bottom-banner -template -template-redirect BaroMedical Hyperbaric Oxygen Centre

Crohn's and colitis

Crohn’s Disease and Ulcerative Colitis

Crohn’s Disease and Ulcerative Colitis are both inflammatory bowel diseases (IBD) and as such respond well to hyperbaric oxygen therapy (HBOT) which has anti-inflammatory, bacteriostatic and pain reducing effect.

The infection and immune attack on normal mucosal bowel flora may affect any part of the gastrointestinal tract, but in Crohn’s the distal ileocecum, small intestine and colon are most commonly involved. Defects in intestinal epithelial cells lead to regional inflammation and ultimately in development of wounds, ulcers, deep fissures and enteric fistulae with risk of perforation within skin, bladder, vagina and other parts of bowel. In local infection hyperbaric oxygen therapy plays an important role in direct effect on bacteria elimination as well as boosting effects of antibiotics and immune system response. Hyperbaric oxygen therapy promotes oxygenation and blood flow to oxygen-deprived areas speeding the draining of the fistulas and wound closure with minimal scar formation. Oxygen promotes bone mineralization and has protective effect on the bones which are affected by long term steroid use.

Hyperbaric oxygen therapy is important in overall symptom improvement and reduced need for pain and anti-inflammatory medication in Crohn’s and Colitis.


Benefits of Hyperbaric Oxygen Therapy in Crohn’s Disease and Ulcerative Colitis
  • Reduces inflammation and infection
  • Decreased pain and need for pain medication
  • Oxygenation promotes neovascularization and collagen synthesis, assisting in fistulae drainage and wound closure
  • Enhanced immune system response and improved restoration of normal bowel flora
  • Improved bone metabolism and mineralization and protective effect from bone damage due to prolonged intake of steroids
  • Amplified effect of antibiotics, i.e. metronidazole, and reduced unwanted side effects

Case report: Ulcerative colitis

A 23 year old female diagnosed with ulcerative colitis for the past 4 years who developed three perianal wounds refractory to conservative treatment with wide spectrum antibiotics and metronidazole, as well as surgical treatment colostomy and ileostomy with failed skin flap followed by a large weight loss. She has been taking analgetics on a regular basis.

When she started hyperbaric oxygen therapy, all medications except analgetics had been cut off by her physician as non-effective and no other treatment was suggested. Hyperbaric oxygen became her “last resource.”

Hyperbaric oxygen  was administered daily in a monoplace hyperbaric oxygen chamber at a pressure of 2.5 ATA for 90 minutes. In parallel electrical stimulation was applied to both gluteus muscles for 30 minutes  three times a week to stimulate muscle work and improve deep wound draining.

After an initial course of 20 sessions the smallest of three wounds closed and there was no more in duration in perianal area. The first significant sign of improvement in pain and less discharge occurred after 28 hyperbaric sessions. After 44 sessions the second wound healed completely and the last third wound closed by the end of session 67 . No side effects of therapy was noted.

At the end of the therapy course, which included 35 sessions of electrical stimulation as well as application of topical hydrogel dressing, we confirmed closure of all perianal lesions, significant improvement in quality of life presented with PCDI from 13 to 4. She was pain free and stopped with analgetics after 3 years of daily usage. She is able to work full time sedentary job and has recently been promoted.

At three months follow-up all wounds remain closed.

Further reading:

  1. Rossignol DA. Hyperbaric oxygen treatment for inflammatory bowel disease: a systematic review and analysis, Medical Gas Research, 2:6, 2012
  2. K.K. Jain: Textbook of hyperbaric medicine: Ch 24: Hyperbaric Oxygen Therapy in Gastroenterology, Hogrefe & Huber Publishers, Inc., 2nd Ed. 24:433 –445, 1997
  3. Brady CE III, Cooley BJ, Davis JC, Healing of severe perineal and cutaneus Crohn’s disease with hyperbaric oxygen , Gastroenterol, 97(3), 756-60, Sep 1989
  4. Brady CE III, Hyperbaric oxygen and perineal Crohn’s disease: a follow-up, Gastroenterol, 105(4), 1264, Oct 1993
  5. Lavy A, Weisz G, Adir Y, Ramon Y, Melamed Y, Eidelman S, Hyperbaric oxygen for perianal Crohn’s disease, J Clin Gastroenterol, 19(3), 202-5, Oct 1994
  6. Nelson EW Jr, Bright DE, Villar LF, Closure of refractory perineal Crohn’s lesions. Integration of Hyperbaric oxygen into case management, Digestive Diseases and Sciences, 35(12), 1561-5, Dec 1990
  7. Colombel JF, Mathieu D, Bouaualt JM, Lesage X, Zavadil P, Quandalle P, Cortot A , Hyperbaric oxygenation in severe perineal Crohn’s disease, Dis Colon Rectum, 38(6), 609-14, Jun 1995
  8. Noyer CM, Brandt LJ, Hyperbaric oxygen therapy for perineal Crohn’s disease, Am J Gastroenterol , 94(2), 318-21, Feb 1999
  9. Cundall JD, Gardiner A, Laden G, Grout P, Duthie GS.:Use of hyperbaric oxygen to treat chronic anal fissure, Br J Surg. 90(4):452-3; Apr. 2003. Published online in Wiley InterScience (www.bjs.co.uk)
  10. Jacobs OW; Rebhen J; Muller MK. Application of hyperbaric oxygen therapy in Crohn disease with fistula formation, EUBS XXII th Annual Scientific meeting, Hamburg-Germany, 12-16 Sep 2001
 

Proudly serving Metro Vancouver and British Columbians with hyperbaric oxygen services and wound care since 1999

© 2017 BaroMedical Research Centre, Inc. All Rights Reserved

7850 Sixth Street - Burnaby V3N 3N3 - British Columbia - Vancouver - CANADA - Ph: 604-777-7055

 Information contained on this site is intended for general consumer understanding and education. It should not be used as a substitute for any medical professional opinion, advice or prescribed medication nor should it serve as diagnosis or treatment of health problems.