***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: Antibiotic-associated diarrhea ( AAD ) is a common complication of antibiotic use . There is growing interest in probiotics for the treatment of AAD and Clostridium difficile infection because of the wide availability of probiotics . The aim of this multicenter , r and omized , placebo-controlled , double-blind trial was to assess the efficacy of probiotic Lactobacillus ( Lacidofil ® cap ) for the prevention of AAD in adults . From September 2008 to November 2009 , a total of 214 patients with respiratory tract infection who had begun receiving antibiotics were r and omized to receive Lactobacillus ( Lacidofil ® cap ) or placebo for 14 days . Patients recorded bowel frequency and stool consistency daily for 14 days . The primary outcome was the proportion of patients who developed AAD within 14 days of enrollment . AAD developed in 4 ( 3.9 % ) of 103 patients in the Lactobacillus group and in 8 ( 7.2 % ) of 111 patients in the placebo group ( P=0.44 ) . However , the Lactobacillus group showed lower change in bowel frequency and consistency ( 50/103 , 48.5 % ) than the placebo group ( 35/111 , 31.5 % ) ( P=0.01 ) . Although the Lacidofil ® cap does not reduce the rate of occurrence of AAD in adult patients with respiratory tract infection who have taken antibiotics , the Lactobacillus group maintains their bowel habits to a greater extent than the placebo group 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 Probiotics purportedly reduce symptoms of gastrointestinal and upper respiratory-tract illness by modulating commensal microflora . Preventing and reducing symptoms of respiratory and gastrointestinal illness are the primary reason that dietary supplementation with probiotics are becoming increasingly popular with healthy active individuals . There is a paucity of data regarding the effectiveness of probiotics in this cohort . The aim of this study was to evaluate the effectiveness of a probiotic on faecal microbiology , self-reported illness symptoms and immunity in healthy well trained individuals . Methods Competitive cyclists ( 64 males and 35 females ; age 35 ± 9 and 36 ± 9 y , VO2max 56 ± 6 and 52 ± 6 ml.kg-1.min-1 , mean ± SD ) were r and omised to either probiotic ( minimum 1 × 109Lactobacillus fermentum ( PCC ® ) per day ) or placebo treatment for 11 weeks in a double-blind , r and omised , controlled trial . The outcome measures were faecal L. fermentum counts , self-reported symptoms of illness and serum cytokines . Results Lactobacillus numbers increased 7.7-fold ( 90 % confidence limits 2.1- to 28-fold ) more in males on the probiotic , while there was an unclear 2.2-fold ( 0.2- to 18-fold ) increase in females taking the probiotic . The number and duration of mild gastrointestinal symptoms were ~2-fold greater in the probiotic group . However , there was a substantial 0.7 ( 0.2 to 1.2 ) of a scale step reduction in the severity of gastrointestinal illness at the mean training load in males , which became more pronounced as training load increased . The load ( duration ×severity ) of lower respiratory illness symptoms was less by a factor of 0.31 ( 99%CI ; 0.07 to 0.96 ) in males taking the probiotic compared with placebo but increased by a factor of 2.2 ( 0.41 to 27 ) in females . Differences in use of cold and flu medication mirrored these symptoms . The observed effects on URTI had too much uncertainty for a decisive outcome . There were clear reductions in the magnitude of acute exercise-induced changes in some cytokines . Conclusion L. fermentum may be a useful nutritional adjunct for healthy exercising males . However , uncertainty in the effects of supplementation on URTI and on symptoms in females needs to be resolved . Trial registration The trial was registered in the Australia and New Zeal and Clinical Trials Registry ( ACTRN12611000006943 ) Background and aims Meta-analyses point to a modest but significant effect of probiotics on symptoms in irritable bowel syndrome ( IBS ) . We aim ed to assess the effect of the probiotic Lactobacillus casei Shirota ( LcS ) on symptoms and quality of life in IBS patients in a r and omized , double-blind , placebo-controlled intervention study . Material s and methods IBS patients ( Rome II ) between 18 and 65 years of age were included . The study consisted of an 8-week intervention period in which the participants received probiotic ( LcS ) or placebo twice daily , followed by an 8-week follow-up period . Symptom diaries and quality of life were scored at weeks 0 , 8 and 16 . The primary outcome parameter was a decrease of at least 30 % in a composite mean symptom score ( MSS ) at week 8 on the basis of an intention-to-treat analysis . Results Thirty-nine individuals ( 67 % women ) were included in the probiotic group and 41 individuals ( 71 % women ) were included in the placebo group . After the intervention period , the mean relative improvement did not reach 30 % for MSS or any individual symptom score . After follow-up ( week 16 ) , a mean