Headings and Sub-Headings
- Colon Cancer
- Cardiovascular Disease (CVD)
- Immune Function
- Inflamation and Allergies
There is an enormous amount of evidence which shows that consumption of dietary calcium and dairy foods are crucial for optimum bone growth, bone mass and preventing osteoporosis.  Calcium intake is especially important during childhood, adolescence and after menopause in women. Depending upon age and sex, the Recommended Dietary Intakes (RDI) (also known as "recommended dietary allowances") of Calcium range between 1000-1300mg in adults , which can be provided by 3 -4 servings of dairy food (preferably low fat) per day. Unfortunately however, most cheeses are relatively high in saturated fat, and milk is generally high in lactose, which may be problematic for those who are "lactose intolerant"; a condition predominantly seen in people of Asian or African descent. Yoghurt however can be found in low fat varieties, and generally contains about 1/3 - 1/2 the lactose of milk.  Moreover, another added benefit of yoghurt is that it frequently contains added fruit pieces.
Other than being an excellent low-fat, low-lactose source of calcium, yoghurt contains lactic acid bacteria including members of the Lactobacillus and Bifidobacterium families. These bacteria are added to produce lactic acid which gives yoghurt its characteristic sour taste. Lactic acid bacteria can also be consumed in “probiotic” supplements, which generally contain very large (useveral billion billion organisms) amounts of specific strains of these “friendly” bacteria. Consumption of yoghurt or other fermented dairy foods, as well as probiotic supplements, has been shown to have a wide range of beneficial effects on human health. The major problem however with taking probiotic supplements is that other than being relatively expensive, different studies have used varying concentrations of a plethora of different species and strains of lactic acid bacteria. Consequently, commerically available brands of probiots may not contain the most appropriate strains or doses.
This article discusses some of those effects which include:
Reduction in the risk of colon cancer
Modulate inflammatory and hypersensitivity responses by regulating cytokine function, improving milk allergies , decreasing the risk of atopic eczema and preventing reoccurrences of Inflammatory Bowel Disease
Improving lactose digestion among those who are lactose intolerant
Cooking meat is known to produce certain chemicals called heterocyclic primary amines that are mutagenic (capable of causing mutations in DNA)  and have been shown to be extremely carcinogenic in animal studies. Milk cultured with Lactobacilli strains have been shown to have anti-mutagenic effects in laboratory experiments including animal studies, reducing mutagenicity  and chromosome damage by approximately 80%. 
One proposed mechanism thought to be able to explain the anti-mutagenic action of lactic acid bacteria, is due to their ability to bind with these heterocyclic primary amines produced from cooked meat.  Several laboratory studies have demonstrated that various species of lactic acid bacteria are capable of binding these mutagenic chemicals,  even in human gastric juice,  thus rendering them harmless.
Further experiments suggest that lactic acid bacteria may be capable of protecting against the mutagenic effect of other carcinogens as well. Researchers in Germany exposed rats to the carcinogens MNNG or DMH (chemicals used to induce colon cancer) which subsequently caused damage to the DNA in their intestinal cells. When they fed the rats lactic acid bacteria or yoghurt however, this DNA damage was prevented. 
Because cancer initiation occurs due to mutations in DNA,  this anti-mutagenic action of lactic acid bacteria lends support to the notion that it may contribute towards preventing cancer of the colon.
Lactic acid bacteria has been shown to prevent or reduce the development of colon cancers and polyps in animal experiments. Researchers in 1983 found that that the survival rate among rats exposed with the carcinogen 1,2-dimethylhydrazine (a potent chemical carcinogen used to induce colon cancer in animals, also referred to as “DMH”), was greater in those given milk fermented with Streptococcus thermophilus or Lactobacillus bulgaricus cultures.
Further investigations have demonstrated a decrease in tumorigenesis (tumour initiation)  as well as a slowing of the development of colon cancer in rats exposed to DMH.  Studies conducted at the University of Ontario  and the University of Minnesota  found that mice exposed to DMH had a 50% reduction in aberrant crypts if they were fed Bifidobacteria.
Similar results were obtained in a study conducted at Alabama University, where rats fed Bifodobacteria along with their normal feed had significantly fewer colonic aberrant crypt foci after being exposed to azoxymethane (another chemical carcinogen used to induce colon cancer, more commonly referred to as “AOM”)  Additional investigations by the American Health Foundation revealed that Bifidobacteria fed to rats exposed to the carcinogen AOM could not only reduce the formation of in aberrant crypt foci but could significantly decrease the activity of faecal beta-glucuronidase; a bacterial enzyme thought to be involved in the process of colon cancer development.  A decrease in beta-glucuronidase activity caused by Bifidobacteria ingestion has been demonstrated in further animal studies as well.
Similar results were obtained by researchers in the U.K found that rats fed a type of Bifidobacteria after being exposed to AOM, had a 26% lower incidence of colonic aberrant crypt foci as well as lower beta-glucuronidase activity and ammonia concentration in the caecal contents than control rats.  This is significant because both these factors have been associated with colon cancer carcinogenesis in animal experiments.
Another study published in the journal Nutrition and Cancer in 1996, reported that rats given Lactobacillus casei in their feed during exposure to DMH had significantly fewer incidence of subsequent colon tumours. 
The results of these experiments give encouraging yet preliminary evidence to support the theory that LAB may assist in the prevention of colon cancer. It should however be noted that these animals were usually given levels of bacteria (approx 1 billion cells) that would be greater than that found in most fermented dairy products such as yoghurt, and probably closer to the numbers found in probiotic supplements.
It is thought that the cancer-causing effect of certain toxic and genotoxic chemicals in the gut are affected by particular bacterial enzymes including ß-glucuronidase, which can regenerate toxic or carcinogenic compounds such as polycyclic aromatic hydrocarbons, that would normally be detoxified by the liver.  These potentially harmful enzymes are produced more by unfavourable bacteria such as Clostridia, and Enterobacteriaceae, whereas “friendly” bacteria such as Lactobacillus and Bifidobacteria produce less of it.  Most importantly, consumption of these lactic acid bacteria has been shown to decrease the activity of ß-glucuronidase.
Faecal ß-glucuronidase activity was significantly reduced in 21 human subjects given Lactobacilli for 4 weeks in a study published in 1984. Bifidobacteria given to 5 volunteers in Japan for 5 weeks also resulted in lower faecal ammonia concentration and beta-glucuronidase activity.  Similarly, another trial in Paris found significantly lower faecal beta-glucuronidase activity in 12 volunteers given Bifidobacteria for 12 days. 
However another study in France found that giving Lactobacillus acidophilus and Bifidobacterium bifidum to 12 healthy volunteers for 3 weeks had no effect on ß-glucuronidase activity, but it did increase the activity of another enzyme called beta- glucosidase.  This is thought to be advantageous because glucosidases can be broken down in the gut and transformed into potentially anti-carcinogenic flavonoids such as quercetin  (an antioxidant phytochemical, also found in certain fruits and vegetables)
Yoghurt and other fermented dairy foods have shown to be protective against colon cancer in a handful of case-control studies. In 1988, researchers from the University of Wisconsin found that fermented dairy products were associated with a significantly decreased risk or colon cancer in a case control study comparing 353 colon cancer patients with 618 cancer free people. 
