Bulletin of Rehabilitation Medicine Bulletin of Rehabilitation Medicine 2078-1962 2713-2625 National Medical Research Center for Rehabilitation and Balneology 623920 10.38025/2078-1962-2023-22-3-113-121 Review Article Non-Drug Methods in the Treatment of Inflammatory Bowel Diseases: a Review Brazhnikova Irina P.

Physiotherapist

 brazhnikova.ip@nczd.ru https://orcid.org/0000-0002-8202-0085 Konova Olga M.

Dr. Sci. (Med.), Head of Physiotherapy Department, Head of the Center for Medical Rehabilitation and Restorative Treatment

 brazhnikova.ip@nczd.ru https://orcid.org/0000-0001-8053-5985 Potapov Alexandr S.

Dr. Sci. (Med.), Professor, Head of the Center of Inflammatory Bowel Diseases in Children, Head of the Gastroenterology Department, National Research Center for Children’s Health, Professor of the Department of Pediatrics and Pediatric Rheumatology

 brazhnikova.ip@nczd.ru https://orcid.org/0000-0003-4905-2373 Sviridovа Tatiana V.

Ph.D. (Psych.), Head of the Laboratory of Special Psychology and Correctional Education at the Center for Psychological and Pedagogical Assistance in Pediatrics

 brazhnikova.ip@nczd.ru https://orcid.org/0000-0001-9838-3457 National Research Center for Children’s Health Clinical Institute of Child Health Sechenov First Moscow State Medical University 28 11 2023 22 3 113 121 27 11 2023 27 11 2023 Copyright © 2023, Brazhnikova I.P., Konova O.M., Potapov A.S., Sviridovа T.V. 2023

INTRODUCTION. The relevance and importance of the problem of inflammatory bowel diseases is associated with a chronic, recurrent course and a steady increase in morbidity. With a complicated course of the disease, extensive operations on the intestine, this leads to disability, reduced working capacity and social adaptation. It is important to note that the maximum number of cases occurs at a young age and increasingly diseases are detected in childhood.

OBSERVATIONS. Based on the analysis of the literature using Russian and foreign sources on the use of non-drug methods in the treatment of inflammatory bowel diseases, it is noted that, despite the constant improvement of drug treatment methods, including the active development of genetic engineering therapy, the search for effective methods and ways to optimize the treatment with the use of non-drug technologies continues.

CONCLUSION. Long-term course of inflammatory bowel diseases is associated with a possible risk of side effects from drug therapy and a decrease in the quality of life of patients. Therefore, the use of non-drug methods in the treatment of IBD in adults and children is relevant at the moment. Data on the use of a number of methods, including non-invasive, in the treatment of this category of patients are presented. High potential, promising direction, a small number of side effects show the need for further research and observations.

