{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:25:31Z","timestamp":1791516331333,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T00:00:00Z","timestamp":1608076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"European Crohn's and Colitis Organisation"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Positive effects of hyperbaric oxygen on perianal fistulas in Crohn's disease have been reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess efficacy, safety and feasibility of hyperbaric oxygen in Crohn's disease patients with therapy\u2010refractory perianal fistulas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty consecutive patients were recruited at the out\u2010patient fistula clinic of the Amsterdam UMC. Crohn's disease patients with high perianal fistula(s) failing conventional treatment for over 6\u00a0months were included. Exclusion criteria were presence of a stoma, rectovaginal fistula(s) and recent changes in treatment regimens. Patients received treatment with 40 hyperbaric oxygen sessions and outcome parameters were assessed at Week 16.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven women and 13 men were included (median age 34\u00a0years). At Week 16, median scores of perianal disease activity index and modified van Assche index (co\u2010primary outcome parameters) decreased from 7.5 (95% CI 6\u20109) to 4 (95% CI 3\u20106, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and from 9.2 (95% CI 7.3\u201011.2) to 7.3 (95% CI 6.9\u20109.7, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004) respectively. Perianal disease activity index scores \u22644 (representing inactive perianal disease) were observed in 13\/20 patients (65%). Twelve patients showed a clinical response (60%) and four (20%) clinical remission, assessed with fistula drainage assessment. Median C\u2010reactive protein and faecal calprotectin levels decreased from 4.2\u00a0mg\/mL (95% CI 1.6\u20108) to 2.2 (95% CI 0.9\u20104.3, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.003) and from 399\u00a0\u00b5g\/g (95% CI 52\u2010922) to 31 (95% CI 16\u2010245, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found significant clinical, radiological and biochemical improvement in Crohn's disease patients with therapy\u2010refractory perianal fistulas after treatment with hyperbaric oxygen.<\/jats:p><jats:p>Clinical trial registration: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.trialregister.nl\/trial\/6489\">www.trialregister.nl\/trial\/6489<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16228","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T08:26:18Z","timestamp":1610958378000},"page":"587-597","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients with Crohn\u2019s disease"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9395-4003","authenticated-orcid":false,"given":"Corine A.","family":"Lansdorp","sequence":"first","affiliation":[{"name":"Department of Anesthesiology\/Hyperbaric Medicine Amsterdam UMC, location AMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krisztina B.","family":"Gecse","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam UMC, location AMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christianne J.","family":"Buskens","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam UMC, location AMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"L\u00f6wenberg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam UMC, location AMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaap","family":"Stoker","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine Amsterdam UMC, location AMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem A.","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam UMC, location AMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert R.A.M.","family":"D\u2019Haens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam UMC, location AMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob A.","family":"van Hulst","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology\/Hyperbaric Medicine Amsterdam UMC, location AMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.32362"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-304488"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030815"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.11.041"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000479"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-005-0072-7"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31203-X"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000148"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3182099d9e"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640615577532"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12753"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/ars.2014.5940"},{"key":"e_1_2_9_14_1","first-page":"247","article-title":"Mechanisms of action of hyperbaric oxygen therapy","volume":"41","author":"Camporesi EM","year":"2014","journal-title":"Undersea Hyperb Med"},{"key":"e_1_2_9_15_1","volume-title":"Hyperbaric Oxygen Therapy Indications","author":"Moon RE","year":"2019"},{"key":"e_1_2_9_16_1","first-page":"253","article-title":"Side effects of hyperbaric oxygen therapy","volume":"41","author":"Camporesi EM","year":"2014","journal-title":"Undersea Hyperb Med"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.4155\/fso.15.77"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0102-86502016001300005"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.22462\/01.03.2019.5"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14190"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20826"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199905063401804"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.22917"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1159\/000201455"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X03256005"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MIB.0000217768.75519.32"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjaa004"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6608"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjw039"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.07.027"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41395-018-0005-z"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-031151"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c1066"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.16228","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.16228","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T22:51:45Z","timestamp":1693695105000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.16228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,16]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1111\/apt.16228"],"URL":"https:\/\/doi.org\/10.1111\/apt.16228","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,16]]},"assertion":[{"value":"2020-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}