Updated: Oct 25
Corticosteroids, anti-inflammatories, and immunomodulators are the standard treatments for irritable bowel disease (IBD), which includes Crohn's disease and ulcerative colitis. Unfortunately, these treatments rarely permanently alleviate problems.
But scientists have come to the conclusion that HBOT, when combined with steroids, led to higher rates of response and remission. Additionally, HBOT slowed the rate of progression to more serious levels. We will discuss how HBOT works with IBD, what IBD is, and finally present the research findings on why HBOT is effective for those with Irritable Bowel Disease.
How HBOT works with IBD
Hyperbaric oxygen therapy (HBOT) has traditionally been used to treat a number of illnesses, such as decompression sickness and the healing of problematic wounds. HBOT has, however, been utilized by certain researchers to treat IBD, including Crohn's disease and ulcerative colitis.
HBOT involves inhaling 100% oxygen at greater than one atmosphere absolute (ATA) in a pressurized chamber. HBOT has been shown to increase the oxygen content of plasma and body tissues and may normalize oxygen levels in ischemic tissues. Recently, evidence has accumulated that HBOT also has potent anti-inflammatory effects, which is why HBOT is effective for those with Irritable Bowel Disease.
What is Irritable Bowel Disease (IBD)?
IBD, which encompasses Crohn's disease and ulcerative colitis, is a chronic inflammatory illness of the gastrointestinal (GI) tract marked by recurring, chronic ulcerations. Severe GI symptoms such as diarrhea, bleeding, abdominal discomfort, weight loss, and anemia are frequently present with IBD. IBD symptoms can come and go, with periods of symptom severity and others where they may be barely noticeable. Intestinal nitric oxide (NO) levels are also increased in some patients with IBD which may lead to increased intestinal tissue injury. Oxidative stress and mitochondrial dysfunction are also found in some patients with IBD. So how is Hyperbaric Oxygen Therapy is effective for those with Irritable Bowel Disease?
There have been a few recent literature reviews in the last decade, one by Rossignol in 2012, one by Alenazi et al. in 2021, and one by Dulai et al. in 2014 to establish the rate of response of IBD patients to treatment with hyperbaric oxygen therapy (HBOT).
"The findings from the review have suggested that hyperbaric therapy can be an effective adjunctive approach for IBD" (Alenazi et. al, 2021).
In the Rossignol review published in 2012, he identified 19 studies to include in his review, out of 466 publications identified:
In 13 studies on the use of HBOT on Crohn’s disease,
31/40 patients, or 78%, showed improvement.
In 6 studies on the use of HBOT on ulcerative colitis,
39/39 patients, or 100%, showed improvement.
In all of these studies, patients had severe (IBD) that was not responsive to standard medical treatment. These findings were supported by Dulai et al. as well in 2014. They conducted a review using17 studies to use in their analysis and outcomes. Out of 42 patients with Crohn’s disease in these studies:
18/40, or 43%, were completely healed, with perineal and/or fistulizing Crohn’s
17/40, or 41%, showed partial healing,
5/40 were unresponsive
2/40 did not finish treatment
88% showed a positive overall response
Out of 42 patients with ulcerative colitis in these studies:
39/39 patients improved, which was a 100% overall response rate!
Since it addresses both tissue hypoxia and inflammation, hyperbaric oxygen therapy presents a promising new therapeutic alternative. Since HBOT operates on several levels, including reducing inflammatory gene expression, repairing microscopic blood vessels and tissues, as well as antimicrobial actions, many of the mechanisms underlying the improvement are not well understood.
HBOT is a largely risk-free treatment. Of course, further research is necessary to fully comprehend the advantages of HBOT. However, HBOT should be seriously taken into consideration as an adjuvant treatment for IBD considering the severity of IBD and its effects on the patient's employment and family life. We find that Hyperbaric Oxygen Therapy is effective for those with Irritable Bowel Disease. Contact us today for more information, or to book your first session today.
Dulai, P. S., Gleeson, M. W., Taylor, D., Holubar, S. D., Buckey, J. C., & Siegel, C. A. (2014). Systematic review: the safety and efficacy of hyperbaric oxygen therapy for inflammatory bowel disease. Alimentary pharmacology & therapeutics, 39(11), 1266-1275.