Hyperbaric Oxygen Therapy in Crohn’s Disease and Ulcerative
Colitis
Ulcerative colitis and Chron disease are inflammatory bowel diseases
(IBD), that tend to be hereditary and affect approximately 1
in 100
people mostly adults between 20 and 40. In around 10% of cases, it is
not possible for doctors to distinguish between ulcerative colitis and
Crohn's disease.
Ulcerative colitis affects the rectum and variable amounts of
the rest of the colon (the large bowel or intestine). Crohn's disease,
can affect any part of the digestive tract from the mouth to the anus.
They usual flare-up with diarrhoea and abdominal pain, then settles
down again, although it is possible to have a single attack of the
condition. In severe cases perianal wounds are common as well as
internal fistulas and fissures with risk of perforation within skin,
bladder, vagina and other parts of bowel.
Common denominator
is regional inflammation, local low blood supply (ischemia) and low
oxygenation usually complicated with bacterial infection. Therapy may
include corticosteroids, immunosuppressive drugs, pain medications and
surgery.
The benefit of Hyperbaric Oxygen Therapy in Crohn’s Disease
and Ulcerative Colitis
- Increased oxygen delivery to all body tissues and reduced
inflammation
- Better oxygenation of the area around the wounds and
fistulas triggers healing response and wound closure
- Reduced pain and intake of pain medications
- Reduced mental and physical stress
- Improving restoration of bowel’s flora
- Improved elimination of toxins and washout of the metabolic
products
- Eliminating bacteria and infection as well as increasing
the effect of antibiotics
- Enhancing the effect of medication (metronidazole)
Case report: Ulcerative colitis
A 23 years 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 metronidazol,
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 HBOT all medications except
analgetics had been cut off by her physician as non-effective and no
other treatment was suggested. HBOT became her “last resource.”
HBOT
was administered daily in a monoplace hyperbaric oxygen chamber at a
pressure of 2.5 ATA for 90 minutes. In parrallel 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 induration 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 which included 35 sessions of eletrical
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.
Conclusion:
Hyperbaric oxygen therapy used in conjunction with electrical
stimualtion provided an effective treatment for severe
perianal
ulcerative colitis.
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Published online in Wiley InterScience (www.bjs.co.uk)
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