Hyperbaric Oxygen for Ulcerative Colitis: Evidence Update

Sometimes a good small study is enough to merit serious attention, help prove a concept, and inspire others to expand the investigation.

The last and only time we reported on hyperbaric oxygen therapy (HBOT) for inflammatory bowel disease (IBD), the subject was a 2012 systematic review of the medical literature. IBD, or chronic inflammation of the digestive tract, includes Crohn's disease and ulcerative colitis. The author selected just 19 human studies for his analysis but showed promise for future research. Dozens of papers have been published since, and it's a pretty mixed bag.

Now comes an interesting little study on HBOT for ulcerative colitis. Including only 18 patients, but quite well designed, the randomized, double-blind, sham-controlled trial was conducted by gastroenterologists at Dartmouth, the Mayo Clinic, University of Pittsburgh, and University of California San Diego. They presented their findings at the 12th Congress of the European Crohn's and Colitis Organisation (ECCO) in February.

Follow this link to the Study Abstract. Then read this helpful Summary and Perspective, which closes with a caveat:

This trial had a very small sample size, and while it produced a suggestive signal of efficacy, more research is clearly needed to determine the optimal dose, how often the therapy should be administered, and how quickly it works. Hyperbaric oxygen therapy is also very expensive, so if it does work, it has to work well to be worth the high cost. 

Hear, hear. Still, clinicians who have have been following the research on hyperbaric oxygen in IBD may find this work newly encouraging. Its careful design, authorship by leading physicians at major academic centers, and presentation at a leading medical conference set it apart from the growing medical literature on this topic.

People living with these chronic diseases should understand these results mark the very first stages of human clinical trials. We will be waiting and watching for more evidence and trends in clinical practice in the months and years ahead. As we see more activity we may add inflammatory bowel disease, including Crohn's and ulcerative colitis, to our directory of diseases and conditions treated with hyperbaric oxygen therapy.

We think it is vitally important that patients and referring physicians get information about the state of clinical evidence, for both approved and off-label conditions, so they can jointly make the best healthcare decisions. Learn more about our Editorial Policy for selecting the information we publish on HyperbaricLink.

So Begins Another Heating and Carbon Monoxide Poisoning Season

In our local broadcast market the first story broke this week: Fumes send 4 to hospital. One man, in critical condition, "was rushed to the nearest hyperbaric chamber," very likely Advocate Lutheran General Hospital, "where the deadly gas will be forced out of his bloodstream under pressure."

All across America temperatures are dropping and buildings are firing up their furnaces. Every year at this time we send out our warning about carbon monoxide poisoning prevention and emergency preparedness. In three years on this beat we have not recorded any noticeable increase in the number of hyperbaric chambers with 24/7 emergency access, like the one at Lutheran General and at the University of Pittsburgh Medical Center, which so proudly promotes its on-call availability and location inside the emergency department. Now that's what we're talking about.

Someday there will be a round-the-clock chamber inside every ER from coast to coast. Until then, let's be careful in there. Install or check your CO detector today.

[Image: WGN-TV video capture]