***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: A double-blind controlled therapeutic trial of factorial design was used to study the therapeutic effects of lorazepam , hyoscine butylbromide , and ispaghula husk in 12 r and omised blocks of eight patients with the irritable bowel syndrome ( IBS ) . Each of the three agents caused a sustained symptomatic improvement in some of the patients , although only with ispaghula was the difference between the real and dummy preparation statistically significant . When the eight possible combinations of treatment were analysed none of the 12 patients who received only dummy preparations of the three agents had maintained any improvement over the three months of the trial . Seven patients improved among the 12 who received potent preparations of all three agents , and between four and six patients improved in the groups receiving one or two of the potent preparations . These therapeutic results , though far from perfect , show that the types of drug commonly used to treat IBS are of some value and may be additive in their effects . Similar combinations of other therapeutic agents may be more effective , but it will be possible to determine this only by carrying out factorial therapeutic trials This placebo controlled , double-blind , cross-over trial involving 20 patients was conducted to assess the effect of ispaghula husk on the major bowel symptoms and the whole gut transit time in irritable bowel syndrome ( IBS ) and to determine if changes in these parameters were related to global improvement . All 20 patients were interviewed at the end of the treatment periods and 14 patients kept concurrent daily records . Ispaghula therapy result ed in improvement in global symptoms and satisfying bowel movements ( P less than 0.001 ) but produced no change in abdominal pain or flatulence . There was a correlation between the improvement of well-being and the number of days of satisfying bowel movements ( P less than 0.001 ) but not with the indexes of pain , stool frequency or changes in the transit time . The easing of bowel dissatisfaction appears to be a major reason for the therapeutic success of ispaghula in IBS A double blind placebo controlled trial of ispaghula husk in 80 patients with irritable bowel syndrome is reported . Global assessment judged treatment to be satisfactory in 82 % of patients receiving ispaghula and 53 % of the placebo group ( p less than 0.02 ) . Bowel habit was unchanged in the placebo group , while constipation significantly improved in patients taking ispaghula ( p = 0.026 ) . Transit time decreased significantly in those taking ispaghula compared with placebo ( p = 0.001 ) , especially in patients with initially high transit times . Abdominal pain and bloating improved in both groups , with no significant differences between ispaghula and placebo . Four of the eight withdrawals on ispaghula and 10 of the 15 withdrawals on placebo were because of treatment failure . Ispaghula significantly improves overall well being in patients with irritable bowel syndrome , and in those with constipation favourably affects bowel habit and transit time Comment Our results confirm that the natural defences of the peritoneum can deal successfully with infection if unhampered by the dialysis fluid . ' Temporary interruption of dialysis avoids protein loss and fluid retention due to peritoneal inflammation , limits the use of costly or toxic antibiotics , and preserves remaining renal function . We found that our patients , having been treated by interruption of dialysis once , subsequently tended to refer themselves early in the hope of being able to receive this short treatment again . The treatment avoids the loss of phagocytic cells and opsonins that occurs during dialysis and allows these cells to be concentrated into a small volume of peritoneal fluid , thus increasing the chance of phagocytosis . It also avoids the detrimental effect of dialysis fluid on phagocytic cells,2 which may enhance survival of bacteria within leucocytes,3 and on the mesothelial cells.4 Interruption of dialysis was regularly effective and was not detrimental to peritoneal function . We believe that this was because of our careful selection of cases and recommend that the treatment is used only in the absence of contraindications . Immediate failure of this treatment was unusual . If not due to the presence of unusual pathogens it would suggest persisting infection from colonisation of the catheter or , if infection were present at the exit site , covert infection around the catheter . In either case the catheter should be removed , as in relapse of peritonitis after conventional A r and omized , double-blind trial of a psyllium preparation was initiated in 77 patients with painful irritable bowel syndrome . Sixty- patients finished and su bmi tted symptom data for 8 weeks while taking placebo ( n = 34 ) or psyllium ( n = 26 ) . Increase in normal stools and decrease in pain severity ( p less than 0.05 ) occurred equally in both groups . Subjective improvement was reported by 24 of 34 patients on placebo and 20 or 26 on psyllium ( p greater than 0.05 ) . Five symptom variables were significantly correlated ( p less than 0.05 ) with patient 's subjective global assessment ( R = 0.64 ) . Discriminant analysis of Minnesota Multiphasic Personality Inventory variables yielded overall rates of correct prediction of 66.1 % for whether patients got " much better " and 77.9 % for whether they voluntarily dropped from the study . A major placebo effect occurs in patients with painful irritable bowel syndrome and is probably responsible for the efficacy of psyllium . Personality factors influence the magnitude of therapeutic response and whether patients discontinue treatment within 8 weeks 
    Output:
    
: Soluble fiber is effective in treating IBS .
Bran did not appear to be of benefit , although we did not uncover any evidence of harm from this intervention , as others have speculated from uncontrolled data