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Gastroenterol Rep (Oxf). 2017 Nov;5(4):320-321. doi: 10.1093/gastro/gov038. Epub 2015 Aug 28.

Hyperbaric oxygen therapy for chronic antibiotic-refractory ischemic pouchitis.

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Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
Department of Gastroenterology/Hepatology, Cleveland Clinic, Cleveland, OH, USA.
Department of Gastroenterology/Hepatology, Cleveland Clinic, Cleveland, OH, USA


Hyperbaric oxygen therapy (HBOT) has been shown to be efficacious in treating various conditions, including perianal Crohn's disease. Here we present a case of a 59-year-old male with a history of ulcerative colitis, who underwent a total proctocolectomy and two-stage J-pouch construction. He later developed chronic antibiotic-refractory pouchitis with endoscopic features of ischemia. At the completion of HOBT-a total of 20 sessions of 100% oxygen at 2.5-3.0 atmospheres absolute for 60-90 minutes per session-a repeat pouchoscopy showed marked improvement of endoscopic mucosal inflammation. HBOT is known to increase tissue oxygenation, reduce tissue hypoxia, alter inflammatory pathways and promote tissue healing. This case demonstrated the therapeutic role of HBOT as well as the possible disease mechanism in chronic antibiotic-refractory pouchitis.


hyperbaric oxygen therapy; ischemic pouchitis; refractory pouchitis

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