Alternative Medicine and Nutritional Therapy in Adult Inflammatory Bowel Disease in India: A Move Towards Holistic Practice.

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is a chronic gastrointestinal disorder with increasing incidence in India (also referred to as Bharat), posing a significant public health challenge. Low-cost alternatives to prohibitively expensive long-term pharmacological treatments remain underutilised and unoptimised in treatment guidelines. Such alternatives include complementary and alternative medicine (CAM) and nutritional therapies. For example, herbal medicines, such as curcumin, may be a safe and feasible adjunct therapy and should be considered in patients with UC. CAM practices are prevalent and accepted by patients in India for a wide range of reasons. This narrative review analyses various types of CAM used in IBD patients across India and evaluates data on their efficacy and safety. Additionally, nutritional therapies, like exclusive enteral nutrition, may show promise in managing CD but are not standard practice. We highlight useful recommendations, such as offering different formulations, involving dietitians and trained nurses in a multidisciplinary team to provide patient support, and researching dietary interventions specifically relevant to India. This review further emphasises that CAM and dietary interventions are well regarded and are sought out by patients. Thus, these options should be better understood by practitioners and integrated into practice. By incorporating such practices, India can develop a low-cost, holistic IBD care model that considers the patients' socioeconomic and cultural contexts.