Crohn's Disease & Ulcerative Colitis

Non-specific Ulcerative Colitis and Crohn's Disease are difficult chronic inflammatory bowel diseases. Their treatment can often be frustrating for both the physician and the patient.

The most common early symptoms are chronic diarrhea, crampy abdominal pain, fever, loss of appetite, and weight loss. A doctor may feel a lump or fullness in the lower part of the abdomen, most often on the right side.

Common complications of inflammation include the development of an intestinal obstruction

abnormal connecting channels (fistulae), and pus-filled pockets of infection (abscesses). Pistulas may develop that connect two different parts of the intestine. Fistulas also may connect the intestine and bladder or the intestine and the skin surface, especially around the anus. When the large intestine is affected by Crohn's disease, rectal bleeding commonly occurs.

Crohn's disease is associated with certain disorders affecting other parts of the body such as gallstones and inadequate absorption of nutrients. When Crohn's disease causes a flare-up of gastrointestinal symptoms, the person may also experience inflammation of the joints (arthritis).

Under chronic inflammation there are microcirculation disorders in bowel mucosa, hypoxia (lack of oxygen) and changes in catecholamine and other metabolisms.

These factors are the reason to use HBO combined with conventional medical management in the treatment of this disease where medication alone has not relieved symptoms to a satisfactory degree.

HBO limits the amount of inflammation in the bowels, lowers the CRP values, lowers Sedimentation values and lowers the WBC values. The pain is alleviated, the patients weight improves, and bowel movements return almost to normal. Although the mechanism is not clearly understood, HBO should be considered in treatment of Crohn's Disease not responding to conventional treatments.

When failure of HBO treatment occurred in trial studies it became quite clear as to the two reasons for the failures:

HBO was used at the late stages of the disease.
For a long time before the hyperbaric oxygenation the hormonotherapy was used.

In the study published in Proceeding of the Tenth International Congress on Hyperbaric Medicine the remission of patients treated with HBO prolonged until 4-5 years in 49% of the cases, the improvement was noted in 37%. Later none of the patients treated with HBO needed operative intervention as compared with the patients treated only with drugs. The considerable improvement induced by HBO treatments allowed some patients to receive lower doses of drugs and in most cases to cease the hormonotherapy.

Brady CE et al. healing of severe perineal and cutaneous Crohn's disease with hyperbaric oxygenation. Gastronenterology 1989;97:756-60.

Nelson EW, et all. Closure of refractory perineal Crohn's lesion; integration of hyperbaric oxygenation into case management. Digestive Diseases and Sciences 1990;35:1561-1565.

Brady CE et al. healing of severe perineal and cutaneous Crohn's disease with hyperbaric oxygenation. Gastroenterology 1989;97:756-60.

Gastroenterology 1098 Sep;97(3):756-60. Healing of severe perineal and cutaneous Crohn's disease with hyperbaric oxygen. Brady CE 3d, Cooley BJ, Davis JC Division of Gastroenterology, University of Texas Health Science Centre, San Antonio.

Nelson EW, et al. Closure of refractory perineal Crohn's lesion; integration of hyperbaric oxygenation into case management. Digestive Diseases and Sciences 2990;35:1561-1565.

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