Zastosowanie tlenoterapii hiperbarycznej w leczeniu przetok okołoodbytniczych w chorobie Leśniowskiego i Crohna
Słowa kluczowe:
Choroba Leśniowskiego-Crohna, tlenoterapia hiperbaryczna, przetoki okołoodbytnicze, nieswoiste choroby zapalne jelit, alternatywne metody leczenia, leczenie ranStreszczenie
Choroba Leśniowskiego i Crohna to przewlekłe schorzenie, prawdopodobnie o podłożu autoimmunologicznym, charakteryzujące się występowaniem odcinkowego zapalenia, mogącego obejmować dowolny odcinek przewodu pokarmowego - od jamy ustnej po odbyt. Proces zapalny stopniowo zajmuje wszystkie warstwy ścian jelita, co prowadzi do powstania poważnych powikłań, m.in. przetok okołoodbytniczych. Pojawienie się tego rodzaju komplikacji znacząco wpływa na obniżenie jakości życia pacjentów. Dotychczasowe metody leczenia, takie jak terapia farmakologiczna czy interwencje chirurgiczne nie zawsze przynoszą zadowalające rezultaty. Nową, obiecującą formą terapii jest leczenie z wykorzystaniem tlenu hiperbarycznego, które może stanowić przełom w poprawie komfortu życia osób z przetokami. Celem niniejszej pracy jest analiza potencjalnych korzyści wynikających z zastosowania terapii tlenem hiperbarycznym w leczeniu przetok okołoodbytniczych.
Bibliografia
Devi J, Ballard DH, Aswani-Omprakash T, Parian AM, Deepak P. Perianal fistulizing Crohn’s disease: Current perspectives on diagnosis, monitoring and management with a focus on emerging therapies. Indian Journal of Gastroenterology. 2024;43(1):48-63. doi:https://doi.org/10.1007/s12664-024-01524-2
Parks AG, Gordon PH, Hardcastle JD. A classification of fistula-in-ano. The British Journal of Surgery. 1976;63(1):1-12. doi:https://doi.org/10.1002/bjs.1800630102
Sandborn WJ, Fazio VW, Feagan BG, Hanauer SB. AGA technical review on perianal Crohn’s disease. Gastroenterology. 2003;125(5):1508-1530. doi:https://doi.org/10.1016/j.gastro.2003.08.025
Singh A, Midha V, Kochhar GS, Shen B, Sood A. Management of Perianal Fistulizing Crohn’s Disease. Inflammatory Bowel Diseases. Published online September 6, 2023:izad195. doi:https://doi.org/10.1093/ibd/izad195
Brady CE, Cooley BJ, Davis JC. Healing of severe perineal and cutaneous Crohn’s disease with hyperbaric oxygen. Gastroenterology. 1989;97(3):756-760. doi:https://doi.org/10.1016/0016-5085(89)90649-5
Andrzej Szczeklik, Piotr Gajewski, Wydawnictwo Medycyna Praktyczna. Interna Szczeklika 2024. Medycyna Praktyczna; 2024.
Tsai L, McCurdy JD, Ma C, Jairath V, Singh S. Epidemiology and Natural History of Perianal Crohn’s Disease: A Systematic Review and Meta-Analysis of Population-Based Cohorts. Inflammatory Bowel Diseases. Published online November 18, 2021. doi:https://doi.org/10.1093/ibd/izab287
Bertin L, Crepaldi M, Miriana Zanconato, et al. Refractory Crohn’s Disease: Perspectives, Unmet Needs and Innovations. Clinical and Experimental Gastroenterology. 2024;Volume 17:261-315. doi:https://doi.org/10.2147/ceg.s434014
Takano S, Nakamura Y, Tamaoka K, Yoshimoto T, Irei Y, Tsuji Y. Management of Anal Fistula with Crohn’s Disease. Journal of the Anus, Rectum and Colon. 2025;9(1):10-19. doi:https://doi.org/10.23922/jarc.2024-067
Panés J, Rimola J. Perianal fistulizing Crohn’s disease: pathogenesis, diagnosis and therapy. Nature Reviews Gastroenterology & Hepatology. 2017;14(11):652-664. doi:https://doi.org/10.1038/nrgastro.2017.104
Marley Ribeiro Feitosa, Rogério Serafim Parra, José João Mendes, et al. Adjunctive Hyperbaric Oxygen Therapy in Refractory Crohn’s Disease: an Observational Study. Gastroenterol Res Pract. 2021;2021:1-8. doi:https://doi.org/10.1155/2021/6628142