improvement of at least 30 % was achieved for MSS in the probiotic group , but no significant difference was found between both treatment groups ( mean±SD : 34±7 % ; 13±8 % , P=0.06 ) . Conclusion After probiotic treatment with LcS , no improvement of 30 % in MSS was observed after 8 weeks AIMS To clarify the effects of Lactobacillus gasseri CP2305 ( CP2305 ) on quality of life and clinical symptoms and its functional mechanisms in patients with irritable bowel syndrome ( IBS ) . METHODS AND RESULTS After the patients were administered CP2305 daily for 4 weeks , the IBS-severity index score was significantly improved compared with that of the placebo group , and this improvement was accompanied by a reduction in health-related worry and changes in intestinal microbiota . The gene expression profiling of the peripheral blood leucocytes showed that CP2305 treatment significantly up-regulated genes related to eukaryotic initiation factor 2 ( EIF2 ) signalling . Eighty-two genes were down-regulated in IBS patients compared with healthy controls . The expression of 23 of these genes exhibited a CP2305-dependent increase associated with an improvement in IBS severity . The majority of the restored genes were related to EIF2 signalling . CONCLUSIONS CP2305 administration is a potential c and i date therapeutic option for patients with IBS . SIGNIFICANCE AND IMPACT OF THE STUDY Although probiotics have been proposed to benefit IBS patients , objective clinical evidence and elucidation of the functional mechanism remain insufficient . Our study demonstrated that CP2305 administration beneficially influences IBS patients in both subjective and objective evaluations , and gene expression profiling provided insights into the functional mechanism AIM To evaluate the effects of a combination probiotic on symptoms and colonic transit in patients with irritable bowel syndrome ( IBS ) and significant bloating . METHODS Forty-eight patients with Rome II IBS were r and omized in a parallel group , double-blind design to placebo or VSL # 3 twice daily ( 31 patients received 4 weeks and 17 patients 8 weeks of treatment ) . Pre- and post-treatment colonic transit measurements were performed using scintigraphy with (111)In charcoal . Symptoms were summarized as an average daily score for the entire period of treatment and separately for the first 4 weeks of treatment . Weekly satisfactory relief of abdominal bloating was assessed . RESULTS Treatment with VSL # 3 was associated with reduced flatulence over the entire treatment period ( placebo 39.5 + /- 2.6 vs VSL # 3 29.7 + /- 2.6 , P = 0.011 ) ; similarly , during the first 4 weeks of treatment , flatulence scores were reduced ( placebo 40.1 + /- 2.5 vs VSL # 3 30.8 + /- 2.5 , P = 0.014 ) . Proportions of responders for satisfactory relief of bloating , stool-related symptoms , abdominal pain and bloating scores were not different . Colonic transit was retarded with VSL # 3 relative to placebo ( colon geometric center 2.27 + /- 0.20 vs 2.83 + /- 0.19 , P = 0.05 respectively ) . CONCLUSION VSL # 3 reduces flatulence scores and retards colonic transit without altering bowel function in patients with IBS and bloating 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 This r and omized double blind placebo controlled dual site clinical trial compared a probiotic dietary supplement to placebo regarding effects on gastrointestinal symptoms in adults with post-pr and ial intestinal gas-related symptoms ( abdominal pain , distention , flatulence ) but no gastrointestinal ( GI ) diagnoses to explain the symptoms . Methods Sixty-one adults were enrolled ( age 36.5 ± 12.6 years ; height 165.1 ± 9.2 cm ; weight 75.4 ± 17.3 kg ) and r and omized to either Digestive Advantage ™ Gas Defense Formula -  ( GanedenBC30Bacillus coagulans GBI-30 , 6086 ) : n = 30 ; or Placebo : n = 31 . Study subjects were evaluated every two weeks over a four-week period using vali date d question naires and st and ard biochemical safety testing . Outcome criteria of interest included change from baseline in Gastrointest 
    Output:
    
Consensus statements with 100 % agreement and " high " evidence level indicated that specific probiotics help reduce overall symptom burden and abdominal pain in some patients with IBS and duration /intensity of diarrhoea in patients prescribed antibiotics or H. pylori eradication therapy , and have favourable safety .
Statements with 70%-100 % agreement and " moderate " evidence indicated that , in some patients with IBS , specific probiotics help reduce bloating/distension and improve bowel movement frequency/consistency .
CONCLUSIONS This up date d review indicates that specific probiotics are beneficial in certain lower GI problems , although many of the new publications did not report benefits of probiotics , possibly due to inclusion of new , less efficacious preparations .
Specific probiotics can relieve lower GI symptoms in IBS , prevent diarrhoea associated with antibiotics and H. pylori eradication therapy , and show favourable safety .