***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Objective . The effect of probiotics on IBS symptoms has been mixed , but remains an intriguing treatment option with appeal to the patient . Material and methods . Patients fulfilling the Rome II criteria were r and omized double-blind to a daily intake of 500 ml of fermented milk containing at least 5 × 107 CFU/ml of Lactobacillus paracasei ssp paracasei F19 , Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 or an equal volume of acidified milk for 8 weeks . Symptoms were assessed at baseline and weekly using a disease-specific vali date d symptom rating scale ( IBS-SSI ) . The predefined primary outcome measure was patient reported adequate symptom relief . Adherence to study protocol were assessed by performing stool sample s at the of the treatment period . Results . Eight-one patients were screened . Sixty-four patients were r and omized ; 18 patients did not complete the study due to protocol violations or withdrew due to lack of effect . Fifty-two patients ( 13 males ) completed the study as per protocol ; mean age was 51.3 years ( range 29–67 ) . The proportion of patients reporting adequate symptom relief increased in both patient groups , but there was not any statistical difference between the groups . IBS-SSI scores did not differ statistically between the groups at the end of the treatment period , but improved during the study period in both groups . Conclusions . During this 8-week trial gastrointestinal symptoms improved . However , there was no difference between treatment with fermented milk containing probiotics or acidified milk . The effect of probiotics on IBS symptoms remains uncertain and further studies are warranted BACKGROUND Micro-inflammation is considered an element in the pathogenesis of irritable bowel syndrome ( IBS ) . High-sensitivity C reactive protein ( hs-CRP ) was previously shown to be higher in IBS compared to healthy controls , albeit within the normal range . Since probiotics may suppress micro-inflammation in the gut , we tested if they reduce symptoms and inflammatory markers ( hs-CRP and fecal calprotectin ( FC ) in diarrhea-predominant IBS ( IBS-D ) . The aim of this study was to assess the clinical and laboratory effects of BIO-25 , a multispecies probiotic , in women with IBS-D. METHODS A double-blind , placebo-controlled study . Following a 2-week run-in , eligible women were assigned at r and om to a probiotic capsule or an indistinguishable placebo , twice daily for 8 weeks . IBS symptoms and stool consistency were rated daily by Visual Analogue Scales ( VAS ) and the Bristol Stool Scale ( BSS ) . High-sensitivity C reactive protein was tested at baseline , 4 and 8 weeks . FC was tested at baseline and 8 weeks . KEY RESULTS One hundred and seventy-two IBS-D patients were recruited and 107 eligible patients were allocated to the  intervention  ( n=54 ) or placebo  ( n=53 ) group . All symptoms improved in both groups with no significant difference between them in symptom improvement , hs-CRP or FC levels . CONCLUSIONS & INFERENCES An 8-week treatment with BIO-25 improved symptoms in women with IBS-D , but was not superior to placebo . This rigorously design ed and executed study supports the findings of other studies that did not demonstrate superiority of probiotics over placebo in IBS . High quality clinical studies are necessary to examine the efficacy of other specific probiotics in IBS-D patients since data are still conflicting AIM To determine the effects of Lactobacillus acidophilus NCFM on  irritable bowel syndrome ( IBS ) symptoms and quality of life ( QoL ) . METHODS In this r and omized triple-blind trial , adult IBS volunteers who were recruited according to Rome III criteria received 109 or 1010 colony-forming units of NCFM or placebo daily for 12 wk . IBS Symptom Severity Score ( IBS-SSS ) , which constituted the primary outcome , and secondary outcomes , including individual IBS symptoms , IBS-related QoL question naire , anxiety and depression , defecation frequency , and stool consistency , were assessed at baseline at the end of the 8-wk run-in period , after 4 and 12 wk of intervention , and after a 4-wk washout . RESULTS A total of 340 of 391 r and omized volunteers completed the trial .  