***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: 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 INTRODUCTION Prebiotics positively affect gut microbiota composition , thus improving gut function . These properties may be useful for the treatment of constipation . OBJECTIVES This study assessed the tolerance and effectiveness of a prebiotic inulin/partially hydrolyzed guar gum mixture ( I-PHGG ) for the treatment of constipation in females , as well as its influence on the composition of intestinal microbiota and production of short chain fatty acids . METHODS Our study enrolled 60 constipated female health worker volunteers . Participants reported less than 3 bowel movements per week . Volunteers were r and omized to treatment with prebiotic or placebo . Treatment consisted of 3 weeks supplementation with 15 g/d IPHGG ( fiber group ) or maltodextrin ( placebo group ) . Abdominal discomfort , flatulence , stool consistency , and bowel movements were evaluated by a recorded daily question naire and a weekly interview . Changes in fecal bacterial population and short chain fatty acids were assessed by real-time PCR and gas chromatography , respectively . RESULTS There was an increased frequency of weekly bowel movements and patient satisfaction in both the fiber and placebo groups with no significant differences . Total Clostridium sp significantly decreased in the fiber group ( p = 0.046 ) and increased in the placebo group ( p = 0.047 ) . There were no changes in fecal short chain fatty acid profile . CONCLUSIONS Consumption of I-PHGG produced clinical results comparable to placebo in constipated females , but had additional protective effects on gut microbiota by decreasing the amount of pathological bacteria of the Clostridium genera Irritable bowel syndrome ( IBS ) is a common condition that negatively impacts the quality of life for many individuals . The exact etiology of this disorder is largely unknown ; however , emerging studies suggest that the gut microbiota is a contributing factor . Several clinical trials show that probiotics , such as VSL#3 , can have a favorable effect on IBS . This double-blind , r and omized placebo-controlled study has been conducted in diarrhea-predominant IBS subjects in order to investigate the effect of VSL#3 on the fecal microbiota . The bacterial composition of the fecal microbiota was investigated using high-throughput microarray technology to detect 16S RNA . Twenty-four subjects were r and omized to receive VSL#3 or placebo for 8 weeks . IBS symptoms were monitored using GSRS and quality -of-life question naires . A favorable change in Satiety subscale was noted in the VSL # 3 groups . However , the consumption of the probiotic did not change the gut microbiota . There were no adverse events or any safety concerns encountered during this study . To summarize , the use of VSL#3 in this pilot study was safe and showed improvement in specific GSRS-IBS scores in diarrhea-predominant IBS subjects . The gut microbiota was not affected by VSL#3 consumption , suggesting that the mechanism of action is not directly linked to the microbiota Background Recent data suggest a role for the intestinal microbiota in the pathogenesis of functional bowel disorders ( FBDs ) . Probiotic studies in FBDs generated inconsistent results suggesting a strain-specific and product-specific effect . Aim To investigate the clinical efficacy of Lactobacillus acidophilus NCFM ( L-NCFM ) and Bifidobacterium lactis Bi-07 ( B-LBi07 ) in nonconstipation FBDs . Methods A double-blind , placebo-control clinical trial of the probiotic bacterias L-NCFM and B-LBi07 twice a day ( 2 × 1011CFU/d ) versus placebo over 8 weeks . Primary endpoints were global relief of gastrointestinal symptoms and satisfaction with treatment . Secondary endpoints were change in symptoms severity , well-being , and quality of life . Microbiological effect was assessed by quantitative real time polymerase chain reaction on fecal sample s. Results Sixty patients ( probiotic , n=31 ; placebo , n=29 ) , 72 % females , 84 % whites , mean age 37 years . Abdominal bloating improved in the probiotics compared with the placebo group at 4 weeks ( 4.10 vs 6.17 , P=0.009 ; change in bloating severity P=0.02 ) and 8 weeks ( 4.26 vs 5.84 , P=0.06 ; change in bloating severity P<0.01 ) . Analyses on the irritable bowel syndrome subgroup ( n=33 ) showed similar results . Conclusions L-NCFM and B-LBi07 twice a day improve symptoms of bloating in patients with FBDs . These data supports the role of intestinal bacteria in the pathophysiology of FBD and the role for probiotic bacteria in the management of these disorders 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 Therapy trials with bacterial compounds in irritable bowel syndrome ( IBS ) have produced conflicting results and , so far , an E.