasir
authors: SM
authors: Laeeq
authors: Department of Hepato-gastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
authors: Zain
authors: Z
authors: Majid
mesh_terms: D000328:Adult; D000529:Complementary Therapies / Q000379:methods* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D005767:Gastrointestinal Diseases / Q000628:therapy*; D006801:Humans; D008297:Male; D008419:Materia Medica / Q000627:therapeutic use; D008875:Middle Aged; D010045:Outpatients; D010154:Pakistan; D008517:Phytotherapy / Q000379:methods*; D026443:Spiritual Therapies / Q000379:methods*; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
chemical_list: D008419:Materia Medica
keywords: Complimentary and alternate medicine; OPD; Pakistan; gastrointestinal symptoms; herbal medication