 inflammatory bowel diseases non-drug treatment hyperbaric oxygenation normoxic barotherapy vagus nerve stimulation acupuncture pelvic floor muscle training the quality of life воспалительные заболевания кишечника немедикаментозное лечение гипербарическая оксигенация нормоксическая баротерапия стимуляция блуждающего нерва акупунктура тренировка мышц тазового дна качество жизни Разенак Й., Ситкин С.И. Воспалительные заболевания кишечника: практическое руководство. 7-е изд., переработанное и дополненное. М.: Форте принт, 2014: 108 с. [Razenak Y., Sitkin S.I. Inflammatory bowel diseases: a practical guide. 7th edition revised and expanded. Moscow: Forte Print, 2014: 108 p. (In Russ.).] Горелов А.В., Каннер Е.В. Воспалительные заболевания кишечника у детей: особенности течения и терапии. Медицинский совет. 2018; (2): 140–145. [Gorelov A.V., Kanner E.V. Inflammatory bowel diseases in children: peculiarities of the disease course and therapy. Medical advice. 2018; (2):140–145 (In Russ.).] Князев О.В., Шкурко Т.В., Каграманова А.В. и др. Эпидемиология воспалительных заболеваний кишечника. Современное состояние проблемы (обзор литературы). Доказательная гастроэнтерология. 2020; 9(2): 66–73. https://doi.org/10.17116/dokgastro2020902166 [Kniazev O.V., Shkurko T.V., Kagramanova A.V. et al. Epidemiology of inflammatory bowel disease. State of the problem (review). Russian Journal of Evidence-Based Gastroenterology. 2020; 9(2): 66–73. https://doi.org/10.17116/dokgastro2020902166 (In Russ.).] Григорьева Г.А. Язвенный колит и болезнь Крона — проблема XXI века. Вестник Смоленской государственной медицинской академии. 2011; 10(1): 12–14. [Grigoryeva G.A. Ulcerative colitis and Krohn’s diseases — XXI century problem. Bulletin of the Smolensk State Medical Academy. 2011; 10(1): 12–14 (In Russ.).] Воробьев Г.И., Халиф И.Л. Воспалительные заболевания кишечника. М.: Миклош, 2008: 424 с. [Vorobyev G.I., Khalif I.L. Nonspecific inflammatory bowel disease. Moscow: Miklosh, 2008: 400 p. (In Russ.).] M’Koma A.E. Inflammatory Bowel Disease: An Expanding Global Health Problem. Therapeutic Advances in Gastrointestinal Endoscopy. 2013; (6): 33–47. https://doi.org/10.4137/CGast.S12731 Белоусова Е.А., Абдулганиева Д.И., Алексеева О.П. Социально-демографическая характеристика, особенности течения и варианты лечения воспалительных заболеваний кишечника в России. Результаты двух многоцентровых исследований. Альманах клинической медицины. 2018; 46(5): 445–463. https://doi.org/10.18786/2072-0505-2018-46-5-445-463 [Belousova E.A., Abdulgarieva D.I., Alexeeva O.B. et al. Social and demographic characteristics, features and diseases course and treatment options of inflammatory bowel disease In Russia: results of two multicenter studies. Almanac of clinical medicine. 2018; 46(5): 445–463. https://doi.org/10.18786/2072-0505-2018-46-5-445-463 (In Russ.).] Садыгова Г.Г. Внекишечные проявления воспалительных заболеваний кишечника: артропатии и артриты. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2016; 26(6): 101–105. [Sadygova G.G. Extraintestinal manifestations of inflammatory bowel diseases: arthropathy and arthritis. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2016; 26(6): 101–105 (In Russ.).] Анушенко А.О., Потапов А.С., Цимбалова Е.Г., Гордеева О.Б. Анемия при воспалительных заболеваниях кишечника у детей. Вопросы современной педиатрии. 2016; 15(2): 128–140. [Anushenko A.O., Potapov A.S., Tsimbalova Ye.G., Gordeeva О.B. Anemia in Inflammatory Bowel Diseases in Children. Current Pediatrics. 