-coli preparation has not been used . METHODS Two hundred and ninety-eight patients with lower abdominal symptoms diagnosed as IBS were treated for 8 weeks by the compound Symbioflor-2 ( Symbiopharm GmbH , Herborn , Germany ) , an Escherichia coli product ( N = 148 ) , or placebo ( n = 150 ) in a double-blinded , r and omized fashion . Patients were seen weekly by the physician , who assessed the presence of core IBS symptoms . Both an abdominal pain score ( APS ) as well as a general symptom score ( GSS ) were used as primary endpoints . Responders had to have complete absence of IBS core symptoms at > or = 1 visit during treatment . RESULTS The responder rate in GSS to the drug was 27 / 148 ( 18.2 % ) in comparison to placebo with 7 / 150 ( 4.67 % ) ( p = 0.000397 ) . The improvement in APS was 28 / 148 ( 18.9 % ) and 10 / 150 ( 6.67 % ) for placebo ( p = 0.001649 ) . The response was reached from visit 3 onwards with both medication and placebo . Post-hoc analysis revealed no significant differences in efficacy of the drug between the gender and different age groups . CONCLUSION Treatment of IBS with the probiotic Symbioflor-2 is effective and superior to placebo in reducing typical symptoms of IBS patients seen by general practitioners and by gastroenterologists Abstract Objective . Meta-analyses have indicated effect of probiotics on irritable bowel syndrome ( IBS ) . However , few long-term trials have been conducted and uncertainty remains as to effectiveness and long-term effect in a primary care setting . We aim ed to investigate the effect of probiotics compared with placebo in the management of IBS in primary care during a 6-month treatment period and with a 6-month follow-up . Material and methods . We r and omized IBS patients fulfilling Rome III criteria to receive two capsules twice daily either containing placebo or a probiotic mixture of Lactobacillus paracasei ssp paracasei F19 , Lactobacillus acidophilus La5 and Bifidobacterium Bb12 in an amount of 1.3 × 1010 CFU per capsule . Primary endpoint was proportion of responders defined as patients reporting adequate relief ( AR ) at least 50 % of the time in the 6-month treatment period . Secondary outcomes were proportions of patients reporting AR at different time points , and change in gastrointestinal symptoms and health-related quality of life ( HrQOL ) from baseline to 6 and 12 months . Results . A total of 131 patients were included in this study . The proportion of responders in the treatment period was 52 % ( 35/67 ) in the probiotic group versus 41 % ( 26/64 ) in the placebo group , p = 0.18 . Overall we found no difference between the groups in change in gastrointestinal symptoms after treatment . Patients improved in HrQOL , but with no statistically significant difference between the groups . Conclusion . During a 6-month treatment period , we were not able to detect a positive effect of probiotic when compared with placebo BACKGROUND The aim of the present study was to investigate the effect of a probiotic beverage on gastrointestinal symptoms in patients with chronic constipation . METHODS A double-blind , placebo-controlled , r and omized study was conducted over a four-week period in patients with symptoms of chronic constipation ( n=70 ) . To all patients , 65 mL/day of a probiotic beverage containing Lactobacillus casei Shirota ( LcS ) or a sensorially identical placebo was administered . Patients completed a question naire on gastrointestinal symptoms , well-being and stool habits and underwent a medical examination weekly . Severity of constipation , flatulence and bloating was summarized into four categories ( severe , moderately severe , mild and no symptoms ) . RESULTS The consumption of LcS result ed in a significant improvement in self-reported severity of constipation and stool consistency , starting in the second week of the intervention phase ( P<0.0001 ) . Severe and moderately severe constipation was observed less in the LcS group . The occurrence and degree of flatulence or bloating sensation did not change . In the final examination , 89 % of the LcS group and 56 % of the placebo group showed a positive effect of their beverage on constipation ( P=0.003 ) . No adverse reactions were reported . CONCLUSIONS The results indicate a beneficial effect on gastrointestinal symptoms of patients with chronic constipation . The administration of probiotic foodstuffs may be recommended as an adjunctive therapy of chronic constipation AIM To investigate the effect of a fermented milk containing Bifidobacterium lactis DN-173010 and yogurt strains ( BIO(R ) ) on adult women with constipation in Beijing . METHODS A total of 135 adult females with constipation were r and omly allocated to consume for 2 wk either 100 g of the test fermented milk or 100 g of an acidified milk containing non-living bacteria ( control ) .  Sto 
    Output:
    
Probiotics had beneficial effects on global IBS , abdominal pain , bloating , and flatulence scores .
: Probiotics are effective treatments for IBS , although which individual species and strains are the most beneficial remains unclear .
The efficacy of all three therapies in CIC is also uncertain