Crohn's Disease And Hyperbaric Oxygen Chambers

Crohn's disease or also known as granulomtous colitis and regional enteritis is an inflammatory disease of the digestive system. The disease affects any part of the gastrointestinal tract from mouth to anus. Because of this, the symptoms of Crohn's disease can vary considerably among the afflicted individuals. The main gastrointestinal symptoms of Crohn's disease are crampy abdominal pain, vomiting, diarrhea, loss of appetite and weight loss. The disease can also cause complications outside the gastrointestinal tract such as having skin rashes, arthritis and inflammation of the eye.

As scary and painful it may seem at having Crohn's disease, all is not hopeless. Studies have already been released that with the combination of conventional medicines and hyperbaric oxygen chamber treatment(HBOT) the disease and its symptoms can be relieved.

While a patient is undergoing treatment, they are placed in a hyperbaric chamber where a minimum of 24% oxygen is circulated, and an even higher percentage when an oxygen mask is used.. The oxygen in the chamber is pressurized so that air may be several times greater than normal. This process allows the the skin and lungs to absorb more concentrated oxygen in a short period of time.

In Crohn's disease, HBOT limits the amount of the inflammation in the gastrointestinal tract, lowers sedimentation values, and also lowers the CRP and WBC values. The pain is alleviated, the afflicted patients weight and appetite improves and bowel movements return to normal. Although further study is to be made in order to understand HBOT's mechanism. It should be considered as part of the treatment of the disease especially in cases where conventional treatments have failed.

It was also discovered in their trial studies that when HBOT treatment failed it was due to the reasons that HBOT was used at the later stages of the disease and for a long time before the hyperbaric oxygenation the hormonotherapy was used.


HYPERBARIC OXYGEN THERAPY AND CROHN’S DISEASE

Johnson KE,1 Hoggard ML1 and Shirachi DY1, 2 1Chico Hyperbaric Center, Chico, CA 95926, USA and 2Department of Physiology and Pharmacology, T. J. Long School of Pharmacy, University of the Pacific, Stockton, CA 95211.

INTRODUCTION:

Crohn’s disease is marked by an abnormal immune response that results in a chronic recurrent inflammation of the intestinal lining. To date there is no effective curative treatment and relapses are frequent. It had been reported in the literature that hyperbaric oxygen (HBO) was effective in treating Crohn’s disease, which was severe or was refractory to treatment (1).

A 50 year old male patient diagnosed with Crohn’s disease was referred to our Center by his gastroenterologist after he became refractory to different treatments, including infliximab, a TNF-α antagonist. In addition the patient previously had undergone a J pouch procedure. We now report on the effect of HBO therapy in this patient.

METHODS:

The patient underwent a physical examination and was cleared for HBO therapy by the Medical Director of our Center who is board certified in Hyperbaric Medicine and in Family Practice. The infliximab therapy previously prescribed was discontinued 8 weeks prior to the HBO treatment. The patient received 42 treatments at 2.5 ATA for 90 minutes. All protocols were followed according to the Declaration of Helsinki and the patient signed an informed consent form detailing the treatment plan, possible risks of HBO and his patient rights. Photomicrographs were taken to determine the state of his clinical condition before and after HBO treatment via video colonoscope.

RESULTS:

Endoscopic Photomicrograph Pre-HBO Therapy Endoscopic Photomicrograph Post-HBO Therapy

DISCUSSION:

The gastroenterologist report stated that there was a significant improvement over the pre-HBO examination, as evidenced by the photomicrographs shown. In addition the patient reported that the pain and discomfort was reduced and he was eating a normal diet and had returned to work. This improvement is at least partially due to a decrease in inflammatory cytokines, TNF-α, IL-1, and IL-6, probably due to the anti-inflammatory effect of HBO (2).

CONCLUSION:

The results of this study suggests that HBO therapy could be an effective adjunctive treatment for Crohn’s disease but verification would require long-term follow up and study.

    REFERENCES:
  1. Noyer CM and Brandt LJ. Hyperbaric oxygen therapy for perineal Crohn’s Disease. Am J Gastroenterol.1999;94:318-21.
  2. Weisz G, Lavy A, Adir Y, Melamed Y, Rubin D, Eidelman S, and Pollack S. Modification of in vivo and in vitro TNF-α, IL-1, and IL-6 secretion by circulating monocytes during hyperbaric oxygen treatment in patients with perianal Crohn’s Disease. J Clin Immunol. 1997;17(2):154-59.