2016; 15(2): 128–140 (In Russ.).] Carroll M.W., Kuenzig M.E., Mack D.R. et al. The Impact of Inflammatory Bowel Disease in Canada 2018: Children and Adolescents with IBD. Journal of the Canadian Association of Gastroenterology. 2019; 2(S1): S49-S67. https://doi.org/10.1093/jcag/gwy056 Zawadka-Kunikowska M., Słomko J., Kłopocka M. et al. Cardiac and autonomic function in patients with Crohn’s disease during remission. Advances in Medical Sciences. 2018; 63(2): 334–340. https://doi.org/10.1016/j.advms.2018.04.009 Aghdasi-Bornaun H., Kutluk G., Keskindemirci G. et al. Evaluation of autonomic nervous system functions in frame of heart rate variability in children with inflammatory bowel disease in remission. The Turkish Journal of Pediatrics. 2018; 60(4): 407–414. https://doi.org/10.24953/turkjped.2018.04.008 Cheng J., Shen H., Chowdhury R. et al. Potential of Electrical Neuromodulation for Inflammatory Bowel Disease. Inflammatory Bowel Diseases. 2020; 26(8): 1119–1130. https://doi.org/10.1093/ibd/izz289 Borovikova L.V., Ivanova S., Zhang M. et al. Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature. 2000; 405(6785): 458–462. https://doi.org/10.1038/35013070 Chen J.D., Yin J., Wei W. Electrical therapies for gastrointestinal motility disorders. Expert Review of Gastroenterology & Hepatology. 2017; 11(5): 407–418. https://doi.org/10.1080/17474124.2017.1298441 Gu P., Kuenzig M.E., Kaplan G.G. et al. Fecal incontinence in inflammatory bowel disease: a systematic review and meta-analysis. Inflammatory Bowel Diseases. 2018; 24(6): 1280–1290. https://doi.org/10.1093/ibd/izx109 Vitton V., Gigout J., Grimaud J.C. et al. Sacral nerve stimulation can improve continence in patients with Crohn’s disease with internal and external anal sphincter disruption. Diseases of the Colon & Rectum. 2008; 51(6): 924–927. https://doi.org/10.1007/s10350-008-9209-4 Brégeon J., Neunlist M., Bossard C. et al. Improvement of refractory ulcerative proctitis with sacral nerve stimulation. Journal of Clinical Gastroenterology. 2015; 49(10): 853–857. https://doi.org/10.1097/mcg.0000000000000331 Makkar R., Graff L.A., Bharadwaj S. et al. Psychological factors in irritable pouch syndrome and other pouch disorders. Inflammatory Bowel Diseases. 2015; 21(12): 2815–2824. https://doi.org/10.1097/mib.0000000000000552 Barnes E.L., Herfarth H.H., Sandler R.S. et al. Pouch‐related symptoms and quality of life in patients with ileal pouch‐anal anastomosis. Inflammatory Bowel Diseases. 2017; 23(7): 1218–1224. https://doi.org/10.1097/mib.0000000000001119 Caron B., Ghosh S., Danese S. et al. Identifying, Understanding, and Managing Fecal Urgency in Inflammatory Bowel Diseases. Clinical Gastroenterology and Hepatology. 2023; 21(6): 1403–1413. https://doi.org/10.1016/j.cgh.2023.02.029 Rao S.S.C., Patcharatrakul T. Diagnosis and treatment of dyssynergic defecation. Journal of Neurogastroenterology and Motility. 2016; 22(3): 423–435. https://doi.org/10.5056/jnm16060 Khera A.J., Chase J.W., Salzberg M. et al. Systematic review: Pelvic floor muscle training for functional bowel symptoms in inflammatory bowel disease. JGH Open. 2019; 3(6): 494–507. https://doi.org/10.1002/jgh3.12207 24. Perera L.P., Ananthakrishnan A.N., Guilday C. et al. Dyssynergic defecation: a treatable cause of persistent symptoms when inflammatory bowel disease is in remission. Digestive Diseases and Sciences. 2013; 58(12): 3600–3605. https://doi.org/10.1007/s10620-013-2850-3 Song G., Fiocchi C., Achkar J.