A study published in 1992 compared the diets of 746 colon cancer patients in California with 746 cancer-free people of the same age. A higher calcium intake was associated with a decreased risk, however the only single food which showed to be significantly protective was yoghurt. 
Another case control study in France found that yoghurt was the only food found to decrease the risk of colon adenomas (precancerous tumours) in a comparison between 208 cases and 462 controls. Moderate consumption decreased the risk by 40%, whilst higher consumption decreased the risk by 50%. The results from prospective cohort studies have been less consistent.
The Netherlands Cohort Study analysed the diets of 120,852 Dutch men and women, aged between 55-69. After 3.3 years, 215 of these people had been diagnosed with colon cancer. Those who consumed the most fermented dairy products had a 30% reduced relative risk compared with those who consumed the least. 
A smaller cohort study whose findings did not support this theory, involved 47,935 American men aged 40-75. After 6 years there were 203 new cases of colon cancer, however consumption of fermented milk products had no significant association. 
At present there is inadequate epidemiological evidence to give strong support to the notion that yoghurt consumption may prevent colon cancer, however these preliminary findings are encouraging, especially given the results from animal experiments and clinical trials measuring biochemical markers. It should however be noted that the majority of clinical and laboratory experiments used levels of lactic acid bacteria which may be greater than that consumed by people in these population-based studies, as presumably their intake would be from fermented fairy foods such as yoghurt, whereas supplemental doses of probiotics may have afforded the more significant effect seen in short term trials. Controlled clinical trials assessing cancer incidence would be needed to determine whether or not probiotic supplements alone may decrease the risk of colon cancer.
It is thought that the mechanisms by which lactic acid bacteria exert their effect on cholesterol is through bile acids. The liver uses cholesterol to produce bile acids, which are secreted into the small intestine, and then absorbed again and sent back to the liver. Whilst these bile acids are in the intestine however they can be broken down by certain kinds of bacteria that inhabit the gut.  This has been evidenced in animal studies which found that greater gut bacteria resulted in greater elimination of bile acids. [37,38]
If the intestinal bacteria are breaking down and thus inhibiting the reabsorption of bile salts, then they would not be able to be recycled. Therefore, livers cholesterol storage would begin to be reduced because it would be needed to synthesise new bile acids due to the lack of recycling.  Therefore it has been suggested that this effect could be increased if the gut were to be colonised with more of the bacterial types capable of breaking down the most bile,  such Lactobacillus acidophilus .  Because most of the cholesterol found in blood serum comes from the liver, this effect would inevitably help to lower serum cholesterol levels, thus decreasing the risk of heart disease.
Studies in animals have demonstrated the ability of food fermented or inoculated with lactic acid bacteria to significantly lower serum levels of total cholesterol and or LDL “bad” cholesterol, using Streptococcus thermophilus  Lactobacillus bulgaricus  and Lactobacillus cremoris  in rats, L. acidophilus in pigs  and mice  as well as Lactobacillus casei and Bifidobacteria bifidum in chickens. 
In 1979, the first trial to evaluate the effects of lactic acid bacteria on serum cholesterol levels in humans was conducted. Fifty four volunteers participated in a randomised cross over trial; the results of which revealed reductions of between 5-10% in serum cholesterol levels after several weeks of moderate consumption of yoghurt fermented with Lactobacillus bulgaricus and S. thermophilus .
In 1995, the results of a 6-week long double blind, placebo-controlled crossover trial in Denmark involving 58 middle-aged healthy men, revealed that consumption of milk fermented with Enterococcus faecium and two strains of S. thermophilus cultures resulted in a 10% decrease in LDL “bad” cholesterol. A similar Danish study using the same fermented milk product this time lasting 6 months, revealed that after as little as 1 month, the lactic acid bacteria containing product lowered LDL cholesterol levels in both men and women by 10 and 8% respectively.
A Dutch trial involving 30 healthy men also found that consuming yoghurt fermented with L. acidophilus cultures for several weeks decreased both total and LDL cholesterol levels by 4.4 and 5.4% respectively compared with controls. 
Similar results were not obtained however, in a controlled trial lasting 6 weeks involving 78 healthy subjects, which found that consumption of yoghurt fermented with L. acidophilus had no significant effect on serum cholesterol levels at all. 
Another study failed to find any significant changes in cholesterol levels after consumption of milk inoculated with L. acidophilus or yoghurt fermented with L. bulgaricus and S. thermophilus , however the subjects in this study had particularly low cholesterol levels to begin with. 
Several of these trials however failed to mention what concentration of bacteria was present in each product; thus it is not possible to know what dosage would be required to obtain these cholesterol-lowering results. Moreover, the subject in these studies had cholesterol levels that were either normal or relatively low, so it can not be know how effective such treatments may be in subjects with high cholesterol. It may be reasonable to speculate that the cholesterol lowering effect may be more pronounced in hypercholesterolemic patients, however at present there is no data to support this theory.
Because milk proteins can be fermented to form peptides which have an action similar to that of a type of medication used to treat high blood pressure known as “ACE Inhibitors”,  it has been suggested that consumption of fermented milk may be beneficial to hypertensive patients, after feeding either fermented products  or peptides isolated from fermented milk [56,57] could lower blood pressure in hypertensive rats.
In a placebo-controlled trial involving hypertensive patients, 8 weeks of consuming sour milk fermented by Lactobacillus helveticus and Saccharomyces cerevisiae resulted in significant reductions in both systolic and diastolic blood pressure. 
Several years later, the results of another 8–week pilot study demonstrated blood pressure lowering effects of milk fermented with Lactobacillus helveticus .  More recently, the same authors published the results of a double blind, placebo -controlled trial involving 39 hypertensive subjects which once again revealed that consumption of milk fermented with L. helveticus could exert a modest lowering effect on blood pressure. 
Although the reductions in blood pressure seen in hypertensive patients consuming fermented milk products may not be significant enough to be used as a sole treatment for high blood pressure, these studies provide preliminary evidence to suggest that consumption of lactic acid bacteria fermented dairy foods along with a host of other functional foods known to have beneficial effects on blood pressure, could at least be incorporated into dietary strategies used to complement medical treatments for hypertensive patients. For the rest of us, it may simply aid in maintaining healthy blood pressure levels; thus acting as a preventative measure.
There is a significant body of evidence from clinical and laboratory investigations to suggest that consumption of lactic acid bacteria may have favourable effects on immune function.
Antibodies such as Immunoglobulin A (IgA) are produced by plasma cells of the immune system and are involved in protecting the body from potentially harmful microbes. Secretory immunoglobulin A, (sIgA) is specifically found at the surface of the intestinal mucosa (the outer membrane layer coated in mucous that is exposed to the guts contents) and works by preventing pathogens from binding with and penetrating the gut wall. Lactobacillus casei , Lactobacillus acidophilus and yogurt have been shown to enhance the number of IgA-producing plasma cells in a dose-dependent manner  as well as increasing sIgA levels in mice and humans. 
