Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients with Crohn’s disease

• Published in: Alimentary pharmacology & therapeutics 2021-03, Vol.53 (5), p.587-597
• Main Authors: Lansdorp, Corine A., Gecse, Krisztina B., Buskens, Christianne J., Löwenberg, Mark, Stoker, Jaap, Bemelman, Willem A., D’Haens, Geert R.A.M., Hulst, Rob A.
• Format: Article
• Language: English
• Subjects: Adult; Crohn Disease - complications; Crohn Disease - therapy; Crohn's disease; Drainage; Female; Fistula; Fistulae; Humans; Hyperbaric Oxygen for Perianal Crohn's Disease; Hyperbaric oxygen therapy; Hyperbaric Oxygenation; Male; Original Scientific Paper; Patients; Rectal Fistula - etiology; Rectal Fistula - therapy; Remission; Treatment Outcome
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/apt.16228

20 Crohn's disease patients with therapy‐refractory fistulas were treated with 40 sessions of hyperbaric oxygen therapy. At week 16 a significant improvement in clinical, radiological and biochemical outcomes was seen. Summary Background Positive effects of hyperbaric oxygen on perianal fistulas in Crohn's disease have been reported. Aim To assess efficacy, safety and feasibility of hyperbaric oxygen in Crohn's disease patients with therapy‐refractory perianal fistulas. Methods Twenty consecutive patients were recruited at the out‐patient fistula clinic of the Amsterdam UMC. Crohn's disease patients with high perianal fistula(s) failing conventional treatment for over 6 months were included. Exclusion criteria were presence of a stoma, rectovaginal fistula(s) and recent changes in treatment regimens. Patients received treatment with 40 hyperbaric oxygen sessions and outcome parameters were assessed at Week 16. Results Seven women and 13 men were included (median age 34 years). At Week 16, median scores of perianal disease activity index and modified van Assche index (co‐primary outcome parameters) decreased from 7.5 (95% CI 6‐9) to 4 (95% CI 3‐6, P