RESUMEN
BACKGROUND AND AIMS: Patients may experience complications of Crohn's disease (CD) even when treated with optimal medical therapy strategies. Previous data have shown the efficacy of hyperbaric oxygen therapy (HBOT) in the management of complicated CD. However, there is no consensus regarding the optimal number of sessions or duration of treatment regimens. The aim of the present study was to investigate the efficacy of HBOT in CD patients who were refractory to conventional medical management. METHODS: This study included patients who underwent HBOT for the treatment of the following complications: perianal fistulizing Crohn's disease (pCD), enterocutaneous fistulas (ECF), or pyoderma gangrenosum (PG). Complete healing was defined as the closure of external orifice and the absence of active draining (in pCD), complete wound healing (in PG), and granulation or complete wound epithelialization with no enteric draining (in ECF). The persistence of draining and the absence of wound granulation were defined as incomplete healing. RESULTS: Forty patients were included. The mean CD duration was 10.6 ± 5.8 years. pCD comprised most of the included patients (25/62.5%), followed by ECF (n = 13/32.5%) and PG (n = 6/15%). In two patients (5%), a combination of ECF and PG was diagnosed, and in one patient (2.5%), all three complications were observed. A total of 32 patients (82.5%) had complete healing. Patients with PG had the highest healing rates (100%), followed by those with ECF (84.6%) and pCD (80%). CONCLUSIONS: Adjunctive HBO was associated with significant healing rates for CD-associated complications such as pCD, ECF, and PG.
RESUMEN
PURPOSE: Evaluate the application of Hyperbaric Oxygen Therapy (HBO) in patients with Crohn's disease (CD) refractory to pharmacologic therapy, who developed abdominal, anorectal or skin complications. METHODS: Fourteen selected patients with refractory CD and treated at the School of Medicine of Ribeirao Preto, University of Sao Paulo (FMRP-USP) and at the Center of Hyperbaric Medicine, São Paulo Hospital (CEMEHI) were submitted to HBO. RESULTS: Of the 14 patients evaluated, 11 had a satisfactory response. CONCLUSION: HBO has shown benefits in patients with CD refractory to pharmacologic therapy.
Asunto(s)
Enfermedad de Crohn/terapia , Oxigenoterapia Hiperbárica/métodos , Adulto , Terapia Combinada , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
PURPOSE: Evaluate the application of Hyperbaric Oxygen Therapy (HBO) in patients with Crohn's disease (CD) refractory to pharmacologic therapy, who developed abdominal, anorectal or skin complications. METHODS: Fourteen selected patients with refractory CD and treated at the School of Medicine of Ribeirao Preto, University of Sao Paulo (FMRP-USP) and at the Center of Hyperbaric Medicine, São Paulo Hospital (CEMEHI) were submitted to HBO. RESULTS: Of the 14 patients evaluated, 11 had a satisfactory response. CONCLUSION: HBO has shown benefits in patients with CD refractory to pharmacologic therapy.
OBJETIVOS: Avaliar a aplicação da Oxigenoterapia Hiperbárica (HBO) nos pacientes com doença de Crohn (CD), refratários a terapia farmacológica, que evoluíram com complicações abdominais, orificiais ou dermatológicas. MÉTODOS: Catorze pacientes selecionados no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo e no Centro de Medicina Hiperbárica do Hospital São Paulo de Ribeirão Preto eram portadores de Doença de Crohn refratária ao tratamento farmacológico e foram submetidos a sessões de HBO. RESULTADOS: Dos 14 pacientes avaliados, 11 apresentaram resposta satisfatória. CONCLUSÃO: A HBO tem demonstrado benefício nos pacientes com Doença de Crohn refratários ao tratamento farmacológico.