***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 
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    Input: 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 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 OBJECTIVE Experimental and clinical studies have shown that a novel symbiotic ( known as SCM-III ) exerts a beneficial effect on gut translocation and local and systemic inflammatory and microbial metabolic parameters . The present investigation was a preliminary trial on the effectiveness of SCM-III for irritable bowel syndrome ( IBS ) . METHODS Sixty-eight consecutive adult patients with IBS who were free from lactose malabsorption , abdominal surgery , overt psychiatric disorders and ongoing psychotropic drug therapy or ethanol abuse were studied prospect ively and divided into 2 groups that were comparable for age , gender , body size , education and pattern of presenting symptoms . The 2 groups were blindly given for 12 weeks either SCM-III 10 mL t.i.d or the same dosage of heat-inactivated symbiotic . RESULTS Treatment with SCM-III was ' effective ' or ' very effective ' in more than 80 % of the patients ( P < 0.01 vs baseline values and control ) . Less than 5 % reported ' not effective ' as the final evaluation compared with over 40 % of patients in the control group . After 6 weeks of treatment , a significant improvement of pain and bloating was reported in the treatment group compared with control and baseline values . There was also a benefit for bowel habits , mostly for patients with constipation or alternating bowel habits . No overt clinical or biochemical adverse side-effects were recorded . CONCLUSION Compared with baseline values and the control group , SCM-III result ed in a significant increase in lactobacilla , eubacteria and bifidobacteria , which suggests that some selected IBS patients could benefit substantially from symbiotics , but the treatment may need to be given on a cyclic schedule because of the temporary modification of the fecal flora BACKGROUND / AIMS Irritable bowel syndrome ( IBS ) is a functional gastrointestinal ( GI ) tract disorder that has heterogeneous clinical presentations such as abdominal pain , diarrhea , constipation , and abdominal distension . It is known that several mechanisms are involved in the pathogenesis of IBS . Probiotics may target one or more pathophysiologic pathways in IBS and may improve the symptoms of IBS . However , the results of studies about probiotics on IBS are controversial . Therefore , the aim of this study was to evaluate the effect of probiotics on GI symptoms and intestinal gas volume changes in patients with IBS . METHODS Forty patients were r and omly allocated to be treated with Medilac DS ( Bacillus subtilis , Streptococcus faecium ) ( n=20 ) or placebo ( n=20 ) in a double-blind , prospect i ve manner . The change in intestinal gas volume and symptom scores after 4-week treatment were evaluated for the efficacy . RESULTS There was no significant difference in bloating , frequency of gas expulsion , frequency of defecation , and hardness of stool before and after the treatment . However , the severity of abdominal pain and the frequency of abdominal pain decreased significantly in Medilac DS group ( 2.4+/-1.3 cm/day -- > 1.6+/-1.6 cm/day , 1.7+/-1.3/day -- > 1.0+/-1.0/day ) ( p=0.044 , p=0.038 ) , but not in placebo group ( 2.1+/-2.0 cm/day -- > 1.8+/-2.1 cm/day , 1.3+/-1.2/day -- > 1.4+/-1.9/day ) . In both groups , intestinal gas volume at baseline , after 2-week treatment , and after 4-week treatment did not show significant change . Medilac DS was well tolerated without adverse events . CONCLUSIONS Medilac DS is a safe and useful probiotic agent for the treatment of abdominal pain in patients with IBS Probiotic bacteria exhibit a variety of properties , which are unique to a particular strain . Lactobacillus acidophilus-SDC 2012 , 2013 are new strains isolated from Korean infants ’ feces . The potential utility of Lactobacillus acidophilus-SDC 2012 , 2013 in irritable bowel syndrome ( IBS ) was studied . Forty IBS patients were r and omized into a placebo ( n = 20 ) and probiotics group ( n = 20 ) . Four weeks of treatment with L. acidophilus-SDC 2012 , 2013 was associated with a reduced score for abdominal pain or discomfort compared to the baseline ( P = 0.011 ) . The percent reduction in abdominal pain or discomfort exceeded the placebo scores by more than 20 % ( 23.8 and 0.2 % for probiotics and placebo , respectively , P = 0.003 ) . There was a significant difference in the proportion of responders between the probiotics and placebo