IBS-SSS improved over 12 wk of treatment in all treatment groups , decreasing by a mean ± SD of 44.0 ± 80.2 , 50.8 ± 82.4 , and 48.3 ± 72.2 in the placebo , active low-dose , and active high-dose groups , respectively . Similarly , secondary outcomes did not differ between treatment groups . However , in a post hoc analysis of volunteers with moderate to severe abdominal pain  at baseline ( VAS > 35/100 ) , the treatment significantly reduced the sensation of abdominal pain . Pain scores fell by 20.8 ± 22.8 , 29.4 ± 17.9 , and 31.2 ± 21.9 in the placebo , active low-dose , and active high-dose groups , respectively ( P value for placebo vs combined active doses = 0.0460 ) . CONCLUSION NCFM  alleviates moderate to severe abdominal pain , consistent with earlier observations of this strain mitigating visceral pain through increased analgesic receptor expression Background Current knowledge suggests that small intestinal overgrowth participates in the pathogenesis of irritable bowel syndrome . It is question able if this association is modulated by intake of proton pump inhibitors ( PPIs ) . Methods In a prospect i ve study , quantitative cultures of duodenal aspirates were performed for aerobic species in 897 consecutive patients undergoing upper GI tract endoscopy . SIBO was defined as equal to or more than 103 cfu/ml . The effect of PPI intake on the relationship between SIBO and IBS was the primary endpoint . Results Analysis among patients without any history of PPI intake ( n = 713 ) showed that odds ratio ( OR ) for IBS in the event of SIBO was 5.63 ( 3.73–8.51 , p < 0.0001 ) ; this was 4.16 ( 1.91–9.06 ) when analysis was done among patients with history of PPI intake ( n = 184 , p : 0.498 between patients without and with PPI intake ) . Multiple logistic regression analysis found that factors independently associated with SIBO were age above or equal to 60 years ( OR : 2.36 ) , body mass index more than or equal to 22 kg/m2 ( OR : 0.60 ) , presence of IBS ( OR : 6.29 ) , type 2 diabetes mellitus ( OR : 1.59 ) and gastritis ( OR : 0.47 ) . Conclusions The association between IBS and SIBO was completely independent from PPI intake . Although gastritis was protective against SIBO , results show that PPI intake can not prime SIBO Irritable bowel syndrome ( IBS ) is a common disorder in gastrointestinal system and impairs the quality of life of the patients . Clostridium butyricum ( CB ) is a probiotics that has been used in several gastrointestinal diseases . The efficacy of CB in treating IBS is still unknown . This prospect i ve , multi-centre , r and omized , double-blind , placebo-controlled trial aim ed to assess the efficacy and safety of CB in treating diarrhea-predominant IBS ( IBS-D ) and analyze the fecal microbiota after treatment . Two hundred patients with IBS-D were recruited and were given CB or placebo for 4 weeks . End points included change from baseline in IBS symptoms , quality of life , stool consistency and frequency . Compared with placebo , CB is effective in improving the overall IBS-D symptoms ( −62.12 ± 74.00 vs. −40.74 ± 63.67 , P = 0.038 ) as well as quality of life ( 7.232 ± 14.06 vs. 3.159 ± 11.73 , P = 0.032 ) and stool frequency ( −1.602 ± 1.416 vs. −1.086 ± 1.644 , P = 0.035 ) . The responder rates are found higher in CB compared with the placebo ( 44.76 % vs. 30.53 % , P = 0.042 ) . The change in fecal microbiota was analyzed and function pathways of CB in treating IBS-D were predicted . In conclusion , CB improves overall symptoms , quality of life and stool frequency in IBS-D patients and is considered to be used as a probiotics in treating IBS-D clinical ly BACKGROUND : Probiotic bacteria exhibit a variety of properties , including immunomodulatory activity , which are unique to a particular strain . Thus , not all species will necessarily have the same therapeutic potential in a particular condition . We have preliminary evidence that Bifidobacterium infantis 35624 may have utility in