From: Hyperbaric oxygen treatment for inflammatory bowel disease: a systematic review and analysis
Author, year, country | Type of study | Number of patients improved/number treated | Location of Crohn's | HBOT parameters | Side effects | Comments/outcomes |
---|---|---|---|---|---|---|
Brady et al. 1989 [39], USA | Case report | 1/1 | Perineal, cutaneous | 2.4 ATA 100% oxygen; 6 days a week; 2 h sessions; 67 total sessions | Blurred vision, resolved | Crohn's disease was refractory to surgery and medical treatment (corticosteroids, sulfasalazine, metronidazole, and 6-mercaptopurine) for 8 years; complete and dramatic healing in 2.5 months with HBOT; patient needed additional HBOT over 11 months, then had lasting improvements |
Brady 1993 [40], USA | Letter to editor/case report | 1/1†| Perineal, cutaneous | Not reported, but presumably the same as previous report (Brady et al. 1989) [39] | NR | Update on patient from previous case report (Brady et al. 1989) [39]. Patient had two additional courses of HBOT (29 and 26 sessions) and was in remission for over 3 years at time of letter |
Colombel et al. 1995 [41], France | Prospective, uncontrolled | 6/10 | Perineal | 2.5 ATA 100% oxygen; 2 sessions per day; 5 sessions per week; 40 planned sessions over 4 weeks; 8 patients completed at least 30 treatments | 1 patient had bilateral ear drum perforation; another had psychological intolerance | All patients had severe Crohn's disease and had failed one or more standard medical treatments; 2 patients stopped treatments after a few sessions due to side effects; 6 of 8 fully treated patients had partial or complete healing |
Fraser and Niv 1995 [42], Israel | Prospective, uncontrolled | 6/6 | Perianal; ileocolonic | Equivalent to 1.05 ATA | NR | 6 patients with Crohn's disease unresponsive to standard medical treatments spent up to 3 weeks at the Dead Sea; significant healing noted in all 6 patients |
Iezzi et al. 2011 [43], Brazil | Prospective, uncontrolled | 11/14 | Perineal or cutaneous | 2.4 ATA; 2 h sessions; 1 session per day; 10-50 total sessions | NR | Patients had Crohn's disease refractory to standard medical treatments; 11 of 14 (79%) had "satisfactory improvement" (complete or partial improvement) with HBOT |
Jiang et al. 2000 [44], USA | Case report | 1/1 | ileocolonic | 2.5 ATA 100% oxygen; 90 min sessions; 28 day duration | NR | Patient had Crohn's disease and Fournier gangrene; good outcome with surgery, medication and HBOT |
Kiel et al. 2011 [45], Australia | Case report | 1/1 | Cecal | NR | NR | Patient had Crohn's disease and Clostridium septicum infection, treated with antibiotics and HBOT postoperatively with improvements noted |
Lavy et al. 1994 [10], Israel | Prospective, uncontrolled | 8/10 | Perianal | 2.5 ATA 100% oxygen; 90 min sessions; 6 times per week; 20 total treatments; HBOT could be repeated for total of 40 sessions | none | 10 patients with Crohn's disease refractory to standard medical treatments; improvement observed in 8 of 10 patients; 6 patients had complete healing |
Nelson et al. 1990 [46], USA | Case report | 1/1 | Perineal | 2.0-2.8 ATA; 90-120 min sessions; total of 62 sessions | NR | Patient had severe refractory Crohn's disease (failed sulfasalazine and corticosteroids), complete healing with HBOT; no reoccurrence in 24 months after HBOT |
Saglam et al. 2008 [47], Turkey | Prospective, uncontrolled | 14, 2 had Crohn's disease | NR | 2.5 ATA; 90 min sessions; 1 treatment per day | NR | Study measured flow-mediated vasodilation of brachial artery; clinical outcomes of HBOT on GI abnormalities in 2 patients with Crohn's disease not reported |
Sipahi et al. 1996 [48], Brazil | Case report | 1/1 | Perianal | 2.4 ATA; 90 min sessions; 7 times per week (1st 2 weeks) then 3 times per week; 45 total sessions over 3 months | NR | Complete healing of perianal Crohn's disease with HBOT and antibiotics |
Takeshima et al. 1999 [11], Japan | Case report, letter to editor | 1/1 | Colonic, rectal | 2.8 ATA 100% oxygen; 120 min sessions; 20 total sessions | NR | Patient had refractory Crohn's disease (failed prednisolone, sulfasalazine and elemental diet); complete healing of rectal ulcer (by endoscopic examination) with HBOT; clinical remission for 7 months at time of publication |
Weisz et al. 1997 [49], Israel | Prospective, controlled (10 healthy controls) | 5/7†[same patients as (Lavy et al. 1994)] [10] | Perianal | 2.5 ATA 100% oxygen; 90 min sessions; 20-40 total sessions | NR | Complete healing in 3 patients after 20 sessions and in 2 patients after 40 sessions; partial improvements observed in remaining 2 patients. Proinflammatory cytokines significantly decreased during HBOT (IL-1, p < 0.01; IL-6, p < 0.05; TNF-α, p < 0.05) |