-P. Acupuncture in Inflammatory Bowel Disease. Inflammatory Bowel Diseases. 2019; 25(7): 1129–1139. https://doi.org/10.1093/ibd/izy371 Liu Z., Jiao Y., Yu T. et al. A Review on the Immunomodulatory Mechanism of Acupuncture in the Treatment of Inflammatory Bowel Disease. Evidence-Based Complementary and Alternative Medicine. 2022. https://doi.org/10.1155/2022/8528938 Farrell D., Artom M., Czuber-Dochan W. et al. Interventions for fatigue in inflammatory bowel disease. Cochrane Database of Systematic Reviews. 2020. https://doi.org/10.1002/14651858.CD012005.pub2 Акалаев Р.Н., Борисова Е.М., Евдокимов А.А. Гипербарическая медицина: история становления и путь развития. Вестник экстренной медицины. 2014; (1): 85–94. [Akalaev R.N., Borisova E.M., Evdokimov E.A. et al. Hyperbaric medicine: the history of formation and path of development. The Bulletin of Emergency Medicine. 2014; (1): 85–94 (In Russ.).] Саливончик Д.П. Лечебный кислород: от физиологии к предпосылкам использования гипероксии в режимах «малых доз» в клинической медицине (обзор литературы). Проблемы здоровья и экологии. 2009; 3(21): 99–106. https://doi.org/10.51523/2708-6011.2009-6-3-22 [Salivonchik D.P. The treatment oxygen: from physiology do the application in the «little» doses in the clinical medicine (references review). Health and Ecology Issues. 2009; 3(21): 99–106. https://doi.org/10.51523/2708-6011.2009-6-3-22 (In Russ.).] Мартусевич А.К., Поповичева А.Н., Соснина Л.Н. Влияние гипербарической оксигенации на состояние окислительного стресса и антиоксидантной системы крови у детей с воспалительными заболеваниями кишечника. Экспериментальная и клиническая гастроэнтерология. 2022; (1): 45–49. https://doi.org/10.31146/1682-8658-ecg-197-1-45-49 [Martusevich A.K., Popovicheva A.N., Sosnina L.N. et al. The effect of hyperbaric oxygenation on the state of oxidative stress and the antioxidant system of blood in children with inflammatory bowel diseases. Experimental and Clinical Gastroenterology. 2022; (1): 45–49. https://doi.org/10.31146/1682-8658-ecg-197-1-45-49 (In Russ.).] Поповичева А.Н., Мартусевич А.К., Соснина Л.Н. Влияние гипербарической оксигенации на состояние реологии крови и гемостаза у детей с воспалительными заболеваниями кишечника. Экспериментальная и клиническая гастроэнтерология. 2022; (6): 83–89. https://doi.org/10.31146/1682-8658-ecg-202-6-83-89 [Popovicheva A.N., Martusevich A.K., Sosnina L.N. et al. The effect of hyperbaric oxygenation on the state of blood rheology and hemostasis in children with inflammatory bowel diseases. Experimental and Clinical Gastroenterology. 2022; (6): 83–89. https://doi.org/10.31146/1682-8658-ecg-202-6-83-89 (In Russ.).] Al-Waili N.S., Butler G.J. Effects of hyperbaric oxygen on inflammatory response to wound and trauma: possible mechanism of action. The Scientific World Journal. 2006; 6: 425–441. https://doi.org/10.1100/tsw.2006.78 Wu X., Liang T.Yu., Wang Z., Chen G. The role of hyperbaric oxygen therapy in inflammatory bowel disease: a narrative review. Medical Gas Research. 2021; 11(2): 66–71. https://doi.org/10.4103/2045-9912.311497 Alenazi N., Alsaeed H., Alsulami A., Alanzi T. A Review of Hyperbaric Oxygen Therapy for Inflammatory Bowel Disease. International Journal of General Medicine. 2021; 14: 7099–7105. https://doi.org/10.2147/ijgm.s336678 Brady 3rd C.E., Cooley B.J., Davis J.C. Healing of severe perineal and cutaneous Crohn’s disease with hyperbaric oxygen. Gastroenterology. 