Many references to use of this bacterium in humans exist, especially in improving the vaginal flora,[5][6][7] improving abdominal pain and bloating in irritable bowel syndrome patients,[8] and increasing immune response to viral challenges.[9] There is evidence from animal research that suggests that bacillus coagulans is effective in both treating as well as preventing recurrence of clostridium difficile associated diarrhea.[10] One strain of this bacterium has also been assessed for safety as a food ingredient.[11] Spores are activated in the acidic environment of the stomach and begin germinating and proliferating in the intestine. Sporeforming B. coagulans strains are used in some countries as probiotics for patients on antibiotics.