Hyperbaric Oxygen Therapy for Antibiotic Refractory Pouchitis

NCT ID: NCT03526796

Last Updated: 2018-05-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-06-01

Study Completion Date

2020-07-31

Brief Summary

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The aim of current study is to evaluate the effect of hyperbaric oxygen therapy for the treatment of chronic antibiotic-refractory pouchitis.

Detailed Description

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Pouch ischemia plays an important role in the pathogenesis of pouchitis after IPAA surgery for ulcerative colitis. Obese Male patients are at high risk for pouchitis because of mesenteric tension. Excessive weight gain is associated with an increased risk for pouch failure in patients with restorative proctocolectomy. Also, patients with an 'S' pouch hardly ever develop chronic pouchitis, owing to the additional length of bowel loop along with mesentery when attached to the anal transitional zone. The treatment of chronic antibiotic-refractory pouchitis(CARP) is difficult.

Hyperbaric oxygen therapy(HBOT) have been proven effecitve in the treatment of inflammatory bowel diseases(IBD). Meta-analysis revealed that the overall response rate was 86% (85% CD, 88% UC), and of the endoscopic response rate to HBOT is 100%. The possible mechanism might be due to the prmoted wound healing by increasing oxygen delivery to hypooxic tissues and changes in inflammatory and immunological mediators.

Therefore, the aim of current study is to examine the therapeutic effect of HBOT for chronic antibiotic-refractory pouchitis(CARP).

Conditions

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Pouchitis Hyperbaric Oxygen Therapy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Hyperbaric oxygen therapy

Patients who recieve hyperbaric oxygen therapy will be maintained at 2.4 ATA with 100% oxygen for 90 min and then decompressed back to 1 ATA. The treatment duration is 4 weeks and extends to 6 weeks if necessary.

Group Type EXPERIMENTAL

Hyperbaric oxygen therapy

Intervention Type PROCEDURE

Patients were maintained at 2.4 ATA with 100% oxygen for 90 min and then decompressed back to 1 ATA. The treatment duration is 4 weeks and extends to 6 weeks if necessary.

Interventions

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Hyperbaric oxygen therapy

Patients were maintained at 2.4 ATA with 100% oxygen for 90 min and then decompressed back to 1 ATA. The treatment duration is 4 weeks and extends to 6 weeks if necessary.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* IPAA performed for ulcerative colitis;
* Pouchitis Disease Activity Index (PDAI) scores ≥7;
* Antibiotic refractory pouchitis(CARP), defined as patients who do not respond to conventional 2-week, single-agent antibiotic therapy including metronidazole,ornidazole,tinidazole, or ciprofloxacin
* 18-75years
* Informed consent given
* Able and willing to comply with all trial procedures
* Including prepouch ileitis

Exclusion Criteria

* Crohn's disease of the pouch
* Pouchitis after IPAA for FAP
* Isolated cuffitis
* with cocomttant Primary sclerosing cholangitis (PSC)
* Pouch strictures
* Abscess/Sinuses
* Perianal disease
* Active malignancy
* Uncontrolled systemic diseases
* History of noninfammatory disease of the pouch
* Decreased pouch compliance
* Irritable pouch syndrome
* Afferent or efferent limb obstruction
* Needing oral or topical steroid or 5-ASA
* Major physical or psychiatric illness within the last 6m
* Active use of cholestyramine, NSAIDs or aspirin
* Pregnant, breast feeding
* Clinically significant co-morbidities causing untolerant or unsuitable for hyperbaric oxygen therapy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jinling Hospital, China

OTHER

Sponsor Role lead

Responsible Party

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Jianfeng Gong

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jianfeng Gong, MD

Role: PRINCIPAL_INVESTIGATOR

Jinling Hospital, China

Locations

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Department of Generay Surgery, Jinling hosptal, Medical School of Nanjing University

Nanjing, Jiangsu, China

Site Status

Countries

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China

Central Contacts

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Jianfeng Gong, MD

Role: CONTACT

+86-25-80860036

Other Identifiers

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HBOT-pouchitis

Identifier Type: -

Identifier Source: org_study_id

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