Another beneficial mechanism that lactic acid bacteria may have on immune function is the ability to enhance a process known as phagocytosis, which is where certain types of white blood cells known as macrophages literally engulf and ingest “invaders” such as harmful bacteria and other disease causing microbes (pathogens) ; a process thought to be one of the bodies first lines of defence against harmful bacterial infections.
Recent investigation have shown that macrophage numbers increased in mice fed cultures of L. acidophilus or L. casei .  Furthermore , Lactobacillus acidophilus and Bifidobacterium longum have been found to enhance phagocytic function of human macrophages in vitro  whilst animal studies have demonstrated that L. acidophilus  L. casei  and Streptococcus thermophilus  either enhanced or increased phagocytosis in the macrophages of rodents.
In a double blind, placebo-controlled trial designed to determine the effects of lactic acid bacteria on immune function, 25 elderly volunteers were given either low fat milk or the same milk with added cultures of a strain of Bifidobacteria lactis called HN019 . The results demonstrated that after 6 weeks, those who received the probiotic milk had significantly improved markers of natural immunity such as e nhanced levels of interferon-alpha and increases in the phagocytic capacity of certain immune cells. 
A similar trial in New Zealand demonstrated that elderly volunteers given the same strain of B. lactis showed significant improvements in the immune function including an increase in the proportion of immune cells known as T lymphocytes, especially helper and activated T-cells, as well as natural killer cells; a type of white cell known to attack tumours.  The same researchers found both an increase the number of natural killer cells as well a 101 and 62% enhancement of their immune cells ability to attack tumours when elderly people were given either B. lactis HN019 or Lactobacillus rhamnosus HN001 respectively, for as little as 3 weeks. 
These probiotic strains have also demonstrated significant immune enhancing ability in animal studies. For example, 27 out of 30 mice given L. rhamnosus HN001 survived after being infected with a deadly type of Salmonella , compared with only 2 out of 29 who did not receive the probiotic. 
In a randomised, double blind, placebo controlled study in Finland, 857 healthy children aged 1-6 years in 18 day-care centres throughout Helsinki were studied for 7 months to see whether consumption of a probiotic milk could reduce the incidence of respiratory infections. The children that were given milk with L. rhamnosus GG had 16% fewer days absent due to illness. Furthermore, there were 17% fewer cases of respiratory tract infections, and a 19% reduction in the need for antibiotic treatment for respiratory infections among the children that received the probiotic compared to those that did not.  Additionally, the children who received the probiotic had 44% fewer dental carries than those who received the placebo (normal milk), presumably because Lactobacillus GG acts as an antagonist to the bacteria that cause dental problems. 
In an open, prospective trial involving 209 volunteers, daily consumption of a probiotic drink resulted in a 19% reduction in the occurrence of potentially disease causing bacteria found in the nasal tract  – a part of the body that can harbour pathogenic microbes such as those that cause pneumonia, haemolytic anaemia as well as Staphylococcus aureus “golden staph”.
Ingestion of lactic acid bacteria has also been found to be beneficial in people infected with the bacterium Helicobacter pylori which is responsible for gastritis and peptic ulcers.  Various strains of lactic acid bacteria probiotics such as those isolated from yoghurt  have been proven to reduce the growth of H.pylori in vitro,  in animal studies [78-80] and human clinical trials, presumable by producing selectively anti-bacterial substances known as bacteriocins , [81,82] and by inhibiting binding ability. Lactobacillus johnsonii is probably the most successful species of probiotic shown to reduce H.pylori infection. For example, L. johnsonii was shown to reduce H.pylori infection in children in Santiago, Chillie. 
A double blind trial in Switzerland randomly assigned 50 patients with H. pylori infections to receive either a L. johnsonii probiotic or a placebo for 16 weeks. Those given the probiotic experienced a modest improvement such as decreases in the severity and activity of antral gastritis, decrease of H.pylori density and increased mucous thickness.  The authors concluded that
“Regular ingestion of fermented milk containing L. johnsonii may reduce the risk of developing disorders associated with high degrees of gastric inflammation and mucus depletion."
Further investigations in Switzerland have found that L. johnsonii probiotics are capable of producing a favourable affect on H.pylori gastritis in human subjects  including a trial which found that 2 weeks of L. johnsonii consumption suppressed H.pylori infection regardless of whether it was combined with a standard medication used to treat H. pylori called omeprazole, or with a placebo. 
Similar investigation demonstrated a modest suppressive effect on H.pylori growth in patients given L. Casei Shirota strain for 3 weeks in the Netherlands  whilst Japanese researchers found that consuming yoghurt containing Lactobacillus gasseri OLL2716 also resulted a suppression of H. pylori as well as a reduction in gastric mucosal inflammation in 31 patients for 8 weeks. 
Similarly, the results of a more recent clinical trial in China revealed that compared to those given a placebo, H.pylori growth was significantly inhibited in after 6 weeks in 59 patients who consumed yoghurt containing L. acidophilus La5 and Bifidobacterium lactis Bb12. 
Other investigations have found that the addition of probiotics to standard drug treatments can enhance their effectiveness  or reduce the severity of the drug-related side effects  including a trial involving 120-infected patients in Italy which found that patients given the conventional medical treatments (rabeprazole, clarithromycin and amoxicillin) had a 72% successful eradication of the infection after 1 week, whereas those given the same treatment plus L. acidophilus probiotics had an 88% rate of success. 
A similar trial by the same authors found no difference in the rate of successful eradication between those given standard drug treatment alone or in conjunction with probiotics; however the probiotics did ease the side effects of the drugs such as diarrhoea and taste disturbance. 
Consumption of Lactobacillus and Bifidobacterium -containing yoghurt was shown to improve drug treatment in a Taiwanese study where the rate of successful eradication after 1 week of treatment in those given only drugs was 78% compared to 91% in those also given the yoghurt. 
Diarrhoea is one of the most common causes of sickness in young children, often caused by rotavirus infections. It results in approximately 3 million doctors visits per year  and contributes roughly 13% of hospitalizations among children under 5. 
The results of randomized, double blind placebo-controlled trials have found that administration of probiotics containing Lactobacillus GG, [96-99] Lactobacillus reuteri [100,101], L. acidophilus  or L. acidophilus combined with L. bulgaris [103,104] have proven effective in the treatment of diarrhoea in children between 1 month and 2.5 years old, by reducing the duration and severity of symptoms.
Consumption of lactic acid bacteria has also been shown to reduce the risk of developing a type of diarrhoea which commonly occurs as a result of antibiotic treatments. The results of various randomized double-blind placebo-controlled trials have demonstrated that probiotics containing Lactobacillus GG may prevent antibiotic associated diarrhoea in both adults [105,106] and children [107,108]. A meta-analysis of these trials reported a 60% average reduction in the incidence of antibiotic-associated diarrhoea in people given probiotics concurrently. 
