Hyperbaric oxygen therapy was first used to treat decompression sickness for deep-sea divers. Now, it has grown to treat many medical problems, including carbon monoxide poisoning, gas gangrene, and necrotizing fasciitis (“flesh-eating disease”), among others. The therapy provides extra levels of oxygen to oxygen-starved tissues. The increased oxygen levels can also promote growth of new blood vessels, reduce inflammation in the body, and help the body fight harmful bacteria.
Because hyperbaric oxygen therapy (HBOT) can reduce inflammation, some experts believe that HBOT can reduce inflammation from Crohn’s disease when it flares. Crohn’s disease is a type of inflammatory bowel disease (IBD) that causes irritation and inflammation in the digestive tract. Left untreated, it can cause serious illness and life-threatening complications. In several studies where no interventions were done, research supported claims that HBOT may be helpful in Crohn’s disease. But more research needs to be done with different types of study designs to figure out if this really is the case.
How Does Hyperbaric Oxygen Therapy Work?
A hyperbaric oxygen chamber is a small room that is sealed off from environmental air. Room air has about 21% oxygen. But air breathed in through a simple oxygen mask can provide 35%-50% oxygen. You stay in the chamber as it is pressurized to 100% oxygen.
Sessions in the hyperbaric oxygen chamber can be as short as 45 minutes or as long as 5 hours. The number of sessions you need depends on what your doctor recommends.
Devices, such as special bags, are used to treat altitude sickness. Some people have tried to use these for do-it-yourself hyperbaric treatments. The Food and Drug Administration (FDA) does not recommend this. These do-it-yourself HBOT devices could cause a fire or suffocate the user, and there is no supervision about how much oxygen you breathe in and for how long.
Using HBOT for Crohn’s Disease
If you have Crohn’s disease, your doctor may recommend HBOT as an additional therapy to your current treatment plan, which could include steroids, anti-inflammatories, and immunomodulatory medications. It is not meant to be the main treatment. Studies looking at hyperbaric oxygen therapy for IBD show conflicting results though, with some patients benefiting, and others not.
That being said, when researchers examined the published studies, they found that more than 80% of patients with Crohn’s disease did report some improvement in their symptoms. And almost 50% of patients who had a fistula experienced complete healing and 35% had partial healing.
Hyperbaric Oxygen Therapy Concerns and Complications
Hyperbaric oxygen therapy should only be done with your doctor’s recommendation and under the right supervision. You can purchase or rent hyperbaric chambers. But the FDA says it’s not a good idea to do these treatments on your own. If you do have your doctor’s approval for HBOT, it is important that you use a properly approved device to make sure you remain safe.
As with any medical treatment, there is a risk of hyperbaric oxygen therapy complications. And some people should be careful about having HBOT. For example, people with an untreated collapsed lung (pneumothorax) should never be given HBOT. And there are many people who should only be given HBOT with caution. They include those who:
- Take certain medications, like doxorubicin, bleomycin, and cisplatin
- Have respiratory problems, like chronic obstructive pulmonary disease (COPD), asthma, infections, or problems with their ears or sinuses
- Have devices, such as an internal cardiac defibrillator or an epidural pain pump
- Are pregnant
- Have a high fever or seizures
- Are claustrophobic
- Have had eye surgeries, optic neuritis, or some other ophthalmological conditions
- Take insulin for diabetes
Once treatment begins, patients and staff should watch for HBOT complications. Most side effects are not serious if the treatment lasts less than 2 hours and the oxygen level remains less than three times the oxygen level of room air. HBOT can also be stopped for short breaks during the treatment, if needed. Some of the possible side effects are:
- Changes in vision
- Drop in blood sugar (hypoglycemia)
- Damage to the lungs, sinuses, or ears
- Cracked teeth
- Oxygen poisoning/toxicity
- Decompression sickness
What’s the Long-Term Outlook for Crohn’s After HBOT?
Since there isn’t a lot of research looking at HBOT as a Crohn’s disease treatment, the jury is still out about the long-term outlook. The studies that are available show that the treatment is considered safe and that patients who have the treatment are less likely (by over 30%) to be readmitted to the hospital and die from Crohn’s-related issues. These patients also seem to have a better quality of life. Finally, more than 80% of patients with Crohn’s disease went into a remission (fewer or no symptoms) after HBOT.
What Are the Barriers to HBOT?
Not everyone who could benefit from hyperbaric oxygen therapy for Crohn’s disease can get it. For example, there has to be a facility close enough that has an HBOT chamber for regular treatment sessions. And cost can also be a factor.
While many insurances, including Medicare and Medicaid, may cover HBOT, it may also be refused, depending on the reason your doctor wants to do it. For example, crush injuries and necrotizing infections (those that spread by destroying body tissue) are covered by Medicare, but Crohn’s disease is not on the list.
Treatment costs vary across the country and between facilities. According to the Department of Health & Human Services, costs can reach thousands of dollars for just one patient.