RT Journal Article
SR Electronic
T1 Hyperbaric oxygen therapy stimulates colonic stem cells and induces mucosal healing in patients with refractory ulcerative colitis: a prospective case series
JF BMJ Open Gastroenterology
FD BMJ Publishing Group Ltd
SP e000082
DO 10.1136/bmjgast-2016-000082
VO 3
IS 1
A1 Mohamed Bekheit
A1 Nahed Baddour
A1 Khaled Katri
A1 Yousry Taher
A1 Khaled El Tobgy
A1 Essam Mousa
YR 2016
UL http://bmjopengastro.bmj.com//content/3/1/e000082.abstract
AB 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.