Several studies have also found that consumption of yoghurt during antibiotic treatment can also halve the likelihood of getting diarrhoea, half the duration of diarrhoea symptoms  as well as decrease some of the other side effects associated with antibiotics s uch as abdominal distress, stomach pain and flatulence. 
Similar randomized trials have demonstrated that consumption of lactic acid bacteria can protect against diarrhoea in healthy people as well. One such recent study involved 541 young soldiers,275 of whom were given yoghurt containing Lactobacillus casei , the other 266 received ordinary non-probiotic yoghurt. Throughout the duration of the study, there were approximately 25% fewer cases of diarrhoea among those given the probiotic yoghurt. 
Several studies have shown that probiotics can alter the production of behavioural and communication molecules called cytokines that are released from certain cells of the immune system and are involved in immune regulation as well as inflammatory responses.
Different strains of Streptococcus thermophilus increased the cytokine production of human white blood cells in vitro  whilst mice given Bifidobacterium bifidum also displayed an increase in cytokine production.  Furthermore, it has been suggested that probiotics may boost the immune systems of the elderly by helping to reverse the age-related decline in the production of cytokines  based on a study where administration various probiotic species in aging rodents resulted in restored production in the levels of certain cytokines 
Some of the many beneficial effects that probiotics have on mediating immune regulation include balancing the control of pro-inflammatory and anti-inflammatory cytokines. Studies indicate that probiotics can be used as innovative tools to alleviate intestinal inflammation, normalize dysfunctional of the mucosa, and down-regulate hypersensitivity reactions such as allergies. 
Human studies have found that administration of Lactobacillus rhamnosus GG can enhance the cellular immune response to intestinal micro-organisms whilst causing a decrease in the production of pro-inflammatory cytokines but an increase in anti-inflammatory cytokines. 
In another interesting study, milk with added Lactobacillus GG prevented the usual hypersensitivity reaction in people with milk allergy, whilst it induced an immune response (but not a hypersensitive one) in those without milk allergy; that is, it stimulated the immune system of healthy volunteers whilst it had an antiinflammatory effect in those prone to over-immune stimulation. No suggestions have been given to explain this selective influence on immune function. 
It has been hypothesized that an increase in the occurrence of childhood allergies may be due to a increase in hygiene, and thus a reduction in the exposure to microbes early in life. Therefore it was suggested that exposure to “friendly” bacteria early in life might reduce the subsequent risk of allergies. In a randomised double-blind, placebo-controlled study in Finland , 132 pregnant women with a family history of atopic (allergic) eczema were given either L. rhamnosus GG or a placebo for several weeks prior to giving birth, as well as to their infants after birth. After both 6 months  and a follow up 4 years later,  there was a 50% reduction in frequency of atopic eczema in the group given the probiotic compared to the placebo group. This is significant because early childhood atopic eczema is an indicator of other allergies later in life.
Other studies conducted by researchers in Finland also demonstrated a significantly greater reduction in the symptoms from atopic eczema and cows milk allergy  as well as a decrease in markers of inflammation  in infants given Lactobacillus GG compared to those given a placebo.
Another potentially beneficial use for probiotics has been found to be in the treatment of Inflammatory Bowel Diseases (IBD), which include Chrohn's Disease (an inflammation of the small intestine), Ulcerative Colitis (an inflammation of the Colon resulting in ulceration) and pouchitis (an inflammation of the pouch created as treatment of a patient with ulcerative colitis).
Researchers are unsure what causes the effects seen in Inflammatory Bowel Disease. Although some investigations have revealed that lactic acid bacteria such as Bifidobacteria sp . are particularly low in Chrohn's Disease patients,  it has been suggested that rather than just a disruption to the normal microbes of the gut, this normal gut “flora” may actually cause an aggressive immunological response in IBD patients. Therefore it has been proposed that perhaps colonizing the gut with bacteria capable of favourably modulating this immunological response may be an effective strategy for preventing relapses in IBD patients. 
A double blind, placebo-controlled trial in which 40 patients suffering from refractory pouchitis were randomly assigned to receive either a treatment of various strains of probiotics or a placebo for 6 months found that the probiotics effectively resulted in 17 out of 20 patients going into remission, whereas all of the patients given the placebo still had symptoms.  The same researchers found that the same probiotic formula resulted in 12 out of 15 patients with Ulcerative Colitis going into remission after 1 year of treatment. 
Similar results were obtained in a randomised clinical trial in Japan where after 12 months, only 3 out of 11 Ulcerative Colitis patients given bifidobacteria-fermented milk still had symptoms compared to 9 out of 10 patients given the placebo. 
More recently, a controlled clinical trial in Italy involved 40 patients which had undergone a procedure called ileal pouch-anal anastomosis for ulcerative colitis. They were randomised to receive either a highly concentrated probiotic supplement or a placebo and monitored for a year. By the end of the trial, only 10% of patients given the probiotic had reported an episode of acute pouchitis compared with 40% of those given the placebo. 
These studies provide encouraging results however further investigation are needed to identify which probiotic strains are the most effective, determine whether or not consumption of lactic acid bacteria may prevent an initial onset of IBD, and help to understand the mechanisms to explain how these probiotics actually exhibit their beneficial effects in inflammatory conditions.
For those who wish to add more yoghurt to their diet, Alice Henneman MS, RD has published a series of "9 delicious recipes" using yoghurt, which can be found on the University of Nebraskas "Cook It Quick" website.
 Weinsier RL, Krumdieck CL. Dairy foods and bone health: examination of the evidence. Am J Clin Nutr. 2000 Sep;72(3):681-9.
 Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine . Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D and Fluoride. Washington DC : The National Academies Press, 1997
 Jackson KA, Savaiano DA. Lactose maldigestion, calcium intake and osteoporosis in African-, Asian-, and Hispanic-Americans . J Am Coll Nutr. 2001 Apr;20(2 Suppl):198S-207S
 McCance and Widdowson's The Composition of Food. 6th Ed . 2002Food Standards Agency Royal Society Of Chemistry
 Commoner et al., 1978. B.A. Commoner, A. Vithayathil, P. Dolara, S. Nair, P. Madyastha and G. Cuca , Formation of mutagens in beef and beef extract during cook. Science 201 (1978), pp. 913–916
 Ohgaki et al., 1991. H.S. Ohgaki, S. Takayama and T. Sugimura , Carcinogenicities of heterocyclic amines in cooked food. Mutation Res. 259 (1991), pp. 399–410.