1989; 97(3): 756–760. https://doi.org/10.1016/0016-5085(89)90649-5 Федулова Э.Н., Шумилова О.В., Широкова Н.Ю. Тканевая гипоксия при болезни Крона у детей: маркеры и методы преодоления. Экспериментальная и клиническая гастроэнтерология. 2021; 1(1): 106–110. https://doi.org/10.31146/1682-8658-ecg-185-1-106-110 [Fedulova E.N., Shumilova O.V., Shirokova N.Yu. Tissue hypoxia in Crohn’s disease in children: markers and coping methods. Experimental and Clinical Gastroenterology. 2021; 1(1): 106–110. https://doi.org/10.31146/1682-8658-ecg-185-1-106-110 (In Russ.).] Altinel O., Demirbas S., Cakir E. et al. Comparison of hyperbaric oxygen and medical ozone therapies in a rat model of experimental distal colitis. Scandinavian Journal of Clinical and Laboratory Investigation. 2011; 71(3): 185–192. https://doi.org/10.3109/00365513.2010.548875 Rossignol D.A. Hyperbaric oxygen treatment for inflammatory bowel disease: a systematic review and analysis. Medical Gas Research. 2012; 2(1): 6. https://doi.org/10.1186/2045-9912-2-6 Abdel-Hakim M.M., Elsakaty T.M., Kaisar H.H. et al. Role of hyperbaric oxygen as an adjuvant therapy in severe ulcerative colitis patients. Annals of the Romanian Society for Cell Biology. 2021; 25(3): 7998–8009. You J.H., Jiang J.L., He W.B., et al. Addition of hyperbaric oxygen therapy versus usual care alone for inflammatory bowel disease: A systematic review and meta-analysis. Heliyon. 2022; 8(10): e11007. https://doi.org/10.1016/j.heliyon.2022.e11007 Feitosa M.R., Parra R.S., Machado V.F. et al. Adjunctive hyperbaric oxygen therapy in refractory Crohn’s disease: an observational study. Gastroenterology Research and Practice. 2021. https://doi.org/10.1155/2021/6628142 Метод гипербарической оксигенации в комплексном лечении язвенного колита и болезни Крона. Практическое руководство для врачей. Москва. 2010: 32 с. [Hyperbaric oxygenation method in the complex treatment of ulcerative colitis and Crohn’s disease. A practical guide for doctors. Moscow. 2010: 32 p. (In Russ.).] Bekheit M., Baddour N., Katri K. et al. Hyperbaricoxygen therapy stimulates colonic stem cells and induces mucosal healing in patients with refractory ulcerative colitis: a prospective case series. BMJ Open Gastroenterol. 2016; 3(1). https://doi.org/10.1136/bmjgast-2016-000082 Oliaei S., Seyedalinaghi S., Mehrtak M. et al. The effects of hyperbaric oxygen therapy (HBOT) on coronavirus disease-2019 (COVID-19): a systematic review. European Journal of Medical Research. 2021; 26(1): 96 p. https://doi.org/10.1186/s40001-021-00570-2 Mathieu D. Handbook on Hyperbaric Medicine. Springer. 2006. https://doi.org/10.1007/1-4020-4448-8 Казанцева Н.В. Нормоксическая компрессия в лечении инсульта. Журнал неврологии и психиатрии им. С.С. Корсакова. 2014; 114(8–2): 42–51. [Kazantseva N.V. Normoxic therapeutic compression in stroke treatment. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2014; 114(8–2): 42–51 (In Russ.).] Лицкевич Л.В., Кривошеева Ж.И. Кардио-респиратопные нарушения при хронической обструктивной болезни легких и бронхиальной астме и роль нормоксической баротерапии в комплексном лечении и реабилитации данных пациентов. Научные исследования XXI века. 2021; 2(10): 320–343. [Litskevich L.V., Krivosheeva Zh.I. Cardio-respiratory disoders in chronical obstructive pulmonary disease and bronchial asthma and the role of normotoxic barotherapy in the complex treatment and rehabilitation of these patients. Naučnye issledovaniâ XXI veka. 2021; 2(10): 320–343 (In Russ.).] Nowakowski J., Chrbac A.A., Dudek D. Psychiatric illnesses in inflammatory bowel disease — psychiatric comorbidity and biological underpinnings. Psychiatria Polska. 