A meta-analysis of studies using probiotics and/or synbiotics and measuring inflammatory markers such as CRP, tumor necrosis factor (TNF)-alpha, and IL-6 showed that probiotic/symbiotic supplementation was able to decrease serum CRP and TNF-alpha in healthy subjects and people with a range of inflammatory conditions, with the greatest effect sizes for both being seen in subjects with IBD [192]. This evidence concerns the gene CRP and irritable bowel syndrome.