 Hosoda M, Hashimoto H, Morita H, Chiba M, Hosono A. Studies on antimutagenic effect of milk cultured with lactic acid bacteria on the Trp-P2-induced mutagenicity to TA98 strain of Salmonella typhimuriumi . J Dairy Res 1992;59:543–9
 Renner HW, Münzner R. The possible role of probiotics as dietary antimutagens . Mutat Res 1991;262:239–45
 Orrhage K, Sillerström E, Gustafsson JÄ, Nord CE, Rafter J. Binding of mutagenic heterocyclic amines by intestinal and lactic acid bacteria . Mutat Res 1994;311:239–48
 Morotomi M, Mutai M. In vitro binding of potent mutagenic pyrolysates. J Natl Cancer Inst 1986;77:195–201
 Zhang XB, Ohta Y. In vitro binding of mutagenic pyrolyzates to lactic acid bacterial cells in human gastric juice . J Dairy Sci 1991; 74:752–7
 Pool-Zobel BL, Neudecker C, Domizlaff I, et al. Lactobacillus - and Bifidobacterium -mediated antigenotoxicity in the colon of rats . Nutr Cancer 1996;26:365–80
 Fearon ER, Vogelstein B. A genetic model for colorectal tumorigenesis . Cell 1990;61:759–67
 Shackelford L., Rao D., Chawan C., Rulusani S. Effect of feeding fermented milk on the incidence of chemically induced colon tumors in rats. Nutr. Cancer 1983;5:159-164
 Takano T., Arai K., Murota I., Hayakawa K., Mizutani T., Mitsuoka T. Effects of feeding sour milk on longevity and tumorigenesis in mice and rats. Bifid. Microflora 1985;4:31-37
 Goldin BR, Gorbach SL. Effect of Lactobacillus acidophilus dietary supplements on 1,2-dimethylhydrazine dihydrochloride-induced intestinal cancer in rats . J Natl Cancer Inst 1980;64:263–5
 Koo M., Rao A. Long-term effect of Bifidobacteria and neosugar on precursor lesions of colonic cancer in CF1 mice . Nutr. Cancer 1991;16:249-257
 Gallaher D., Stallings W., Blessing L., Busta F., Brady L. Probiotics, cecal microflora, and aberrant crypts in the rat colon . J. Nutr. 1996;126:1362-1371
 Challa A, Rao DR , Chawan CB, Shackelford L. Bifidobacterium longum and lactulose suppress azoxymethane-induced colonic aberrant crypt foci in rats. Carcinogenesis 1997;18:517–21
 Kulkarni N., Reddy B. Inhibitory effect of Bifidobacterium longum cultures on the azoxymethane-induced aberrant crypt foci formation and fecal bacterial ß-glucuronidase. Proc. Soc. Exp. Biol. Med. 1994;207:278-283
 Abdelali H., Cassand P., Soussotte V., Daubeze M., Bouley C., Narbonne J. Effect of dairy products on initiation of precursor lesions of colon cancer in rats . Nutr. Cancer 1995;24:121-132
 Rowland IR, Rumney CJ, Coutts JT, Lievense LC. Effect of Bifidobacterium longum and inulin on gut bacterial metabolism and carcinogen-induced aberrant crypt foci in rats. Carcinogenesis 1998;19:281–5
 Goldin BR, Gualtieri LJ, Moore RP. The effect of Lactobacillus GG on the initiation and promotion of DMH-induced intestinal tumors in the rat . Nutr Cancer 1996;25:197–204
 Benno Y, Mitsuoka T. Impact of Bifidobacterium longum on human fecal microflora . Microbiol Immunol 1992;36:683–94
 Bouhnik Y, Flourie B, Andrieux C, Bisetti N, Briet F, Rambaud J-C . Effects of Bifidobacterium sp fermented milk ingested with or without inulin on colonic bifidobacteria and enzymatic activities in healthy humans . Eur J Clin Nutr 1996;50:269–73
 Marteau P, Pochart P, Flourie B, et al. Effect of chronic ingestion of a fermented dairy product containing Lactobacillus acidophilus and Bifidobacterium bifidum on metabolic activities of the colonic flora in humans . Am J Clin Nutr 1990;52:685–8
 Rowland. I. R. 1995.Toxicology of the colon - role of the intestinal microflora. In: Human Colonic Bacteria, Role in Nutrition, Physiology and Pathology. Macfarlane, G T and Gibson, G (Ed) CRC Press Boca Raton , FL. pp 155-174.
 Young, TB, Wolf DA. Case-control study of proximal and distal colon cancer and diet in Wisconsin . Int J Cancer 1988;42:167–75
 Peters RK, Pike MC, Garabrant D, Mack TM. Diet and colon cancer in Los Angeles County, California . Cancer Causes Control 1992;3:457–73
 Boutron MC, Faivre J, Marteau P, Couillault C, Senesse P, Quipourt V. Calcium, phosphorus, vitamin D, dairy products and colorectal carcinogenesis: a French case-control study . Br J Cancer 1996; 74:145–51
 Kampman E, Goldbohm RA, van den Brandt PA, van't Veer P. Fermented dairy products, calcium, and colorectal cancer in the Netherlands cohort study . Cancer Res 1994;54:3186–90
 Rowland IR. Nutrition and gut microflora metabolism. In: Rowland IR, ed. Nutrition, toxicity and cancer. Boston : CRC Press, 1991: 113–36.
 Hawksworth G, Drasar BS, Hill MJ. Intestinal bacteria and the hydrolysis of glycoside bonds. J Med Microbiol 1971;4:451–9
 Goldin B, Gorbach SL. The effect of milk and lactobacillus feeding on human intestinal bacterial enzyme activity . Am J Clin Nutr 1984;39:756–61
 Kearney J, Giovannucci E, Rimm E, et al. Calcium, vitamin D, and dairy foods and the occurrence of colon cancer in men. Am J Epidemiol 1996;143:907–17
 Hentges DJ. Biotransformation of bile acids and cholesterol by the intestinal microflora. Human intestinal microflora in health and disease. New York : Academic Press, 1983.
 Eyssen H. Role of the gut microflora in metabolism of lipids and sterols . Proc Nutr Soc 1973;32:59–63
 Mott GE, Moore RW, Redmond HE, Reiser R. Lowering of serum cholesterol by intestinal bacteria in cholesterol-fed piglets . Lipids 1973;8:428–31
 Gilliland SE, Speck ML. Deconjugation of bile acids by intestinal Lactobacilli . Appl Environ Microbiol 1977;33:15–8
 Gilliland SE. Health and nutritional benefits from lactic acid bacteria . FEMS Microbiol Rev 1990;7:175–88
 Gilliland SE, Nelson CR, Maxwell C. Assimilation of cholesterol by Lactobacillus acidophilus . Appl Environ Microbiol 1985;49:377–81
 Rao DR, Chawan CB, Pulusani SR. Influence of milk and thermophilus milk on plasma cholesterol and hepatic cholesterogenesis in rats. J Food Sci 1981;46:1339–41 ]
 Beena A, Prasad V. Effect of yogurt and bifidus yogurt fortified with skim milk powder, condensed whey and lactose-hydrolyzed condensed whey on serum cholesterol and triacylglycerol concentrations in rats . J Dairy Res 1997;64:453–7
 Nakajima H, Suzuki Y, Hirota T. Cholesterol-lowering activity of ropy fermented milk. J Food Sci 1992;57:1327–9.