2016; 50(6): 1152–1166. https://doi.org/10.12740/pp/62382 Walker J.R., Ediger J.P., Graff L.A. et al. The Manitoba IBD cohort study of the prevalence study of lifetime and 12-month anxiety and mood disorders. The American Journal of Gastroenterology. 2008; 103(8): 1989–1997. https://doi.org/10.1111/j.1572-0241.2008.01980.x Тагирова А.Р., Сичинава И.В., Савватеева О.А., Борисова Е.В. Качество жизни детей с болезнью Крона как потенциальный критерий мониторинга активности заболевания. Доктор.Ру. 2020; 19(10): 27–32. https://doi.org/10.31550/1727-2378-2020-19-10-27-32 [Tahirova A.R., Sichinava I.V., Savvateeva O.F., Borisova E.V. Quality of Life of Children with Crohn’s Disease as a Potential Criterion for Monitoring Disease Activity. Doctor.ru. 2020; 19(10): 27–32. https://doi.org/10.31550/1727-2378-2020-19-10-27-32 (In Russ.).] Knowles S.R., Keefer L., Wilding H. et al. Quality of life in inflammatory bowel disease: a systematic review and meta-analyses — part II. Inflammatory Bowel Diseases. 2018; 24(5): 966–976. https://doi.org/10.1093/ibd/izy015 Тагирова А.Р., Сичинава И.В., Ивардава М.И. Изучение взаимосвязи показателей качества жизни и клинических характеристик при болезни Крона у детей. Русский медицинский журнал. 2020; 2: 11–14. [Tagirova A.R., Sichinava I.V., Ivardava M.I. Association between the quality of life and clinical features of Crohn’s disease. RMJ. 2020; (2): 11–14. (In Russ.).] Lix L.M. Graff L.A. Walker J.R. et al. Longitudinal study of quality of life and psychological functioning for active, fluctuating, and inactive disease patterns in inflammatory bowel disease. Inflammatory Bowel Diseases. 2008; 14(11): 1575–1584. https://doi.org/10.1002/ibd.20511 Голышева С.В., Успенская Ю.Б., Григорьева Г.А. Качество жизни больных с воспалительными заболеваниями кишечника. Гастроэнтерология. 2004; 1(5): 96–97. [Golysheva S.V., Uspenskaya Yu.B., Grigorieva G.A. Quality of life of patients with inflammatory bowel disease. Gastroenterology. 2004; (1): 96–97 (In Russ.).] Свиридова Т.В., Лазуренко С.Б., Венгер А.Л. Исследование психологических особенностей детей и подростков с заболеваниями органов пищеварения. Вестник Российской академии медицинских наук. 2015; 70(5): 519–525. https://doi.org/10.15690/vramn.v70.i5.1437 [Sviridova T.V., Lazurenko S.B., Venger A.L. The Study of Psychological Characteristics of Children and Adolescents with Digestive Diseases. Annals of the Russian Academy of Medical Sciences. 2015; 70(5): 519–525 https://doi.org/10.15690/vramn.v70.i5.1437 (In Russ.).] Ганич Е.Г., Щукина О.Б., Габрусская Т.В. Зачем нужен процесс перехода ребенка с воспалительным заболеванием кишечника во взрослую сеть. Доктор.Ру. 2017; 12(146): 36–40 [Ganich E.G., Shchukina O.B., Gabrusskaya T.V. et al. Why a Formal Procedure Is Needed for Inflammatory Bowel Disease Patients Transitioning from Pediatric to Adult Care. Doctor.ru. 2017; 12(141): 36–40 (In Russ.).] Симатов С.А. Проблемы организации оказания медицинской и реабилитационной помощи стомированным больным на современном этапе. Вестник медицинского института «Реавиз»: реабилитация, врач и здоровье. 2017; 3(27): 78–82. [Simatov S.A. Current problems of health care delivery and rehabilitation of pathients with stoma. Bulletin of the Medical Institute “REAVIZ” (Rehabilitation, Doctor and Health). 2017; 3(27): 78–82 (In Russ.).]