Ulcerative colitis and Crohn’s 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 diarrhea 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 year 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
metronidazole, 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 parallel 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 in duration 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 included 35 sessions of
electrical 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 stimulation provided an effective treatment for severe
perianal ulcerative colitis.
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