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Holistic healthcare in inflammatory bowel disease: time for patient-centric approaches?
  1. Padhmanand Sudhakar1,
  2. Judith Wellens1,2,
  3. Bram Verstockt2,
  4. Marc Ferrante2,
  5. João Sabino2,
  6. Séverine Vermeire2
  1. 1 Department of Chronic Diseases, Metabolism and Ageing, Translational Research Center for Gastrointestinal Disorders, KU Leuven, Leuven, Belgium
  2. 2 Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
  1. Correspondence to Dr Séverine Vermeire, KU Leuven University Hospitals Leuven, Leuven 3000, Belgium; severine.vermeire{at}


Inflammatory bowel disease (IBD) is an emerging global disease characterised by chronic inflammation of the gastrointestinal tract. However, IBD is also manifested by several extraintestinal symptoms which, along with the intestinal symptoms, impact on the mental and emotional well-being of patients. Despite therapeutic advancements, only one-third of the diagnosed patients receiving approved medical treatments achieve short-term to medium-term remission. Consequently, patients who do not get successfully treated might resort to using complementary and alternative approaches to manage their symptoms, with or without consulting their treating clinician. Despite their possible potential, such approaches have various risks stemming from unknown adverse reactions and possible interference with medically approved therapies. In this study, we present the results of a well-performed literature review where we included randomised clinical trials which have assessed the efficacy of complementary approaches and dietary therapy on at least one of the following four outcomes: clinical remission, endoscopic remission, modulation of molecular biomarkers or quality of life metrics. By pointing out intraoutcome and interoutcome concordance, we identified possible candidates for clinical adoption and further study in larger randomised clinical trials covering the broad spectrum of IBD heterogeneity. We finally proposed a patient-centric clinical care model and a series of recommendations for stakeholders, with special attention to complementary approaches and dietary strategies, aimed at achieving holistic remission.

  • IBD clinical
  • IBD
  • inflammatory bowel disease

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  • PS and JW contributed equally.

  • Contributors PS and JW designed and performed the study including data collection, evaluation and assessment. BV, JS, MF and SV provided valuable clinical feedbacks, supervision and criticial reading of the manuscript. All the coauthors read and approved the final version of the manuscript.

  • Funding BV is supported by a Clinical Research Fund (KOOR) from the University Hospitals Leuven and the Research Council KU Leuven, Belgium. S Verstockt is a postdoctoral researcher and JS and MF are senior clinical investigators of Fonds Wetenschappelijk Onderzoek (FWO), Flanders, Belgium. SVis supported by a BOF-ZAP from KU Leuven, Belgium.

  • Competing interests BV reports research support for research from Pfizer, speaker’s fees from Abbvie, Biogen, Bristol Myers Squibb, Chiesi, Falk, Ferring, Galapagos, Janssen, MSD, Pfizer, R-Biopharm, Takeda, Truvion and Viatris and consultancy fees from Abbvie, Alimentiv, Applied Strategic, Atheneum, Bristol Myers Squibb, Galapagos, Guidepont, Ipsos, Janssen, Progenity, Sandoz, Sosei Heptares, Takeda, Tillots Pharma and Viatris. SV has received research support from AbbVie, Johnson & Johnson, Pfizer, and Takeda; lecture fees from AbbVie, Centocor, Ferring, Genentech/Roche, Hospira, Johnson & Johnson, Merck Sharp & Dohme, Pfizer, Takeda, and Tillotts; and consulting fees from AbbVie, Abivax, Celgene, Celltrion, Centocor, Ferring, Galapagos, Genentech/Roche, Gilead, GlaxoSmithKline, Hospira, Johnson & Johnson, Merck Sharp & Dohme, Mundipharma, Pfizer, ProDigest, Prometheus, Second Genome, Takeda, and Tillotts. JS reports lecture fees from Abbvie, Takeda, Janssen, and Nestle Health Sciences. MF reports financial support for: research from AbbVie, Amgen, Biogen, Janssen, Pfizer, Takeda; consultancy from Abbvie, Boehringer-Ingelheim, Lilly, MSD, Pfizer, Sandoz, Takeda, and Thermo Fisher; speaking from Abbvie, Amgen, Biogen, Boehringer-Ingelheim, Falk, Ferring, Janssen, Lamepro, MSD, Mylan, Pfizer, Sandoz, Takeda, and Truvion Healthcare. JC, SV and PS do not have any conflicts to disclose.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.