Abstract
A role for endogenous digestive microflora in the pathogenesis of inflammatory bowel disease has been proposed on the basis of results of both experimental and clinical studies. Due to the great heterogeneity among available studies in terms of design, methodology and appropriateness of statistical analysis, the question whether endogenous microflora is involved in the initiation or perpetuation of disease is still unanswered. In addition to quantitative changes in the composition of microflora, abnormalities in the metabolic functions of bacteria can also be implicated. Despite somewhat conflicting results of basic investigations, oral bacteriotherapy with high-potency probiotic preparations greatly enriched in lactic acid bacteria appears to have an interesting clinical potential for the treatment of ulcerative colitis and pouchitis, the non-specific inflammation that frequently complicates the long-term course of pouch surgery for ulcerative colitis.