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fistula is a common complication of Crohn's disease, and about two-thirds of Crohn's patients have fistula at least once during the course of the disease.
spontaneous closure of fistula is rare and most patients require medical and/or surgical intervention.
the success rate of anti-tumor necrotics is about 40%.
, fistula does relapse within 2 years in up to 50% of patients.
use of interstate stem cells is a new treatment in some complex fistula cases.
recent study showed that injecting stem cells around fistula to close internal openings can cause clinical and radiological healing in 50 percent of patients by week 24.
hyperbaric oxygen therapy has been recommended as a potential complementary treatment for IBD patients.
hyperbaric oxygen therapy refers to breathing 100% of the oxygen at higher than normal atmospheric pressure: usually 202-253 kPascals (equivalent to 2.0-2.5 atmosphere).
study aims to assess the effectiveness, safety and feasibility of hyperbaric oxygen in patients with crohn's disease-incurable fistula.
researchers recruited 20 patients with continuous Crohn's fistula at a medical clinic in Amsterdam, all of them patients with Crohn's disease, including those with high fistula, who had failed routine treatment for more than six months.
exclusion criteria for the presence of angus, rectal vaginal fistula and recent changes in treatment options.
all patients were evaluated for prognostic indicators at week 16 after receiving 40 hyperbaric oxygen treatments.
study found that in week 16, the index of disease activity in patients with Crohn's disease dropped from 7.5 (95% CI 6-9) to 4 (95% CI 3-6, P slt;0.001), improved van The assche index's median score ranges from 9.2 (95% CI 7.3-11.2) to 7.3 (95% CI 6.9-9.7, P s 0.004).
disease activity index score of ≤4 (representing in activity disease) was observed in 13/20 patients (65%).
patients assessed through fistula drain assessment showed clinical response (60%) and (20%) clinical remission.
the C-reactive protein decreased from 4.2 mg / mL (95% CI 1.6-8) to 2.2 (95% CI 0.9-4.3, P s 0.003) and the median fecal calcium protein decreased from 399 mg / g to 31ug/g, P s0.001).
the authors of this study found significant clinical, radiological and biochemical improvements in crohn's disease patients with resuscable fistula after hyperbaric oxygen therapy.
