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Table 1 Studies of HBOT in Crohn's disease

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)

  1. NR not reported
  2. † contained patient(s) from a previous study