Changes in the Faecal Flora During Treatment with Metronidazole or Sulfasalazine

Abstract

In the search for etiological factors in Crohn’s disease the attention has also been directed to the possibility of a change of the normal bowel microflora. As gut bacteria live in close contact with the bowel mucosa, there is good reason to believe that they play a primary or secondary role in the pathogenesis of Crohn’s disease. Observations such as increased immune response to Escherichia coli and Bacteroides fragilis in patients with Crohn’s disease (1) support this hypothesis. The hypothesis is further supported by the fact that metronidazole, which is highly active against anaerobic bacteria has a good effect in some patients with Crohn’s disease (2,3) and that sulfasalazine which also has an antibacterial effect is effective in active Crohn’s disease (4). However, both these drugs have several other pharmacological effects such as chemotactic, immunosuppressive and anti-inflammatory properties.