Dulai PS, Gleeson MW, Taylor D, Holubar SD, Buckey JC, Siegel CA, et al.
Alimentary pharmacology & therapeutics. Date of publication 2014 Jun 1;volume 39(11):1266-75.
1. Aliment Pharmacol Ther. 2014 Jun;39(11):1266-75. doi: 10.1111/apt.12753. Epub
2014 Apr 16.
Systematic review: The safety and efficacy of hyperbaric oxygen therapy for
inflammatory bowel disease.
Dulai PS(1), Gleeson MW, Taylor D, Holubar SD, Buckey JC, Siegel CA.
Author information:
(1)Inflammatory Bowel Disease Center, Dartmouth-Hitchcock Medical Center,
Lebanon, NH, USA; Center for Hyperbaric Medicine, Dartmouth-Hitchcock Medical
Center, Lebanon, NH, USA.
BACKGROUND: Hyperbaric oxygen therapy (HBOT) provides 100% oxygen under pressure,
which increases tissue oxygen levels, relieves hypoxia and alters inflammatory
pathways. Although there is experience using HBOT in Crohn's disease and
ulcerative colitis, the safety and overall efficacy of HBOT in inflammatory bowel
disease (IBD) is unknown.
AIM: To quantify the safety and efficacy of HBOT for Crohn's disease (CD) and
ulcerative colitis (UC). The rate of adverse events with HBOT for IBD was
compared to the expected rate of adverse events with HBOT.
METHODS: MEDLINE, EMBASE, Cochrane Collaboration and Web of Knowledge were
systematically searched using the PRISMA standards for systematic reviews.
Seventeen studies involving 613 patients (286 CD, 327 UC) were included.
RESULTS: The overall response rate was 86% (85% CD, 88% UC). The overall response
rate for perineal CD was 88% (18/40 complete healing, 17/40 partial healing). Of
the 40 UC patients with endoscopic follow-up reported, the overall response rate
to HBOT was 100%. During the 8924 treatments, there were a total of nine adverse
events, six of which were serious. The rate of adverse events with HBOT in IBD is
lower than that seen when utilising HBOT for other indications (P < 0.01). The
risk of bias across studies was high.
CONCLUSIONS: Hyperbaric oxygen therapy is a relatively safe and potentially
efficacious treatment option for IBD patients. To understand the true benefit of
HBOT in IBD, well-controlled, blinded, randomised trials are needed for both
Crohn's disease and ulcerative colitis.
© 2014 John Wiley & Sons Ltd.
DOI: 10.1111/apt.12753
PMID: 24738651 [Indexed for MEDLINE]
