50 In a third study with a different probiotic treatment, an improvement was observed in the composite score of IBS symptoms in the probiotic group vs the placebo group, but this just failed to reach statistical significance.
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Systematic review: probiotics in the management of lower gastrointestinal symptoms - an updated evidence-based international consensus.
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85 Two studies (both included in the original consensus) had mixed results: 1 showed a trend towards a beneficial effect in the weekly symptom score for abdominal pain (and, in a secondary analysis, abdominal pain was reduced in a significantly greater proportion of the probiotic group than of the placebo group) 56 and the other showed no significant increase in the proportion of patients reporting symptom relief, but a significantly greater decrease in the abdominal pain score in the probiotic group than in the placebo group. 43 Abdominal pain was evaluated as a secondary endpoint only in 21 studies.
Of these, 5 reported a significant beneficial effect of 5 different probiotics 33 , 49 , 55 , 82 , 96 (1 of which 33 also showed no significant effect in another study 50 ), 15 (examining 11 different probiotics) reported no significant effect 30 , 36 , 37 , 50 , 57 , 59 , 60 , 61 , 66 , 80 , 83 , 88 , 93 , 94 , 95 (of which 1 reported a nonsignificant trend in favour of probiotics vs placebo), 95 and another reported a negative effect of the specific probiotic treatment. 64 Of the 21 studies, 9 had been published since the original consensus.