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. 2021 Apr 26:2021:6628142.
doi: 10.1155/2021/6628142. eCollection 2021.

Adjunctive Hyperbaric Oxygen Therapy in Refractory Crohn's Disease: An Observational Study

Marley R Feitosa  1 , Rogério S Parra  1 , Vanessa F Machado  1 , Gustavo N Vilar  1 , Jussara C Aquino  2 , José J R Rocha  1   2 , Paulo G Kotze  3 , Omar Féres  1   2
Affiliations

Adjunctive Hyperbaric Oxygen Therapy in Refractory Crohn's Disease: An Observational Study

Marley R Feitosa et al. Gastroenterol Res Pract. .

Abstract

Background and aims: Patients may experience complications of Crohn's disease (CD) even when treated with optimal medical therapy strategies. Previous data have shown the efficacy of hyperbaric oxygen therapy (HBOT) in the management of complicated CD. However, there is no consensus regarding the optimal number of sessions or duration of treatment regimens. The aim of the present study was to investigate the efficacy of HBOT in CD patients who were refractory to conventional medical management.

Methods: This study included patients who underwent HBOT for the treatment of the following complications: perianal fistulizing Crohn's disease (pCD), enterocutaneous fistulas (ECF), or pyoderma gangrenosum (PG). Complete healing was defined as the closure of external orifice and the absence of active draining (in pCD), complete wound healing (in PG), and granulation or complete wound epithelialization with no enteric draining (in ECF). The persistence of draining and the absence of wound granulation were defined as incomplete healing.

Results: Forty patients were included. The mean CD duration was 10.6 ± 5.8 years. pCD comprised most of the included patients (25/62.5%), followed by ECF (n = 13/32.5%) and PG (n = 6/15%). In two patients (5%), a combination of ECF and PG was diagnosed, and in one patient (2.5%), all three complications were observed. A total of 32 patients (82.5%) had complete healing. Patients with PG had the highest healing rates (100%), followed by those with ECF (84.6%) and pCD (80%).

Conclusions: Adjunctive HBO was associated with significant healing rates for CD-associated complications such as pCD, ECF, and PG.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Main results of HBOT in 40 patients.
Figure 2
Figure 2
Significant healing of perineal fistulizing Crohn's disease wounds observed at the beginning of treatment (10 sessions) after perineal surgery (a) and at the end of 20 sessions (b).
Figure 3
Figure 3
Enterocutaneous fistula with active draining at the beginning of hyperbaric oxygen therapy (a). After 30 sessions, closure of the fistula tract was observed (b).
See this image and copyright information in PMC

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