irritable bowel syndrome ( IBS ) . OBJECTIVES : This study was design ed to confirm the efficacy of the probiotic bacteria B. infantis 35624 in a large-scale , multicenter , clinical trial of women with IBS . A second objective of the study was to determine the optimal dosage of probiotic for administration in an encapsulated formulation . METHODS : After a 2-wk baseline , 362 primary care IBS patients , with any bowel habit subtype , were r and omized to either placebo or freeze-dried , encapsulated B. infantis at a dose of 1 × 106 , 1 × 108 , or 1 × 1010 , cfu/mL for 4 wk . IBS symptoms were monitored daily and scored on to a 6-point Likert scale with the primary outcome variable being abdominal pain or discomfort . A composite symptom score , the subject 's global assessment of IBS symptom relief , and measures of quality of life ( using the IBS-QOL instrument ) were also recorded . RESULTS : B. infantis 35624 at a dose of 1 × 108 cfu was significantly superior to placebo and all other bifidobacterium doses for the primary efficacy variable of abdominal pain as well as the composite score and scores for bloating , bowel dysfunction , incomplete evacuation , straining , and the passage of gas at the end of the 4-wk study . The improvement in global symptom assessment  exceeded placebo by more than 20 % ( p < 0.02 ) . Two other doses of probiotic ( 1 × 106 and 1 × 1010 ) were not significantly different from placebo ; of these , the 1 × 1010 dose was associated with significant formulation problems . No significant adverse events were recorded . CONCLUSIONS : B. infantis 35624 is a probiotic that specifically relieves many of the symptoms of IBS . At a dosage level of 1 × 108 cfu , it can be delivered by a capsule making it stable , convenient to administer , and amenable to widespread use . The lack of benefits observed with the other dosage levels of the probiotic highlight the need for clinical data in the final dosage form and dose of probiotic before these products should be used in practice Background The treatment of Irritable bowel syndrome ( IBS ) is still challenging . Partially hydrolyzed guar gum ( PHGG ) is a known prebiotic fiber . To assess the effects of PHGG on clinical symptoms of IBS patients in a prospect i ve r and omized double blind placebo-controlled study . Methods Suitable IBS patients were recruited into an 18-week-long study ( 2 weeks of run-in , 12 weeks of treatment and 4 weeks of follow-up ) . They were blindly r and omized to receive 6 gr of PHGG or placebo . Treatment efficacy was evaluated by the Francis Severity IBS score , the IBS quality -of-life scores and scored parameters of weekly journal of symptoms . Deltas of changes between the final and baseline scores were compared between two groups . Results Of 121 patients who underwent r and omization , 108 patients ( 49 in the PHGG group and 59 in the placebo group ) had all the data needed for intention-to-treat analysis . A 12-week administration of PHGG led to a significant improvement of journal bloating score in the PHGG group versus placebo ( −4.1±13.4 versus −1.2±11.9 , P=0.03 ) , as well as in bloating+gasses score ( −4.3±10.4 versus −1.12±10.5 , P = 0.035 ) . The effect lasted for at least 4 weeks after the last PHGG administration . PHGG had no effect on other journal reported IBS symptoms or on Severity and Quality of life scores . There were no significant side effects associated with PHGG ingestion . The rate of dropouts was significantly higher among patients in the placebo group compared with the PHGG group ( 49.15 % versus 22.45 % , respectively , P = 0.01 ) . Conclusions The results of this study support the administration of 6 g/day PHGG for IBS patients with bloating . Trial registration BACKGROUND Interest in fructooligosaccharides as a health-promoting food component is increasing . Fructool 
    Output:
    
This remained apparent in both single- and multi-strain probiotic interventions as well as synbiotic formulations .
However , evidence regarding prebiotics was scarce .
There were no significant inter-group differences in terms of the frequency of adverse events .