Hyperbaric oxygen therapy and ano-perineal lesions

Introduction: Perineal fistulizing Crohn's disease (CD) is a disabling condition. Hyperbaric oxygen therapy (HBOT) has been studied as a new therapy for CD.Objective: to evaluate the place of HBOT in the treatment of anoperineal manifestations of CD.Materials and methods: We conducted a literature review including studies on the results of treatment of anoperineal fistulas in CD with hyperbaric oxygen therapy.Results: We included 12 studies that investigated the effect of hyperbaric oxygen therapy in the treatment of anoperineal fistulas in CD. The mean pressure was 2.1 atm with an average of 30 daily sessions.Closure as evidenced by clinical findings and imaging was achieved in more than half the cases (59%).The application of hyperbaric oxygen therapy was complicated by adverse effects in 20.8% (n=36) considered serious in only 3% of cases.Conclusion: Hyperbaric oxygen therapy appears to be a safe and effective treatment for complex CD fistulas.