Is Lactobacillus GG helpful in children with Crohn's disease? Results of apreliminary, open-label study

Background: Lactobacillus GG is a safe probiotic bacterium known to transie ntly colonize the human intestine. It has been found to be useful in treatm ent of several gastrointestinal conditions characterized by increased gut p ermeability. In the current study, the efficacy of Lactobacillus GG was inv estigated in children with Crohn's disease. Methods: In this open-label pilot evaluation viewed as a necessary prelimin ary step for a possible subsequent randomized placebo-controlled trial, fou r children with mildly to moderately active Crohn's disease were given Lact obacillus GG (10(10) colony-forming units [CFU]) in enterocoated tablets tw ice a day for 6 months. Changes in intestinal permeability were measured by a double sugar permeability test. Clinical activity was determined by meas uring the pediatric Crohn's disease activity index. Results: There was a significant improvement in clinical activity 1 week af ter starting Lactobacillus GG, which was sustained throughout the study per iod. Median pediatric Crohn's disease activity index scores at 4 weeks were 73% lower than baseline. Intestinal permeability improved in an almost par allel Fashion. Conclusions: Findings in this pilot study show that Lactobacillus GG may im prove gut barrier function and clinical status in children with mildly to m oderately active, stable Crohn's disease. Randomized, double-blind, placebo -controlled trials are warranted for a final assessment of the efficacy of Lactobacillus GG in Crohn's disease.