Part 4 · The future · 19/22
Vagus nerve, hyperbaric chamber, faecal microbiota transplant… What exists, what the studies say, and what is available in France.
These approaches never replace your long-term treatment. Stopping your treatment for a “natural” method exposes you to severe flares. Beware of promises of a cure, high prices and miracle testimonials. Always talk to your gastro about them: some are done within trials, and your gastro can refer you to them.
A small stimulator, placed on the vagus nerve in the neck, might calm inflammation. A team in Grenoble was a pioneer.
What the studies say : A European trial treated 16 people with Crohn's that did not respond to biologics: improvement in some of them, but with no placebo. The same device has been approved in the United States since 2025 for rheumatoid arthritis, not for IBD.
Sources : Bonaz, Neurogastroenterol Motil 2016; D'Haens, J Crohns Colitis 2023; FDA 2025
You breathe pure oxygen in a pressurised chamber, to get more oxygen to the gut wall.
What the studies say : Severe UC flare in hospital: a small trial of 18 patients showed more remissions than with a sham chamber; a Swedish trial found no difference. A large placebo-controlled trial (126 patients) is under way in the United States. Crohn's fistulas: studies with no comparison group.
Sources : Dulai, Am J Gastroenterol 2018; Pagoldh, Scand J Gastroenterol 2013; NCT05987852
Gut bacteria from a healthy donor are transferred, by colonoscopy, enema or capsules.
What the studies say : UC: the transplant makes remission about 1.8 times more frequent than placebo, according to a review of 10 trials and 468 patients (low certainty according to Cochrane). Crohn's: weak evidence; a French trial (MIRACLE, AP-HP, Paris) is under way. It is a medicine: never do it yourself.
Sources : Sci Rep 2023; Cochrane 2023; ANSM (French medicines agency); MIRACLE trial
The patient’s own fat, and cells extracted from it, are injected around an anal fistula that will not heal.
What the studies say : A first study in 10 patients was encouraging. The ADICROHN II trial (Marseille) is comparing it with a placebo. The earlier stem-cell product (Alofisel) was withdrawn in Europe in December 2024, because its efficacy was not confirmed.
Sources : ADICROHN II trial, NCT04010526; EMA 2024
“Friendly” bacteria in capsules or sachets.
What the studies say : Useful mainly to prevent pouchitis after an ileo-anal pouch, and one strain (E. coli Nissle) for maintenance in UC. No proven effect in Crohn's.
Sources : ECCO guidelines
Viruses that attack only certain bacteria suspected in Crohn's (“sticky” E. coli).
What the studies say : A first trial in humans has been completed in the United States, with no published results; another molecule of this type has been abandoned.
Sources : NCT03808103; NCT03943446
An old medicine, used at a very low dose (about 4.5 mg).
What the studies say : Two small, older trials were encouraging, but the most recent Dutch trial (41 patients, against placebo) was stopped because it had no effect on inflammation; only fatigue seemed to decrease.
Sources : Cochrane 2018; LDN Crohn, Dig Dis Sci 2026
Worm eggs swallowed to “retrain” the immune system.
What the studies say : The large trials showed no benefit in Crohn's: this approach has been abandoned. Do not buy worms on the internet.
Sources : TRUST-I 2013; TRUST-II, J Crohns Colitis 2017
The immune system is “reset” with chemotherapy, followed by the patient’s own stem cells.
What the studies say : Two British trials: improvement in some patients, but serious complications, including deaths; the second was stopped for this reason. Reserved for exceptional cases, in a specialist centre.
Sources : ASTIC, JAMA 2015; ASTIClite, Lancet Gastroenterol Hepatol 2024
A Chinese medicine plant sold online.
What the studies say : Effective in a Japanese trial in UC, but it can cause serious pulmonary hypertension and complications in the gut. Not authorised in France.
Sources : Japanese trial (UC); safety alerts
Methods offered outside medicine, often expensive.
What the studies say : No evidence in IBD. Colon cleansing and rectal ozone can cause infections or perforations in an inflamed gut. In France, homeopathy has not been reimbursed since 2021.
Sources : No serious studies; Assurance Maladie (French national health insurance) 2021