groups ( P = 0.011 ) . There was no drop out or adverse events for either group during the study period . Lactobacillus acidophilus-SDC 2012 , 2013 appeared to have a beneficial effect in patients with IBS . Further studies are warranted Aim : To investigate the effects of a probiotic formulation , VSL#3 , on gastrointestinal transit and symptoms of patients with Rome II irritable bowel syndrome with predominant diarrhoea OBJECTIVES The purpose of this study was to evaluate the effects of a probiotic combination on symptoms in patients with irritable bowel syndrome ( IBS ) . METHODS We investigated the efficiency of a probiotic dietary supplement , containing four strains of lactic acid bacteria , on symptoms of IBS . One hundred and sixteen patients with IBS fulfilling the Rome II criteria were r and omized in a parallel group , double-blind study to receive a placebo or a probiotic combination ( 1 x 10(10 ) cfu once daily ) for four weeks . The symptoms that were monitored weekly included discomfort , abdominal pain , and stool frequency and quality . Quality of life was assessed before and at the end of the treatment using the SF36 and FDD- quality -of-life question naires . RESULTS One hundred subjects completed the study ( 48 probiotic combination  , 52 placebo )  . The probiotic combination was not superior to the placebo in relieving symptoms of IBS ( 42.6 versus 42.3 % improvement ) . However , the decrease of abdominal pain between the first and the fourth week of treatment was significantly higher in probiotic treated patients ( -41.9 versus -24.2 % , P=0.048 ) . Interesting findings from the IBS sub-groups were also observed such as a lower pain score at end point in patients with alternating bowel habits ( P=0.023 ) and an increase of stool frequency in the constipated sub-group from the first week of probiotic treatment ( P=0.043 ) . CONCLUSIONS The probiotic combination was not significantly superior to the placebo in relieving symptoms of IBS . Despite the apparent high placebo response , interesting findings from IBS sub-groups were observed in the field of abdominal pain and stool frequency OBJECTIVE : The influence of the gastrointestinal ( GI ) microflora in patients with irritable bowel syndrome ( IBS ) has not been clearly eluci date d. This study was undertaken to see if patients with IBS have an imbalance in their normal colonic flora , as some bacterial taxa are more prone to gas production than others . We also wanted to study whether the flora could be altered by exogenous supplementation . In a previous study we have characterized the mucosa-associated lactobacilli in healthy individuals and found some strains with good colonizing ability . Upon colonization , they seemed to reduce gas formation . METHODS : The study comprised 60 patients with IBS and a normal colonoscopy or barium enema . Patients fulfilling the Rome criteria , without a history of malabsorption , and with normal blood tests underwent a sigmoidoscopy with biopsy .  They were r and omized into two groups , one receiving 400 ml per day of a rose-hip drink containing 5 × 107 cfu/ml of Lactobacillus plantarum ( DSM 9843 ) and 0.009 g/ml oat flour , and the other group receiving a plain rose-hip drink , comparable in color , texture , and taste . The administration lasted for 4 wk . The patients recorded their own GI function , starting 2 wk before the study and continuing throughout the study period . Twelve months after the end of the study all patients were asked to complete the same question naire regarding their symptomatology as at the start of the study . RESULTS : All patients tolerated the products well . The patients receiving Lb . plantarum had these bacteria on rectal biopsies . There were no major changes of Enterobacteriaceae in either group , before or after the study , but the Enterococci increased in the placebo group and remained unchanged in the test group . Flatulence was rapidly and significantly reduced in the test group compared with the placebo group ( number of days with abundant gas production , test group 6.5 before , 3.1 after vs 7.4 before and 5.6 after for the placebo group ) . Abdominal pain was reduced in both groups . At the 12-month follow-up , patients in the test group maintained a better overall GI function than control patients . There was no difference between the groups regarding bloating . Fifty-nine percent of the test group patients had a continuous intake of fermented 
    Output:
    
Probiotics appear to be efficacious in IBS , but the magnitude of benefit and the most effective species and strain are uncertain