Attitudes toward the use of complementary and alternative medicine in children with gastrointestinal symptoms, a multicenter survey study among parents and pediatricians.

Disorders of gut-brain interaction (DGBI) are common in children and often persist despite conventional treatments, leading families to seek complementary and alternative medicine (CAM). However, evidence for CAM in pediatric DGBI is scarce. This multicenter survey study assessed parents' and pediatricians' experiences with and attitudes toward CAM for children with gastrointestinal symptoms. Parents and pediatricians of children (0-18 years) with gastroesophageal reflux disease (GERD) and DGBI (infant colic (IC), functional abdominal pain, and functional constipation) from six Dutch hospitals were included. GERD diagnosis was based on international guidelines, DGBI on Rome IV criteria. Parental surveys addressed child health, medication, (reasons for) CAM use, and attitudes toward CAM research. Pediatricians' surveys covered experiences and attitudes toward CAM for pediatric DGBI. A total of 677 parents (71%) and 76 pediatricians (79%) responded. Most patients had functional constipation (45%) or abdominal pain (41%), with 8% IC and 6% GERD. Seventy-one percent had symptoms for over a year; 58% used medication, and 49% reported side effects. Overall, 42% of patients used CAM, mainly manual therapies, homeopathy, and natural remedies. Predictors of CAM use included IC, longer symptom duration, higher household income, and positive parental CAM experience. Among pediatricians, 53% recommended CAM. Pediatricians with over 15 years' experience were less likely to recommend CAM. Sixty-five percent of parents were willing to participate in CAM research.

conclusionCAM use is common among children with DGBI or GERD, and over half of pediatricians have recommended CAM, underscoring the need for efficacy studies of frequently used CAM. WHAT IS KNOWN: • Complementary and alternative medicine (CAM) is commonly used among pediatric patients with gastrointestinal symptoms but often excluded in evidence-based guidelines due to insufficient evidence. • Previous research has examined perspectives of patients and families, with limited insight into pediatricians' recommendations. WHAT IS NEW: • In Dutch hospitals, 42% of children with infant colic, reflux, abdominal pain, or constipation used CAM. Most pediatricians (52.6%) recommended some CAM to these patients. • Predictors for CAM use include infant colic, longer symptom duration, positive parental CAM experience, and higher income; pediatricians with > 15 years' experience were less likely to recommend CAM. Parental interest in CAM research is high (65%).