 Gilliland SE, Nelson CR, Maxwell C. Assimilation of cholesterol by Lactobacillus acidophilus . Appl Environ Microbiol 1985;49:377–81
 Akalin AS, Gonc S, Duzel S. Influence of yogurt and acidophilus yogurt on serum cholesterol levels in mice. J Dairy Sci 1997;80:2721–5
 Mohan B, Kadirvel R, Natarajan A, Bhaskaran M. Effect of probiotic supplementation on growth, nitrogen utilization and serum cholesterol in broilers . Br Poult Sci 1996;37:395–401
 Hepner G, Fried R, St Jeor S, Fusetti L, Morin R. Hypocholesterolemic effect of yogurt and milk . Am J Clin Nutr 1979;32:19–24
 Agerbaeck M, Gerdes LU, Richelsen B. Hypocholesterolemic effect of a new fermented milk product in healthy middle-aged men . Eur J Clin Nutr 1995;49:346–52
 Richelsen B, Kristensen K, Pedersen SB . Long-term (6 months) effect of a new fermented milk product on the level of plasma lipoproteins—a placebo-controlled and double blind study . Eur J Clin Nutr 1996;50:811–3
 Schaafsma G, Meuling WJA, van Dokkum W, Bouley C. Effects of a milk product, fermented by Lactobacillus acidophilus and with fructo-oligosaccharides added, on blood lipids in male volunteers . Eur J Clin Nutr 1998;52:436–40
 de Roos NM, Schouten G, Katan MB . Yoghurt enriched with Lactobacillus acidophilus does not lower blood lipids in healthy men and women with normal to borderline high serum cholesterol levels. Eur J Clin Nutr 1998;53:277–80.
 Thompson LU, Jenkins DJ, Amer MA, Reicher R, Jenkins A, Kamulsky J. The effect of fermented and unfermented milks on serum cholesterol . Am J Clin Nutr 1982;36:1106–11.
 Yamamoto N, Takano T. Antihypertensive peptides derived from milk proteins. Nahrung 1999;43:159–64.
 Nakamura Y, Yamamoto N, Sakai K, Takano T. Antihypertensive effects of sour milk and peptides isolated from it that are inhibitors to angiotensin I-converting enzyme . J Dairy Sci 1995;78:1253–7
 Yamamoto N, Maeno M, Takano T. Purification and characterization of an antihypertensive peptide from a yogurt-like product fermented by Lactobacillus helveticus CPN4 . J Dairy Sci 1999;82:1388–93
 Maeno M, Yamamoto N, Takano T. Identification of an antihypertensive peptide from casein hydrolysate produced by a proteinase from Lactobacillus helveticus CP790. J Dairy Sci 1996;79:1316–21
 Hata Y, Yamamoto M, Ohni M, Nakajima K, Nakamura Y, Takano T. A placebo-controlled study of the effect of sour milk on blood pressure in hypertensive subjects . Am J Clin Nutr 1996;64:767–71.
 Seppo L, Kerojoki O, Suomalainen T, Korpela R. The effect of a Lactobacillus helveticus LBK-16 H fermented milk on hypertension: a pilot study on humans. Milchwissenschaft 2002;57:124–7.
 Seppo L, Jauhiainen T, Poussa T, Korpela R. A fermented milk high in bioactive peptides has a blood pressure-lowering effect in hypertensive subjects . Am J Clin Nutr. 2003 Feb;77(2):326-30.
 Perdigon, G., Alvarez, S., Rachid, M., Aguero, G. & Gobbato, N. (1995) Immune system stimulation by probiotics. J. Dairy Sci. 78: 1597-1606.
 Perdigon, G., Alvarez, S. & Pesce cle Ruiz Holgado. A. (1991) Immunoadjuvant activity of oral Lactobacillus case/: influence of dose on the secretory immune response and protective capacity in intestinal infections. J. Dairy Res. 58: 485-496.
 Adolfsson, O., S.N. Meydani, and R.M. Russell. Am. J. Clin. Nutr. 80: 245, 2004.
 Haacher GE, Lambrecht RS. Augmentation of macrophage phagocytic activity by cell-free extracts of selected lactic acid-producing bacteria. J Dairy Sci. 1993 Sep;76(9):2485-92.
 Neumann, E., Oliveira, M. A., Cabral, C. M., Moura, L. N., Nicoli, J. R., Vieira, E. C., Cara, D.C., Podoprigora,G. I.&Vieira, L. Q. (1998)
 Perdigon, G., Alvarez, S., Rachid, M., Aguero, G. & Gobbato, N. (1995) Immune system stimulation by probiotics. J. Dairy Sci. 78: 1597-1606.
 Perdigon G, Nader de Macias ME, Alvarez S, Oliver G, Pesce de Ruiz Holgado AA. Enhancement of immune response in mice fed with Streptococcus thermophilus and Lactobacillus acidophilus. J Dairy Sci. 1987 May;70(5):919-26.
 Arunachalam K, Gill HS, Chandra RK Enhancement of natural immune function by dietary consumption of Bifidobacterium lactis (HN019). Eur J Clin Nutr. 2000 Mar;54(3):263-7.
 Gill HS, Rutherfurd KJ, Cross ML. Dietary probiotic supplementation enhances natural killer cell activity in the elderly: an investigation of age-related immunological changes . J Clin Immunol. 2001 Jul;21(4):264-71.
 Gill HS, Rutherfurd KJ, Cross ML, Gopal PK. Enhancement of immunity in the elderly by dietary supplementation with the probiotic Bifidobacterium lactis HN019 . Am J Clin Nutr. 2001 Dec;74(6):833-9.
 Gill HS, Shu Q, Lin H, Rutherfurd KJ, Cross ML. Protection against translocating Salmonella typhimurium infection in mice by feeding the immuno-enhancing probiotic Lactobacillus rhamnosus strain HN001 . Med Microbiol Immunol (Berl). 2001 Dec;190(3):97-104.
 Hatakka K, Savilahti E, Ponka A, Meurman JH, Poussa T, Nase L, Saxelin M, Korpela R. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ. 2001 Jun 2;322(7298):1327
 Nase L, Hatakka K, Savilahti E, Saxelin M, Ponka A, Poussa T, Korpela R, Meurman JH. Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children . Caries Res. 2001 Nov-Dec;35(6):412-20.
 Gluck U, Gebbers JO Ingested probiotics reduce nasal colonization with pathogenic bacteria (Staphylococcus aureus, Streptococcus pneumoniae, and beta-hemolytic streptococci ) Am J Clin Nutr. 2003 Feb;77(2):517-20.
 Felley C, Michetti P. Probiotics and Helicobacter pylori . Best Pract Res Clin Gastroenterol. 2003 Oct;17(5):785-91.
 Oh Y, Osato MS, Han X, Bennett G, Hong WK. Folk yoghurt kills Helicobacter pylori. J Appl Microbiol. 2002;93(6):1083-8.
 Midolo PD, Lambert JR, Hull R, Luo F, Grayson ML. In vitro inhibition of Helicobacter pylori NCTC 11637 by organic acids and lactic acid bacteria. J Appl Bacteriol 1995;79:475–9.
