Use of Lactobacillus GG for Treatment of Allergic Colitis in Children

62 Use of Lactobacillus GG for Treatment of Allergic Colitis in Children Cow’s milk protein allergy (CMPA) is a relatively common gastrointestinal disease in infants and is associated with rectal bleeding and diarrhea. CMPA involves intestinal inflammation, and fecal calprotectin, a marker of intestinal inflammation, may be helpful in following the disease course of CMPA. The authors of this study evaluated calprotectin as a marker of disease activity in CMPA and also evaluated the therapeutic efficacy of Lactobacillus GG added to hydrolyzed casein infant formula for treatment of CMPA. Infants between 0 to 12 months of age with CMPA were compared to age-matched, sex-matched controls. CMPA infants underwent multiple tests at enrollment including prick test for cow’s milk, patch test for cow’s milk protein, C-reactive protein, fecal occult blood, stool tests for bacterial pathogens and parasites, and fecal calprotectin. CMPA infants were then randomized to receive hydrolyzed infant formula or hydrolyzed infant formula with the addition of Lactobacillus GG. A repeat fecal calprotectin test was performed one month after this formula intervention. Thirty patients were enrolled in the intervention group, and 32 patients were enrolled in the control. Fecal calprotectin levels were significantly higher in CMPA infants compared to control infants at enrollment. In all groups, including the control group, fecal calprotectin levels decreased four weeks after initial enrollment. However, a mean decrease in fecal calprotectin levels was significantly greater in infants who received hydrolyzed formula with Lactobacillus GG compared to infants who received hydrolyzed formula alone or to a separate control group. Significantly more infants receiving hydrolyzed formula with Lactobacillus GG became fecal occult blood negative compared to those infants receiving hydrolyzed formula alone. This study suggests that the addition of Lactobacillus GG to hydrolyzed casein infant formula leads to greater mucosal healing in CMPA infants. Additionally, fecal calprotectin appears to correlate well with intestinal inflammation in CMPA and may prove to be a useful marker for this disease. (Baldassarre M, Laforgia N, Fanelli M, Laneve A, Grosso R, Lifschitz C. “Lactobacillus GG improves recovery in infants with blood in the stools and presumptive allergic colitis compared with extensively hydrolyzed formula alone.” The Journal of Pediatrics. 2010; 156: 397-401).