From the Guidelines
Hyperbaric oxygen therapy (HBOT) is not a recommended treatment for Primary Sclerosing Cholangitis (PSC) as there is no evidence supporting its effectiveness in managing this condition. PSC is a chronic liver disease characterized by inflammation and scarring of the bile ducts, and its standard treatments typically include ursodeoxycholic acid (UDCA) at doses of 13-15 mg/kg/day, management of complications like pruritus with cholestyramine, and ultimately liver transplantation for advanced disease 1. The British Society of Gastroenterology and UK-PSC guidelines for the diagnosis and management of PSC do not mention HBOT as a treatment option, instead focusing on evidence-based treatments such as UDCA, corticosteroids, and immunosuppressants for specific cases, and liver transplantation for advanced disease 1.
The pathophysiology of PSC involves immune dysregulation, genetic factors, and progressive fibrosis of bile ducts, mechanisms that are not primarily driven by tissue hypoxia that HBOT might address 1. While HBOT has shown benefits in certain conditions involving tissue hypoxia or wound healing by delivering 100% oxygen at increased atmospheric pressure, it has not been established as a therapeutic option for PSC in clinical practice.
Key aspects of PSC management include:
- Monitoring for complications like cholangiocarcinoma
- Managing symptoms such as pruritus with cholestyramine
- Considering liver transplantation for advanced disease
- Following guidelines for the diagnosis and management of PSC as outlined by the British Society of Gastroenterology and UK-PSC 1.
Patients with PSC should work with hepatologists to develop evidence-based treatment plans focused on managing symptoms, slowing disease progression, and monitoring for complications rather than pursuing unproven therapies like HBOT 1.
From the Research
Hyperbaric Oxygen Therapy for Primary Sclerosing Cholangitis (PSC)
There is no direct evidence in the provided studies to support the effectiveness of hyperbaric oxygen therapy (HBOT) in treating Primary Sclerosing Cholangitis (PSC).
- The studies focus on the diagnosis, management, and treatment of PSC, but none of them mention HBOT as a potential therapy 2, 3, 4, 5, 6.
- Current management of PSC is mainly focused on treatment of symptoms and addressing complications, with liver transplantation being the only life-extending therapeutic approach for eligible patients with end-stage PSC 2, 3, 4.
- Several novel therapeutic strategies are in various stages of development, including bile acid-based therapies, but HBOT is not mentioned as a potential treatment option 3, 5.
Current Treatment Options for PSC
- Ursodeoxycholic acid is widely used to improve biochemical parameters of cholestasis, but there is no evidence that it delays the time to liver transplant or increases survival 3, 5.
- Endoscopic interventions, such as balloon dilatation and biopsy, may be used to manage clinically relevant strictures 3.
- Liver transplantation is currently the only life-extending therapeutic approach for eligible patients with end-stage PSC 2, 3, 4.