Irritable bowel disease (IBD), including Crohn’s disease and ulcerative colitis, are traditionally treated with corticosteroids, anti-inflammatories and immunomodulators. Unfortunately, these treatments seldom eliminate symptoms long-term.
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However, researchers in a recent study concluded that HBOT, along with steroids, resulted in higher rates of response and remission. HBOT also reduced rates of progression to more severe levels
IBD causes serious complications. Patients often have abdominal pain, fever, weight loss, mucosal inflammation and diarrhea. Sadly, IBD patients frequently fail other treatments. The Siegel Study Description of 2018 highlighted that nearly 25% of severe acute episode Ulcerative Colitis patients are hospitalized. Of these, 30% will undergo surgery. Of these 25% will experience post-operative complications. Thus, it’s a serious issue for which patients need alternative healing regimens.
In a multi-center, 2017 study by Dulai et al., patients who were hospitalized for moderate to severe flareups of UC were placed in a double blind randomized study. There were a total of 18 patients treated, (10 HBOT, 8 sham treatments), in several medical centers including UC San Diego, Mayo Clinic, Dartmouth Hitchcock Medical Center and the University of Pittsburgh Medical Center. The patients were treated either with steroids and HBOT or steroids and a sham HBOT treatment. After 10 days of daily treatments, the HBOT group had a response of 80% vs. 25% for the sham group, and remission of 50% for the HBOT group vs. 0% for the sham group. Response to HBOT was seen in some patients as early as the third day of treatment.
The researchers concluded that HBOT, along with steroids, resulted in higher rates of response and remission as well as a reduction in rates of colectomy surgeries (0% HBOT vs. 38% sham). It also resulted in reduced rates of progression on to anti-TNF therapy for hospitalized patients with moderate to severe flares. For patients with UC, and especially those who have been hospitalized, HBOT should clearly be considered.
There have been two recent literature reviews in the last decade, one by Rossignol in 2012 and one by Dulai et al. in 2014 to quantify the rate of response of IBD patients to treatment with hyperbaric oxygen therapy (HBOT).
In the Rossignol review published in 2012,This is the content of my tooltip! he identified 19 studies to include in his review, out of 466 publications identified:
In 13 studies on the use of HBOT on Crohn’s disease,
- 31/40 patients, or 78%, showed improvement.
In 6 studies on the use of HBOT on ulcerative colitis,
- 39/39 patients, or 100%, showed improvement.
In all of these studies, patients had severe (IBD) that was not responsive to standard medical treatment.
Dulai et al.  conducted a review in 2014 that identified 17 studies to use in their analysis and outcomes:
Out of 42 patients with Crohn’s disease in these studies:
- 18/40, or 43%, were completely healed, with perineal and/or fistulising Crohn’s
- 17/40, or 41%, showed partial healing,
- 5/40 were unresponsive
- 2/40 did not finish treatment
- 88% showed a positive overall response
Out of 42 patients with ulcerative colitis in these studies:
- 39/39 patients improved, which was a 100% overall response rate!
Hyperbaric oxygen therapy offers a promising new treatment option since it targets both tissue hypoxia and inflammation. Many of the mechanisms underlying the improvement are not really known partially because HBOT works on many levels including suppressing inflammatory gene expression, rebuilding microscopic blood vessels and tissues as well as antibacterial mechanisms.
Chronic inflammatory bowel disease is often difficult to treat and the two systematic reviews cited show impressive responses.
HBOT is a relatively safe treatment. Of course, we need more studies to understand the true benefits of HBOT. But given the severity of IBD and its impact on the patient’s work and family life, HBOT should be seriously considered as an adjunctive treatment for IBD.
Hyperbaric oxygen treatment for inflammatory bowel disease: a systematic review and analysis (Rossignol Medical Gas Research 2012)
Traditionally, hyperbaric oxygen treatment (HBOT) has been used to treat a limited repertoire of disease, including decompression sickness and healing of problem wounds.
Systematic review: the safety and efficacy of hyperbaric oxygen ther-apy for imflammatory bowel disease (By Dulai et al.)
Hyperbaric oxygen therapy (HBOT) provides 100% oxygen under pressure, which increases tissue oxygen levels, relieves hypoxia and alters inflammatory pathways.
Hyperbaric Oxygen Therapy is Safe and Effective for Hospitalized Ul-cerative Colitis Patients Suffering from Moderate-Severe Flares: A Multi-Center, Randomized, Double-Blind, Sham-Controlled Trial (Dulai et al., April 2017)
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