What is the role of hyperbaric oxygen therapy (HBOT) in the treatment of ulcerative colitis and Crohn disease?

Updated: Nov 16, 2020
  • Author: Emi Latham, MD, FACEP, FAAEM, UHM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

Ulcerative colitis (UC) and Crohn disease (CD) are chronic diseases characterized by chronic mucosal ulcers. UC/CD exacerbations exhibit an increased frequency of bowel motions with or without lower gastrointestinal bleeding. These manifestations are reversed by induction of mucosal healing and subsiding inflammation. There are many treatment options and medications, but they do not work for all people. As a result of the chronic inflammation, mucosal hypoxia results.

The utility of HBOT to treat inflammatory bowel diseases did not receive attention until recently, and its use in gastrointestinal conditions is not yet well established. The UHMS does not currently list UC/CD as an approved indication, although it does acknowledge that HBOT can be beneficial. HBOT is thought to exert its effects by down-regulating the inflammatory process and improving tissue oxygenation. Typical treatments are once daily on a standard wound care treatment table, for 30-40 treatments.

The more recent case reports and series have suggested a decrease in remission rates and decreased need for colectomy in acute flares. [122] Another case study demonstrated improvement in clinic, endoscopic, and histopathologic parameters. [123] There are current multicenter studies ongoing to better characterize HBOT as a treatment for UC.


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