Petronio L, Buono AD, Gabbiadini R, et al. Drug Development in Inflammatory Bowel Diseases: What Is Next? Pharmaceuticals. 2025;18(2):190-190. doi:https://doi.org/10.3390/ph18020190
Krstulović J, Augustin G, Romić I, Tavra A, Batinović F, Hrgović Z. Hyperbaric Oxygen Therapy in the Treatment of Crohn’s Disease. Healthcare. 2025;13(2):128. doi:https://doi.org/10.3390/healthcare13020128
Catalán-Serra I, Ricanek P, Grimstad T. "Out of the box new therapeutic strategies for Crohn's disease: moving beyond biologics. Revista Española de Enfermedades Digestivas. Published online 2022. doi:https://doi.org/10.17235/reed.2022.9010/2022
DuBose KJ, Cooper JS. Hyperbaric Patient Selection. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK499820/
Nakutis FS, Iêda Nishitokukado, Maria, et al. Evaluation of oxidative stress in an experimental model of Crohn’s disease treated with hyperbaric oxygen therapy. Clinics. 2023;78:100305-100305. doi:https://doi.org/10.1016/j.clinsp.2023.100305
Agrawal G, Borody T, Turner R, Leis S, Campbell J. Combining infliximab, anti-MAP and hyperbaric oxygen therapy for resistant fistulizing Crohn’s disease. Future Science OA. 2015;1(4). doi:https://doi.org/10.4155/fso.15.77
Wang X, Shen B. Advances in Perianal Disease Associated with Crohn’s Disease-Evolving Approaches. Gastrointestinal Endoscopy Clinics of North America. 2019;29(3):515-530. doi:https://doi.org/10.1016/j.giec.2019.02.011
Rossignol DA. Hyperbaric oxygen treatment for inflammatory bowel disease: a systematic review and analysis. Medical Gas Research. 2012;2(1):6. doi:https://doi.org/10.1186/2045-9912-2-6
Mintz MJ, Lukin DJ. Mycobacterium avium subspecies paratuberculosis (MAP) and Crohn’s disease: the debate continues. Translational gastroenterology and hepatology. 2023;8:28-28. doi:https://doi.org/10.21037/tgh-23-16
Wang Z, Wu X, Liang TY, Chen G. The role of hyperbaric oxygen therapy in inflammatory bowel disease: a narrative review. Medical Gas Research. 2021;11(2):66. doi:https://doi.org/10.4103/2045-9912.311497
Chen L, Wang Y, Zhou H, Liang Y, Zhu F, Zhou G. The new insights of hyperbaric oxygen therapy: focus on inflammatory bowel disease. Precision Clinical Medicine. 2024;7(1). doi:https://doi.org/10.1093/pcmedi/pbae001
Lavy A, Weisz G, Adir Y, Ramon Y, Melamed Y, Eidelman S. Hyperbaric Oxygen for Perianal Crohn???s Disease. Journal of Clinical Gastroenterology. 1994;19(3):202-205. doi:https://doi.org/10.1097/00004836-199410000-00006
Colombel JF, Mathieu D, Bouault JM, et al. Hyperbaric oxygenation in severe perineal Crohn’s disease. Diseases of the Colon and Rectum. 1995;38(6):609-614. doi:https://doi.org/10.1007/BF02054120
Weisz G, Lavy A, Adir Y, et al. Modification of in Vivo and in Vitro TNF-alpha, IL-1, and IL-6 Secretion by Circulating Monocytes during Hyperbaric Oxygen Treatment in Patients with Perianal Crohn’s disease. Journal of Clinical Immunology. 1997;17(2):154-159. doi:https://doi.org/10.1023/a:1027378532003
Iezzi LE, Feitosa MR, Medeiros BA, et al. Crohn’s disease and hyperbaric oxygen therapy. Acta Cirurgica Brasileira. 2011;26(suppl 2):129-132. doi:https://doi.org/10.1590/s0102-86502011000800024
Feitosa MR, Féres Filho O, Tamaki CM, et al. Adjunctive Hyperbaric Oxygen Therapy promotes successful healing in patients with refractory Crohn’s disease. Acta Cirurgica Brasileira. 2016;31(suppl 1):19-23. doi:https://doi.org/10.1590/s0102-86502016001300005
