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Exploring the use, safety and efficacy of complementary medicines for the management of eosinophilic oesophagitis in Australian adults [Abstract and Citation Only]
Thesis

Exploring the use, safety and efficacy of complementary medicines for the management of eosinophilic oesophagitis in Australian adults [Abstract and Citation Only]

Nicole Hannan
Southern Cross University
Doctor of Philosophy (PhD), Southern Cross University
2026
DOI:
https://doi.org/10.25918/thesis.606
Appears in  Recent Southern Cross PhD Theses

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Abstract

Eosinophilic oesophagitis (EoE) Complementary medicine Herbal medicine Nutrition Meriva® Curcumin Phytosome® Turmeric Quality of Life (QoL)
Background: Eosinophilic oesophagitis (EoE) is a rare Th2‑mediated, antigen‑driven gastrointestinal disorder. Limited conventional treatment options and other unmet needs may lead some individuals with EoE to seek complementary medicine (CM), yet evidence supporting the safety and efficacy of CM for EoE remains scarce. Objective: To explore the attitudes, use, satisfaction, safety and efficacy of CMs for adults living with EoE. Methods: This sequential exploratory mixed‑methods project comprised four phases. Phase 1. A systematic review of controlled trials examined existing evidence for the safety and efficacy of CMs in adults with eosinophilic GI disorders. Phase 2. An international cross‑sectional survey of adults with EoE across five countries, explored biomedical and CM management practices and participants’ beliefs and attitudes toward these treatments. Phase 3. A series of focus groups with Australian CM practitioners, investigated their clinical experiences managing adults with EoE. Phase 4. A pilot feasibility trial evaluated the preliminary safety, efficacy, and feasibility of Meriva® Curcumin Phytosome® for adults with EoE in Australia. Results: No studies met the eligibility criteria for this review, underscoring the lack of clinical research on CM effectiveness for EGIDs. The international survey (n = 362) showed that CM product use is common among adults with EoE and appears largely driven by dissatisfaction with conventional care and limited treatment options. Although many respondents perceived CM as helpful, they also reported concerns about effectiveness, practitioner training, and side effects. In Australia, CM practitioners managing EoE adopted a structured, safety‑focused, diet‑centred approach, using CM products conservatively and guided by swallow safety, mechanistic reasoning, and patient reactivity. Their decisions were shaped by holistic assessment, psychosocial burden, and the need for practitioner‑led education and interprofessional coordination. The Meriva® pilot demonstrated that CM product use can be feasible, well tolerated, and safe in EoE, with preliminary indicators of symptom, quality‑of‑life, and absolute eosinophil count improvements, although differences in response between groups require further clarification. Conclusions: Improving care for adults with EoE requires greater visibility, safety, and integration of CM within existing practice, supported by clearer communication and coordinated shared‑care processes. Strengthening the evidence base for commonly used CM products, enhancing practitioner capability across conventional and CM professions, and embedding consistent safety and documentation standards will be essential. As research, education, and policy progress together, there is a clear opportunity to deliver more coherent, patient centred, and mechanism aligned EoE care that integrates CM safely alongside guideline recommended management.

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