PRESENTATIONSProbiotics in Pediatric Liver DiseaseMiloh, Tamir MD*,† Author Information *Department of Pediatrics, Mayo Clinic, University of Arizona †Department of Child Health University of Arizona, Department of Pediatrics, Mayo Clinic, Phoenix Children’s Hospital, Phoenix, AZ The author declares that there is nothing to disclose. Reprints: Tamir Miloh, MD, Department of Child Health University of Arizona, Department of Pediatrics, Mayo Clinic, Phoenix Children’s Hospital, 1919 East Thomas Rd., Phoenix, AZ 85016 (e-mail: [email protected]). Journal of Clinical Gastroenterology: November/December 2015 - Volume 49 - Issue - p S33-S36 doi: 10.1097/MCG.0000000000000365 Buy Metrics Abstract The gut-liver axis involves complex interaction between the intestinal microbiome and the liver parenchyma. Probiotics are live microorganisms that are used in a variety of diseases. With currently only 2 randomized-controlled studies (one with Lactobacillus GG and the other with VSL #3), data are scarce to support the clinical effect of probiotic use in children with nonalcoholic fatty liver disease. There is evidence that probiotics decrease the risk of necrotizing enterocolitis and thereby reduce the prevalence of total parenteral nutrition–induced chronic liver disease. Probiotics are used with a few reported positive outcomes in patients with cystic fibrosis and familial hypercholesterolemia and may be promising in other liver conditions. Probiotics are generally safe and well tolerated in children, premature infants, and in patients after liver transplantation. Large, prospective, randomized clinical trials are needed to evaluate the benefit of probiotics in children with liver diseases. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.