Adjunctive Hyperbaric Oxygen Therapy in Refractory Crohn's Disease: An Observational Study
Marley R Feitosa1, Rogério S Parra1, Vanessa F Machado1
1Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
Gastroenterology Research and Practice
|May 17, 2021
Summary
Hyperbaric oxygen therapy (HBOT) shows significant healing rates for Crohn's disease (CD) complications. This treatment is effective for perianal fistulizing CD, enterocutaneous fistulas, and pyoderma gangrenosum.
Area of Science:
- Gastroenterology
- Dermatology
- Surgical Innovation
Background:
- Crohn's disease (CD) can lead to severe complications despite optimal medical therapy.
- Hyperbaric oxygen therapy (HBOT) has shown promise in managing complicated CD.
- Optimal HBOT protocols, including session number and duration, require further investigation.
Purpose of the Study:
- To evaluate the efficacy of HBOT in CD patients refractory to conventional treatments.
- To assess HBOT's effectiveness for specific CD complications: perianal fistulizing CD (pCD), enterocutaneous fistulas (ECF), and pyoderma gangrenosum (PG).
Main Methods:
- A cohort of 40 patients with CD complications underwent HBOT.
- Treatment outcomes were assessed based on complete healing criteria for pCD, ECF, and PG.
- Incomplete healing was defined by persistent drainage or lack of granulation.
Main Results:
- 82.5% of patients achieved complete healing with HBOT.
- Healing rates varied by complication: 100% for PG, 84.6% for ECF, and 80% for pCD.
- Most patients (62.5%) had pCD, followed by ECF (32.5%) and PG (15%).
Conclusions:
- Adjunctive HBOT is associated with significant healing rates for CD-associated complications.
- HBOT offers a viable treatment option for refractory cases of pCD, ECF, and PG.
- Further research may refine HBOT protocols for enhanced patient outcomes.
Related Concept Videos
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
407
Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
407
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
266
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
266
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
2.7K
Assessing and diagnosing Chronic Obstructive Pulmonary Disease (COPD) involves a detailed approach that includes a comprehensive review of medical history, physical examination, and a variety of diagnostic tests. This thorough evaluation is essential to ensure an accurate diagnosis and guide effective management strategies.
Medical History
Medical History
2.7K
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
300
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
300
01:30Inflammatory Bowel Disease II: Crohn's Disease
520
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
520
01:29Inflammatory Bowel Disease IV: Pharmacological Management
258
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
258