• Basic Info

Category

Herbs & Supplements

Synonyms

Brewer's yeast, Florastor®, Florastor® Kids, Hansen CBS 5926, Lactobacillus, Lactobacillus acidophilus, Lactobacillus bulgaricus, Lactobacillus gasseri, Lactobacillus GG, Lactobacillus plantarum, Perenterol®, probiotic, S. boulardii, Saccharomyces cerevisiae, Saccharomyces salivarius, Saccharomyces thermophilus, Saccharomycetaceae (family), Ultra-Levure®, yeast.

Note: There is debate as to whether Saccharomyces boulardii is a subspecies of Saccharomyces cerevisiae or a separate entity. Traditional techniques cannot distinguish the two, but manufacturers of Saccharomyces boulardii claim that the two yeasts are separate species.

Background

Saccharomyces boulardii is a non-pathogenic yeast strain that has been used for treatment and prevention of diarrhea. Saccharomyces boulardii is classified as a "probiotic," or a microorganism that when ingested may have a positive influence on the host's health. Probiotics may exert their effects on the gastrointestinal system directly, or may modulate the immune system in a larger scope.

Human studies indicate Saccharomyces boulardii may prevent antibiotic-associated diarrhea, Clostridium difficile diarrhea in combination with antibiotic therapy, diarrhea associated with tube feeds, and acute childhood diarrhea. Promising initial studies have shown that Saccharomyces boulardii may be beneficial in treating diarrhea associated with HIV.

The German Commission E has approved the use of Saccharomyces boulardii for symptomatic treatment of acute diarrhea, prophylactic and symptomatic treatment of diarrhea during travel, treatment of diarrhea occurring while tube feeding, use as an adjuvant for chronic acne, for a dietary supplementation, and for a source of B vitamins and protein.

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Diarrhea (antibiotic associated): There is good evidence that concurrent use ofSaccharomyces boulardiiwith antibiotic therapy reduces the incidence of developing antibiotic-associated diarrhea (AAD) (Clostridium difficileand other). In general, positive results occur only whenSaccharomyces boulardiiis continued for several days to several weeks after the course of antibiotics is stopped. Duplication of these results should still be attempted to confirm these findings.
Grade: A

Diarrhea in children: Several trials suggest efficacy ofSaccharomyces boulardiiin the treatment of diarrhea in childhood. Further studies are still required. Use ofSaccharomyces boulardiimay be advantageous in both the reduction of stool frequency per day and the duration of diarrhea in this age group.
Grade: B

Antibacterial (amebiasis): Evidence from one clinical trial supports improvement of symptoms and in patients with amebiasis treated withSaccharomyces boulardii, in addition to standard therapy. Further clinical trials are required before a firm recommendation can be made.
Grade: C

Crohn's disease: Evidence supports mild improvement of symptoms and quality of life in patients with Crohn's disease who useSaccharomyces boulardii. More clinical trials are required before a firm recommendation can be made in this area.
Grade: C

Diarrhea (Clostridium difficile): With the introduction of broad-spectrum antibiotics into clinical practice,Clostridium difficileinfection has become a common cause of infectious diarrhea in hospitalized patients. For treatment of recurrentClostridium difficile-associated diarrhea,Saccharomyces boulardiimay decrease recurrences by about 50%, especially when combined with high-dose vancomycin. Further studies are still required.
Grade: C

Diarrhea (HIV associated): While only small studies have been performed, treatment withSaccharomyces boulardiimay improve quality of life for AIDS patients with chronic diarrhea. As fungemia has been associated withSaccharomyces boulardiiadministration in patients with central lines, care should be exercised in treating these patients.
Grade: C

Diarrhea (prevention during tube feeding): Preliminary evidence supports the use ofSaccharomyces boulardiifor this indication. However, the role of antibiotics in the results is unclear. More studies should be performed before a strong recommendation can be made.
Grade: C

Diarrhea (traveler's): Although evidence supports the use ofSaccharomyces boulardiifor other forms of diarrhea, little evidence exists to support standard treatment withSaccharomyces boulardiifor traveler's diarrhea. More studies need to be performed.
Grade: C

Irritable bowel syndrome (IBS): One clinical trial exists to support treatment withSaccharomyces boulardiifor irritable bowel syndrome. Additional study is required before a firm recommendation can be made.
Grade: C

Nutritional support (premature infants): One clinical trial exists investigating the addition ofSaccharomyces boulardiito nutritional support for premature infants. No evidence was found for lipid gut absorption or increased weight gain. A benefit was noted on gut flora. Additional study is needed.
Grade: C