Interest in probiotics has stemmed from the accumulating suggestive evidence that bacterial products play a role in the pathogenesis of inflammatory bowel disease (IBD) (Kleessen et al, 2002; Martin and Rhodes, 2000; Schultsz et al, 1999) and that certain "beneficial" bacteria may have anti-inflammatory properties (Borruel et al,2002). A small pilot study looked at four children with mild to moderate CD treated with Lactobacillus GG and showed significant improvement in mucosal permeability and clinical activity over the 6-month study period (Gupta et al, 2000). Little other data is available on pediatric CD. Despite this, many of our patients are using probiotics and other complementary and alternative therapies. There is a separate chapter on alternative medicines (Chapter 58, "Complementary and Alternative Medicine in Gastrointestinal Disease"). Probiotics are discussed in chapters on ulcerative colitis (Chapter 78, "Ulcerative Colitis") and on pouchitis.
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