Hamidreza Kianifar - Department of Gastroenterology,Faculty of medicine,Mashhad university of medical sciences,Mashhad,Iran
Seyed Ali Jafari - Department of Pediatrics, School of Medicine, Akbar hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Maryam Khalesi - Department of Pediatrics, School of Medicine, Akbar hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammadali Kiani - Department of Pediatrics, School of Medicine, Antimicrobial Resistance Research Center, Basic Sciences Research Institute, Akbar hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Tahereh Sadeghi - Department of Pediatrics, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Akbar hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Mahmoud Reza Jaafari - Department of Pharmaceutical Nanotechnology, School of Pharmacy, Nanotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Fatemeh Amani - Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Background: Inflammatory Bowel Disease (IBD) is a multifactorial disease, posing significant challenges to public health. The aim of this study is to determine the effect of silymarin on the symptom severity in pediatric patients with IBD.Methods & Materials: This randomized clinical trial was conducted on children aged ۵-۱۸ diagnosed with IBD referred to the GI clinic at Akbar Children's Hospital in Mashhad. Those who met the inclusion criteria were randomly allocated into either the intervention or placebo group, each group consisting of ۲۰ participants. In the intervention group, silymarin was administered three times daily in divided doses for three months. The control group received a placebo. To assess the efficacy of silymarin, PUCAI and PCDAI were evaluated for all patients at three different time points: before the intervention, during the first visit, and after the intervention. Data were analyzed utilizing the SPSS version ۲۵, with a significance level set at p < ۰.۰۵.Results: The comparison of the disease activity index scores in patients with IBD between the silymarin and placebo groups revealed that during the initial evaluation, no significant difference was observed in the disease activity index score between the two groups before the intervention (p>۰.۰۵). However, a statistically significant difference was observed in the disease activity index score between the two groups during the second, and third evaluations (p<۰.۰۵).

Inflammatory bowel disease, Crohn’ s disease, Ulcerative colitis, Silymarin