Article Text

Download PDFPDF

Hyperbaric oxygen therapy stimulates colonic stem cells and induces mucosal healing in patients with refractory ulcerative colitis: a prospective case series
  1. Mohamed Bekheit1,2,
  2. Nahed Baddour3,
  3. Khaled Katri2,
  4. Yousry Taher4,
  5. Khaled El Tobgy5,
  6. Essam Mousa2
  1. 1Department of Surgery, El Kabbary General Hospital, Alexandria, Egypt
  2. 2Department of Surgery, Faculty of Medicine, Alexandria Main University Hospital, Alexandria, Egypt
  3. 3Department of Pathology, Faculty of Medicine, Alexandria Main University Hospital, Alexandria, Egypt
  4. 4Department of Internal Medicine, Faculty of Medicine, Alexandria Main University Hospital, Alexandria, Egypt
  5. 5Department of Hyperbaric Medicine, Naval Hospital, Alexandria, Egypt
  1. Correspondence to Dr Mohamed Bekheit; dr_mohamedbekheit{at}


Background Hyperbaric oxygen (HBO) is used as part of treatment in a variety of clinical conditions. Its use in the treatment of ulcerative colitis has been reported in few clinical reports.

Objective We report the effect of HBO on refractory ulcerative colitis exploring one potential mechanism of action.

Design A review of records of patients with refractory ulcerative colitis who received HBO was conducted. Clinical and histopathological scoring was utilised to evaluate the response to HBO therapy (HBOT).

Results All patients manifested clinical improvement by the 40th cycle of HBOT. The median number of stool frequency dropped from seven motions/day (range=3–20) to 1/day (range=0.5–3), which was significant (z=−4.6, p<0.001). None of the patients manifested persistent blood passage after HBOT (z=−3.2, p=0.002). The severity index significantly improved after HBOT (z=−4.97, p<0.001). Histologically, a significant reduction of the scores of activity was recorded accompanied by a significant increase in the proliferating cell nuclear antigen labelling index of the CD44 cells of the colonic mucosa (p=0.001).

Conclusions HBOT is effective in the setting of refractory ulcerative colitis. The described protocol is necessary for successful treatment. HBOT stimulates colonic stem cells to promote healing.


This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.