The effects of hyperbaric treatment on perianal fistula activity in patients with Crohn’s disease

Introduction:
Crohn’s disease is a chronic, complex inflammatory disorder of the gastrointestinal tract. Among its most challenging complications are perianal fistulas.

Aim:
This study aims to explore the efficacy of hyperbaric oxygen therapy (HBOT) in reducing the activity of perianal fistulas in Crohn’s disease patients.

Material and methods:
This study enrolled patients diagnosed with Crohn’s disease-associated perianal fistulas, with a disease duration of at least 3 years. Participants underwent HBOT in conjunction with standard medical therapy. The therapeutic effects were assessed at predetermined intervals using the Crohn’s Disease Activity Index (CDAI), and laboratory parameters including faecal calprotectin levels, C-reactive protein (CRP) activity, serum iron concentration, and peripheral blood haemoglobin levels. Additionally, the Simple Endoscopic Score for Crohn’s Disease (SESCD) and the Perianal Disease Activity Index (PDAI) were employed for evaluation.

Results:
The adjunctive use of HBOT with conventional therapy yielded significant clinical improvements in patients with Crohn’s disease complicated by perianal fistulas. This was shown by an 81.8% improvement in CDAI scores and a 54.5% clinical remission rate, as determined by SESCD and PDAI. Notably, the beneficial effects of HBOT on SESCD, PDAI, and faecal calprotectin levels were statistically significant and persisted for 6 weeks post-HBOT, with sustained improvements observed in a follow-up assessment approximately 9 months after treatment.

Conclusions:
The findings of this study suggest that HBOT may be a viable therapeutic adjunct in the management of complex cases of Crohn’s disease, particularly those with recurrent symptoms and limited responsiveness to conventional treatments. HBOT demonstrated potential in improving clinical outcomes and achieving remission rates exceeding 50%, indicating its promise as a treatment modality in this patient population.