 Sgouras D, Maragkoudakis P, Petraki K, Martinez-Gonzalez B, Eriotou E, Michopoulos S, Kalantzopoulos G, Tsakalidou E, Mentis A. In vitro and in vivo inhibition of Helicobacter pylori by Lactobacillus casei strain Shirota. Appl Environ Microbiol. 2004 Jan;70(1):518-26.
 Johnson-Henry KC, Mitchell DJ, Avitzur Y, Galindo-Mata E, Jones NL, Sherman PM Probiotics reduce bacterial colonization and gastric inflammation in H. pylori-infected mice . Dig Dis Sci. 2004 Aug;49(7-8):1095-102.
 Aiba Y, Suzuki N, Kabir AM, Takagi A, Koga Y. Lactic acid-mediated suppression of Helicobacter pylori by the oral administration of Lactobacillus salivarius as a probiotic in a gnotobiotic murine model . Am J Gastroenterol. 1998 Nov;93(11):2097-101.
 Pinchuk IV, Bressollier P, Verneuil B, Fenet B, Sorokulova IB, Megraud F, Urdaci MC. In vitro anti-Helicobacter pylori activity of the probiotic strain Bacillus subtilis 3 is due to secretion of antibiotics . Antimicrob Agents Chemother. 2001 Nov;45(11):3156-61.
 Avonts L, De Vuyst L. Antimicrobial potential of probiotic lactic acid bacteria. Meded Rijksuniv Gent Fak Landbouwkd Toegep Biol Wet.
 Mukai T, Asasaka T, Sato E, Mori K, Matsumoto M, Ohori H. Inhibition of binding of Helicobacter pylori to the glycolipid receptors by probiotic Lactobacillus reuteri. FEMS Immunol Med Microbiol. 2002 Jan 14;32(2):105-10
 Cruchet S, Obregon MC, Salazar G, Diaz E, Gotteland M. Effect of the ingestion of a dietary product containing Lactobacillus johnsonii La1 on Helicobacter pylori colonization in children. Nutrition. 2003 Sep;19(9):716-21.
 Pantoflickova D, Corthesy-Theulaz I, Dorta G, Stolte M, Isler P, Rochat F, Enslen M, Blum AL. Favourable effect of regular intake of fermented milk containing Lactobacillus johnsonii on Helicobacter pylori associated gastritis . Aliment Pharmacol Ther. 2003 Oct 15;18(8):805-13.
 Felley CP, Corthesy-Theulaz I, Rivero JL, Sipponen P, Kaufmann M, Bauerfeind P, Wiesel PH, Brassart D, Pfeifer A, Blum AL, Michetti P. Favourable effect of an acidified milk (LC-1) on Helicobacter pylori gastritis in man . Eur J Gastroenterol Hepatol. 2001 Jan;13(1):25-9.
 Michetti P , Dorta G , Wiesel PH , Brassart D , Verdu E , Herranz M , Felley C , Porta N , Rouvet M , Blum AL , Corthesy-Theulaz I . Effect of whey-based culture supernatant of Lactobacillus acidophilus (johnsonii) La1 on Helicobacter pylori infection in humans. Digestion. 1999;60(3):203-9.
 Cats A, Kuipers EJ, Bosschaert MA, Pot RG, Vandenbroucke-Grauls CM, Kusters JG Effect of frequent consumption of a Lactobacillus casei-containing milk drink in Helicobacter pylori-colonized subjects . Aliment Pharmacol Ther. 2003 Feb;17(3):429-35.
 Sakamoto I, Igarashi M, Kimura K, Takagi A, Miwa T, Koga Y. Suppressive effect of Lactobacillus gasseri OLL 2716 (LG21) on Helicobacter pylori infection in humans. J Antimicrob Chemother. 2001 May;47(5):709-10.
 Wang KY, Li SN, Liu CS, Perng DS, Su YC, Wu DC , Jan CM, Lai CH, Wang TN , Wang WM. Effects of ingesting Lactobacillus- and Bifidobacterium-containing yogurt in subjects with colonized Helicobacter pylori . Am J Clin Nutr. 2004 Sep;80(3):737-41
 Tursi A, Brandimarte G, Giorgetti GM, Modeo ME. Effect of Lactobacillus casei supplementation on the effectiveness and tolerability of a new second-line 10-day quadruple therapy after failure of a first attempt to cure Helicobacter pylori infection . Med Sci Monit. 2004 Dec;10(12):CR662-6.
 Armuzzi A, Cremonini F, Bartolozzi F, Canducci F, Candelli M, Ojetti V, Cammarota G, Anti M, De Lorenzo A, Pola P, Gasbarrini G, Gasbarrini A. The effect of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori eradication therapy . Aliment Pharmacol Ther. 2001 Feb;15(2):163-9.
 Canducci F , Armuzzi A , Cremonini F, Cammarota G, Bartolozzi F, Pola P , Gasbarrini G , Gasbarrini A . A lyophilized and inactivated culture of Lactobacillus acidophilus increases Helicobacter pylori eradication rates. Aliment Pharmacol Ther. 2000 Dec;14(12):1625-9.
 Cremonini F, Di Caro S, Covino M, Armuzzi A, Gabrielli M, Santarelli L, Nista EC, Cammarota G, Gasbarrini G, Gasbarrini A. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol. 2002 Nov;97(11):2744-9.
 Sheu BS, Wu JJ, Lo CY, Wu HW, Chen JH, Lin YS, Lin MD. Impact of supplement with Lactobacillus- and Bifidobacterium-containing yogurt on triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther. 2002 Sep;16(9):1669-75.
