- At a conference this week, researchers unveiled some potential new treatments for inflammatory bowel disease (IBD) conditions such as ulcerative colitis and Crohn’s disease.
- Among the presentations was research on the effectiveness of using wearable devices to predict IBD flares.
- Another study looked at the use of oxygen chambers as a treatment for Crohn’s disease.
Wearable devices and oxygen chambers are just some of the tools that may soon be used regularly in the treatment and management of inflammatory bowel disease (IBD).
Several studies presented this week at the 2023 Crohn’s and Colitis Congress reviewed the latest advancements in improving the lives of the more than
The studies haven’t been published yet in a peer-reviewed journal.
Nonetheless, medical professionals are optimistic about the newly revealed research.
“The future is exciting. As a matter of fact, it’s becoming difficult to keep track of everything that’s being developed,” Dr. Rudolph Bedford, a gastroenterologist at Providence Saint John’s Health Center in California, told Healthline.
“I suspect that over the next decade, we certainly will not be treating these diseases the way that we’re treating them today,” he noted.
Among the studies presented at the annual meeting was research into the use of wearable devices such as Apple watches in the management of IBD.
Researchers involved in the study say that markers of nervous system function that can be collected by wearable devices such as Apple watches could help identify an IBD flare.
“Inflammatory bowel disease (IBD) flares are common and unpredictable. Disease monitoring relies on symptom reporting or single timepoint assessments of stool, blood, imaging, or endoscopy. These are inconvenient and invasive and do not always reflect the patient perspective. Advances in wearable technology allow for passive, continuous, and non-invasive assessment of physiological metrics including heart rate variability, the measure of small time differences between each heartbeat, a marker of autonomic nervous system function,” the researchers wrote in the study abstract.
“Our group has previously demonstrated that changes in autonomic function precede an IBD flare, can predict psychological state transitions, and even identify inflammatory events including SARS-CoV-2 infection. This preliminary analysis… demonstrates the feasibility of using wearable devices to identify, and potentially predict IBD flares,” they added.
Symptoms of IBD vary between people and predicting when a flare may occur can be challenging.
Dr. Berkeley Limketkai, the director of clinical research at the UCLA Center for Inflammatory Bowel Diseases in California, says the use of a wearable device could be useful in detecting flares early.
“Data from UCLA and other institutions have previously shown stress and heart rate variability to be associated with increased disease activity,” he told Healthline. “This thus lends plausibility to the use of continuous heart rate monitors for early detection of flares. Such a feature would be very useful for alerting treatment teams to proactively address an impending or nascent flare while employing strategies to prevent further aggravation (akin to ‘nipping it in the bud’).”
“A mild flare in its early stages is much easier to control than a severe flare,” Limketkai added. “A potential challenge with these monitors though would be discrimination between true and false positives. That is, patients experiencing flare-like symptoms could also arise due to reasons unrelated to intestinal inflammation (e.g., irritable bowel syndrome, infection, food intolerance).”
However, Dr. Ashkan Farhadi, a gastroenterologist at MemorialCare Orange Coast Medical Center in California argues a wearable device may not be able to accurately detect a flare.
“Is this tool sensitive enough to pick up these subtle changes? We know there is change, we know this change is subtle. But can this pick up between that subtle change between health and disease? Between clear and remission? I’m not sure about that,” he told Healthline.
This week, researchers also delivered their findings on the use of hyperbaric oxygen therapy as a treatment for Crohn’s disease.
“Hyperbaric oxygen therapy (HBOT) delivers 100 percent oxygen in a pressurized chamber, increasing tissue oxygen levels and regulating inflammatory pathways,” the study authors wrote.
“With a pooled overall clinical response rate of 87 percent and low adverse event rate, our review emphasizes the potential clinical benefit and safety of adjunctive HBOT in refractory cases of fistulizing Crohn’s disease,” they added.
Fistulas can occur when inflammation from Crohn’s causes ulcers or sores to develop on the inside of the intestinal walls or on nearby organs. Abscesses (a collection of pus) can also cause fistulas to develop.
Most commonly in Crohn’s, this can occur between two areas of the intestine or between the intestine and other organs like the vagina or bladder.
In women with Crohn’s, fistulas can also form between the rectum and vagina.
The researchers said there was a high clinical response rate to the use of hyperbaric oxygen therapy. Experts say this is promising.
“Hopefully, with more robust data to support such therapy, it will become part of the IBD guidelines at some point. Then, there would be hope that such therapy becomes popular and widely used as soon as insurance companies start paying for this treatment as the standard of care,” Dr. Florence M Hosseini-Asliania, a gastroenterologist at The University of Kansas Health System and faculty at Kansas University Medical Center, Division of Gastroenterology, told Healthline.
Between 35 and 50% of adults living with Crohn’s will develop a fistula.
Bedford says that while biologic therapies have been useful in the treatment of fistulizing Crohn’s disease, the use of hyperbaric oxygen therapy could be a helpful addition.
“We’ve always had quite a difficult time in dealing with the fistulizing disease of Crohn’s. With the advent of these biologics, it truly has helped and saved us, but it’s not the panacea. So using hyperbaric oxygen as a supplement or even as a potential primary therapy, certainly would be beneficial,” he said.