Lansdorp CA, Buskens CJ, Gecse KB, et al. Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients with Crohn’s disease: Results of the HOT‐TOPIC trial after 1‐year follow‐up. United European Gastroenterology Journal. 2022;10(2):160-168. doi:https://doi.org/10.1002/ueg2.12189
Fahad H, Dulai PS, Shen B, Kochhar GS. Hyperbaric Oxygen Therapy is Effective in the Treatment of Inflammatory and Fistulizing Pouch Complications. Clinical Gastroenterology and Hepatology. Published online June 2020. doi:https://doi.org/10.1016/j.cgh.2020.06.029
Hasan B, Yim Y, Ur Rashid M, et al. Hyperbaric Oxygen Therapy in Chronic Inflammatory Conditions of the Pouch. Inflammatory Bowel Diseases. 2020;27(7):965-970. doi:https://doi.org/10.1093/ibd/izaa245
Lansdorp CA, Gecse KB, Buskens CJ, et al. Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients with Crohn’s disease. Alimentary Pharmacology & Therapeutics. Published online December 16, 2020. doi:https://doi.org/10.1111/apt.16228
McCurdy J, Siw KCK, Kandel R, Larrigan S, Rosenfeld G, Boet S. The Effectiveness and Safety of Hyperbaric Oxygen Therapy in Various Phenotypes of Inflammatory Bowel Disease: Systematic Review With Meta-analysis. Inflammatory Bowel Diseases. Published online May 18, 2021. doi:https://doi.org/10.1093/ibd/izab098
Dokmak A, Sweigart B, Orekondy NS, et al. Efficacy and Safety of Hyperbaric Oxygen Therapy in Fistulizing Crohn’s Disease. Journal of Clinical Gastroenterology. 2023;58(2):120-130. doi:https://doi.org/10.1097/mcg.0000000000001905
You J, Jiang J, He W, et al. Addition of hyperbaric oxygen therapy versus usual care alone for inflammatory bowel disease: A systematic review and meta-analysis. Heliyon. 2022;8(10):e11007-e11007. doi:https://doi.org/10.1016/j.heliyon.2022.e11007
Jokinen-Gordon H, Barry RC, Watson B, Covington DS. A Retrospective Analysis of Adverse Events in Hyperbaric Oxygen Therapy (2012-2015): Lessons Learned From 1.5 Million Treatments. Advances in Skin & Wound Care. 2017;30(3):125-129. doi:https://doi.org/10.1097/01.asw.0000508712.86959.c9
Kaur H, Kochhar GS, Dulai PS. Role of hyperbaric oxygen therapy in patients with inflammatory bowel disease. Current Opinion in Gastroenterology. 2023;39(4):263-267. doi:https://doi.org/10.1097/mog.0000000000000952
Lee K, Tu V, Faye A. Optimal Management of Refractory Crohn’s Disease: Current Landscape and Future Direction. Clinical and experimental gastroenterology. 2024;Volume 17:75-86. doi:https://doi.org/10.2147/ceg.s359376
Piotrowicz G, Kot J, Babicki A, et al. The effects of hyperbaric treatment on perianal fistula activity in patients with Crohn’s disease. Gastroenterology Review. 2024;19(3):321-332. doi:https://doi.org/10.5114/pg.2024.143439
Dulai PS, Gleeson MW, Taylor D, Holubar SD, Buckey JC, Siegel CA. Systematic review: the Safety and Efficacy of Hyperbaric Oxygen Therapy for Inflammatory Bowel Disease. Alimentary Pharmacology and Therapeutic. 2014;39(11):1266-1275. doi:https://doi.org/10.1111/apt.12753
Kante B, Sahu P, Kedia S, et al. Efficacy and tolerability of hyperbaric oxygen therapy in small bowel stricturing Crohn’s disease: a pilot study. Intestinal research. 2022;20(2):231-239. doi:https://doi.org/10.5217/ir.2021.00056
Opublikowane
24 sierpnia 2025
Prawa autorskie (c) 2025 Kacper Jaros, Kaja Hanys, Kamila Wawrzyniak, Martyna Szymańska
Licencja
Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Użycie niekomercyjne – Bez utworów zależnych 4.0 Międzynarodowe.