 Glass RI, Lew JF, Gangarosa RE, LeBaron CW, Ho MS. Estimates of morbidity and mortality rates for diarrheal diseases in American children . J Pediatr .1991; 118 :S27 –S33
 Parashar UD, Holman RC, Clarke MJ, Bresee JS, Glass RI . Hospitalizations associated with rotavirus diarrhea in the United States, 1993 through 1995: surveillance based on the new ICD-9-CM rotavirus-specific diagnostic code . J Infect Dis .1998; 177 :13 –17
 Guandalini S, Pensabene L, Zikri MA, et al. Lactobacillus GG administered in oral rehydration solution to children with acute diarrhea: a multicenter European trial . J Pediatr Gastroenterol Nutr .2000; 30 :54 –60
 Shornikova AV, Isolauri E, Burkanova L, Lukovnikova S, Vesikari T. A trial in the Karelian Republic of oral rehydration and Lactobacillus GG for treatment of acute diarrhoea. Acta Paediatr .1997; 86 :460 –465
 Kaila M, Isolauri E, Soppi E, Virtanen E, Laine S, Arvilommi H. Enhancement of the circulating antibody secreting cell response in human diarrhea by a human Lactobacillus strain. Pediatr Res .1992; 32 :141 –144
 Raza S, Graham SM, Allen SJ, Sultana S, Cuevas L, Hart CA. Lactobacillus GG promotes recovery from acute nonbloody diarrhea in Pakistan. Pediatr Infect Dis J .1995; 14 :107 –111
 Shornikova AV, Casas IA, Isolauri E, Mykkanen H, Vesikari T. Lactobacillus reuteri as a therapeutic agent in acute diarrhea in young children. J Pediatr Gastroenterol Nutr .1997; 24 :399 –404
 Shornikova AV, Casas IA, Mykkanen H, Salo E, Vesikari T. Bacteriotherapy with Lactobacillus reuteri in rotavirus gastroenteritis. Pediatr Infect Dis J .1997; 16 :1103 –1107
 Simakachorn N, Pichaipat V, Rithipornpaisarn P, Kongkaew C, Tongpradit P, Varavithya W. Clinical evaluation of the addition of lyophilized, heat-killed Lactobacillus acidophilus LB to oral rehydration therapy in the treatment of acute diarrhea in children . J Pediatr Gastroenterol Nutr .2000; 30 :68 –72
 Pearce JL, Hamilton JR. Controlled trial of orally administered lactobacilli in acute infantile diarrhea. J Pediatr .1974; 84 :261 –262
 Chicoine L, Joncas JH. [ Use of lactic enzymes in non-bacterial gastroenteritis ]. Union Med Can .1973; 102 :1114 –1115
 Gotz V, Romankiewicz JA, Moss J, Murray HW. Prophylaxis against ampicillin-associated diarrhea with Lactobacillus preparation. Am J Hosp Pharm 1979; 36 : 754 7.
 Armuzzi A, Cremonini F, Bartolozzi F, et al. The effect of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori eradication therapy. Aliment Pharmacol Ther 2001; 15 : 163-9
 Vanderhoof JA, Whitney DB, Antonson DL, Hanner TL, Lupo JV, Young RJ. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children. Pediatr 1999; 135 : pp 564
 Arvola T, Laiho K, Torkkeli S, et al. Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics 1999; 104 : A64
 Cremonini F, Di Caro S, Nista EC, Bartolozzi F, Capelli G, Gasbarrini G, Gasbarrini A Meta-analysis: the effect of probiotic administration on antibiotic-associated diarrhoea .
Aliment Pharmacol Ther. 2002 Aug;16(8):1461-7..
 Beniwal RS, Arena VC, Thomas L, Narla S, Imperiale TF, Chaudhry RA, Ahmad U A randomized trial of yogurt for prevention of antibiotic-associated diarrhea . Dig Dis Sci. 2003 Oct;48(10):2077-82
 Siitonen S, Vapaatalo H, Salminen S, Gordin A, Saxelin M, Wikberg R, Kirkkola AL. Effect of Lactobacillus GG yoghurt in prevention of antibiotic associated diarrhoea.
Ann Med. 1990 Feb;22(1):57-9
 Pereg D, Kimhi O, Tirosh A, Orr N, Kayouf R, Lishner M The effect of fermented yogurt on the prevention of diarrhea in a healthy adult population . Am J Infect Control. 2005 Mar;33(2):122-5..
 Marin, M. L., Tejada-Simon, M. V., Lee, J. H., Murtha, J., Ustunol, Z. & Pestka, J. J. (1998) Stimulation of cytokine production in clonal macrophage and T-cell models by Streptococcus thermophilus: comparison with Bifidobacterium sp. and Lactobacillus butgaricus. J. Food Prot. 61: 859-864.
 Nicaise, P., Gleizes, A., Forestier, F., Quero, A. M. & Labarre, C. (1993) Influence of intestinal bacterial flora on cytokine (IL-1, IL-6 and TNF-alpha) production by mouse peritoneal macrophages. Eur. Cytokine Netw. 4: 133-138.
 Famu laro, G., Moretti, S., Marcell ini, S. & De Simone, C. (1997) Stimulation of immunity by probiotics. In: Probiotics 2: Applications and Practical Aspects (Fuller, R., ed. ), pp. 133-161. Chapman and Hall, London , UK .
 Muscettola, M., Massai, L., Tanganelli, C. & Grasso, G. (1994) Effects of lactobacilli on interferon production in young and aged mice. Ann. N.Y. Acad. Sci. 717: 226-232.
 Isolauri E, Sutas Y, Kankaanpaa P, Arvilommi H, Salminen S. Probiotics: effects on immunity. Am J Clin Nutr. 2001 Feb;73(2 Suppl):444S-450S
 Schultz M, Linde HJ, Lehn N, Zimmermann K, Grossmann J, Falk W, Scholmerich J . Immunomodulatory consequences of oral administration of Lactobacillus rhamnosus strain GG in healthy volunteers . J Dairy Res. 2003 May;70(2):165-73.
 Pelto, L., Isolauri, E., Lilius, E. M., Nuutila, J. & Salminen, S. (1998) Probiotic bacteria down-regulate the milk-induced inflammatory response in milk-hypersensitive subjects but have an immunostimulatory effect in healthy subjects. Clin. Exp. Allergy 28: 1474-1479.
 Kalliomaki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial . Lancet. 2001 Apr 7;357(9262):1076-9
 Kalliomaki M, Salminen S, Poussa T, Arvilommi H, Isolauri E. Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet. 2003 May 31;361(9372):1869-71.
 Kirjavainen PV, Salminen SJ, Isolauri E Probiotic bacteria in the management of atopic disease: underscoring the importance of viability. J Pediatr Gastroenterol Nutr. 2003 Feb;36(2):223-7
 Majamaa H, Isolauri E Probiotics: a novel approach in the management of food allergy . J Allergy Clin Immunol. 1997 Feb;99(2):179-85.
 M.H. Giaffer, C.D. Holdsworth and B.I. Duerden, The assessment of faecal flora in patients with inflammatory bowel disease by a simplified bacteriological technique. J Med Microbiol 35 (1991), pp. 238–243.
 Schultz, M., and R.B. Sartor. Probiotics and inflammatory bowel diseases. Am. J. Gastroenterol. 95: 19s, 2000.
 P. Gionchetti, F. Rizzello, A. Venturi et al. , Maintenance therapy of chronic pouchitis: A randomized, placebo-controlled, double blind trial with a new probiotic preparation. Gastroenterology 114 (1998), p. A4037.
 P. Gionchetti, F. Rizzello, D. Matteuzzi et al. , Microflora in the IBD pathogenesis. Possible therapeutic use of probiotics. Gastroenterol Internat 11 (1998), pp. 108–110
 Ishikawa H, Akedo I, Umesaki Y, Tanaka R, Imaoka A, Otani T Randomized controlled trial of the effect of bifidobacteria-fermented milk on ulcerative colitis. J Am Coll Nutr. 2003 Feb;22(1):56-63.
 Gionchetti P, Rizzello F, Helwig U, Venturi A, Lammers KM, Brigidi P, Vitali B, Poggioli G, Miglioli M, Campieri M. Prophylaxis of pouchitis onset with probiotic therapy: a double-blind, placebo-controlled trial. Gastroenterology. 2003 May;124(5):1202-9.