Abstract

Hyperbaric Oxygen Therapy in Chronic Inflammatory Conditions of the Pouch

Inflamm Bowel Dis. 2021 Jun 15;27(7):965-970. doi: 10.1093/ibd/izaa245.

Badar Hasan 1, Yunjoo Yim 1, Mamoon Ur Rashid 2, Rumman A Khalid 1, Deepika Sarvepalli 2, Daniel Castaneda 1, Asad Ur Rahman 1, Nicole Palekar 1, Roger Charles 1, Fernando J Castro 1, Bo Shen 3

 
     

Author information

1Department of Gastroenterology, Cleveland Clinic Florida, Weston, FL, USA.

2Department of Internal Medicine, AdventHealth, Orlando, FL, USA.

3Inflammatory Bowel Disease Center, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, NY, USA.

Abstract

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.

© Copyright 2013-2022 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.