The antibacterial effect of a home-made raw garlic extract and commercial garlic tablets alone and in combination with antibiotics or omeprazole was determined against clinical isolates of Helicobacter pylori. MIC values of raw garlic extract and three types of commercial garlic tablets ranged from 10,000 to 17,500 mg/L. When MIC values of the commercial tablets were based on the allicin content, no differences between the three types were observed. The combination of garlic and omeprazole, studied with killing curves, showed a synergic effect which was concentration dependent. Further clinical evaluation of garlic in combination with the conventional agents for H. pylori treatment seems warranted.

INTRODUCTIONPatients with Crohn's disease are at high risk of developing osteopenia and osteoporosis. 1±5 The pathogenesis and pathophysiology of these conditions in Crohn's disease are still not completely understood. A number of factors are considered to contribute to the reduced bone density. These include: steroid use, malnutrition, vitamin D and calcium de®ciency, immobilization, smoking, sex hormone de®ciency, hyperparathyroidism, and the in¯ammatory process itself.6 It has been demonstrated that clinical risk factors are poor diagnostic predictors of actual bone mass. 7 In a large controlled study, low bone mineral density was found in patients with Crohn's disease, but not in those with ulcerative colitis. The pathophysiological process can be clari®ed by studying bone turnover by means of biochemical markers that re¯ect bone turnover in the entire skeleton and have the advantage of being non-invasive, relatively inexpensive and of allowing repeated evaluation. 9 Biochemical markers of bone resorption are: serum osteocalcinl total and bone-speci®c alkaline SUMMARY Background: A high prevalence of osteoporosis is found in patients with Crohn's disease. The pathogenesis of this condition seems to be multifactorial and its pathophysiology is still not completely understood. Aim: To elucidate the pathophysiology of osteopenia in quiescent Crohn's disease. Methods: Bone turnover was studied in 26 patients (13 males and 13 females) with long-standing quiescent Crohn's disease and small bowel involvement. Bone mineral density was assessed by dual energy X-ray absorptiometry. Biochemical markers for bone formation (osteocalcin and bone-speci®c alkaline phosphatase) and for bone resorption (deoxypyridinoline and collagen type I C-terminal crosslinks) were measured. Urinary calcium excretion was determined.