Hasan B, Yim Y, Ur Rashid M, Khalid RA, Sarvepalli D, Castaneda D, Ur Rahman A, Palekar N, Charles R, Castro FJ, Shen B, et al.
Inflammatory bowel diseases. Date of publication 2021 Jun 15;volume 27(7):965-970.
1. Inflamm Bowel Dis. 2021 Jun 15;27(7):965-970. doi: 10.1093/ibd/izaa245.
Hyperbaric Oxygen Therapy in Chronic Inflammatory Conditions of the Pouch.
Hasan B(1), Yim Y(1), Ur Rashid M(2), Khalid RA(1), Sarvepalli D(2), Castaneda
D(1), Ur Rahman A(1), Palekar N(1), Charles R(1), Castro FJ(1), Shen B(3).
Author information:
(1)Department of Gastroenterology, Cleveland Clinic Florida, Weston, FL, USA.
(2)Department of Internal Medicine, AdventHealth, Orlando, FL, USA.
(3)Inflammatory Bowel Disease Center, Columbia University Irving Medical
Center-New York Presbyterian Hospital, New York, NY, USA.
BACKGROUND: Pouchitis can be a chronic complication of ileal pouch-anal
anastomosis. We aimed to determine the efficacy and safety of hyperbaric oxygen
therapy (HBOT) for chronic antibiotic-refractory pouchitis (CARP) and other
inflammatory conditions of the pouch.
METHODS: This was a retrospective case series of adults with inflammatory bowel
disease (IBD) who underwent ileal pouch-anal anastomosis and then developed CARP
and received HBOT between January 2015 and October 2019. A modified Pouchitis
Disease Activity Index (mPDAI) score was used to quantify subjective symptoms
(0-6) and endoscopic findings (0-6) before and after HBOT.
RESULTS: A total of 46 patients were included, with 23 (50.0%) being males with
a mean age of 43.6 ± 12.9 years. The median number of HBOT sessions was 30
(range 10-60). There was a significant reduction in the mean mPDAI symptom
subscore from 3.19 to 1.91 after HBOT (P < 0.05). The pre- and post-HBOT mean
mPDAI endoscopy subscores for the afferent limb were 2.31 ± 1.84 and 0.85 ± 1.28
(P = 0.006); for the pouch body, 2.34 ± 1.37 and 1.29 ± 1.38 (P < 0.001); and
for the cuff, 1.93 ± 1.11 and 0.63 ± 1.12 (P < 0.001), respectively. Transient
side effects included ear barotrauma in 5 patients (10.9%) and hyperbaric myopic
vision changes in 5 patients (10.9%).
CONCLUSIONS: Despite minor adverse events, HBOT was well tolerated in patients
with CARP and significantly improved symptoms and endoscopic parameters.
© 2020 Crohn’s & Colitis Foundation. Published by Oxford University Press. All
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DOI: 10.1093/ibd/izaa245
PMID: 32944766 [Indexed for MEDLINE]
