Fistulizing Crohn’s disease (CD) presents a therapeutic challenge as fistulae are notoriously difficult to heal. Mycobacterium avium ss paratuberculosis (MAP) treatment in CD is gaining attention. We evaluated healing of CD fistula(e) using a novel combination therapy. Nine consecutive patients who failed to heal fistulae on conventional treatment including anti-TNF, were treated with at least three doses of infliximab, 18-30 courses of hyperbaric oxygen therapy and anti-MAP antibiotics comprising rifabutin, clarithromycin and clofazimine. All patients achieved complete healing of fistulae by 6-28 weeks and follow-up for mean 18 months.
Agrawal, Borody, Turner, Leis, Campbell (2015). Combining infliximab, anti-MAP and hyperbaric oxygen therapy for resistant fistulizing Crohn’s disease. Future science OA, 2015 Nov;1(4):FSO77. https://www.ncbi.nlm.nih.gov/pubmed/28031926