Saccharomyces Boulardii - Why It Is So Important in Treating IBD (and not just diarrhea!)
Updated February 2019
As noted by L. V. McFarland in Chapter 18 of The Microbiota in Gastrointestinal Pathophysiology (2017) “Saccharomyces boulardii is one of the most studied types of probiotics and has been found to be effective for a wide diversity of infections. From 1976 to 2015, 90 randomized controlled trials covering 15 different types of disease conditions have been conducted with S. boulardii. The most robust evidence-based efficacy is for the treatment of acute pediatric diarrhea, for the prevention of antibiotic-associated diarrhea, for the treatment of Helicobacter pylori infections and the prevention of side effects associated with H. pylori eradication treatments. Strong evidence is also found for S. boulardii efficacy for the treatment of acute adult diarrhea and the treatment of inflammatory bowel disease” and efficacy in other disease indications include clostridium difficile, giardiasis, “traveler’s diarrhea,” and enteral nutrition-related diarrhea. We note, the experience of the Raw Feeding for IBD Cats group is that it is very effective at clearing Clostridium perfrigens infections, and it has been used by UC Davis to treat Clostridium difficile in cats. Importantly, McFarland notes: “S. boulardii was well tolerated by study participants, regardless of age, or disease condition.”
S boulardii is not a typical probiotic, as it is yeast-based, not a bacteria. As explained in the Biocodex FDA submission (last link), S boulardii is not digested and absorbed in the gut and does not exert its effect systemically. Instead, S boulardii acts locally in the lumen of the gut. During its passage through the intestine, S boulardii mimics the physiological effects of the digestive flora, stimulating healthy immune response and reducing inflammation. The research demonstrates its ability to mimic healthy intestinal walls, which attracts many pathogens (reviewed in the research, below) and results in excretion rather than colonization. This is why it must be given a minimum of twice a day. Please refer to our article Probiotics for Pets - Why and Which Ones.
Please note, Saccharomyces boulardii works synergistically with mannan oligosaccharides (MOS) (review of the science, here). This is why we stress the importance of using specifically the Jarrow brand of S boulardii. This is the only formulation we’re aware of that contains this powerful combination. Internationally, Jarrow S Boulardii + MOS can be purchased on iHerb.com.
The Review Studies:
Stier & Bischoff 2016. [S. boulardii has direct effects on pathogens and their toxins and has a positive impact on immune system response.] Influence of Saccharomyces boulardii CNCM I-745 on the gut-associated immune system https://www.dovepress.com/influence-of-saccharomyces-boulardii-cncm-i-745-on-the-gut-associated--peer-reviewed-article-CEG
West et al. 2016. Effects of Saccharomyces cerevisiae or boulardii yeasts on acute stress induced intestinal dysmotility, World J Gastroenterol. 2016 Dec 28; 22(48): 10532–10544.
More & Swidisnki 2015. [Using S boulardii in gut dysbiosis leads to the faster reestablishment of a healthy microbiome.] Saccharomyces boulardii CNCM I-745 supports regeneration of the intestinal microbiota after diarrheic dysbiosis - a review. https://www.dovepress.com/saccharomyces-boulardii-cncm-i-745-supports-regeneration-of-the-intest-peer-reviewed-article-CEG
Kelesidis & Pothoulakis 2012. Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296087/pdf/10.1177_1756283X11428502.pdf
Thomas et al. 2011. Anti-inflammatory effects of Saccharomyces boulardii mediated by myeloid dendritic cells from patients with Crohn’s disease and ulcerative colitis. http://ajpgi.physiology.org/content/ajpgi/301/6/G1083.full.pdf
McFarland 2010. Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868213/
Zanello 2009. Saccharomyces boulardii effects on gastrointestinal diseases. http://www.horizonpress.com/cimb/v/v11/47.pdf
Pouthoulakis 2009. Review article: anti-inflammatory mechanisms of action of Saccharomyces boulardii http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2009.04102.x/pdf
Point Institute Technical Report 2008. Saccharomyces boulardii in Gastrointestinal Related Disorders http://www.pointinstitute.org/wp-content/uploads/2012/10/Saccharomyces-Boulardii-in-GI-related-disorders-paper.pdf
Initial doses for cats source:
Madewell 1999. Clostridium difficile: a survey of fecal carriage in cats in a veterinary medical teaching hospital. http://journals.sagepub.com/doi/pdf/10.1177/104063879901100108
New Dietary Ingredient Notification for S boulardii (FDA submission) by Biocodex (Florastor) (includes summary table and research references) http://www.fda.gov/ohrms/dockets/dockets/95s0316/95s-0316-rpt0301-04-vol239.pdf
As noted by L. V. McFarland in Chapter 18 of The Microbiota in Gastrointestinal Pathophysiology (2017) “Saccharomyces boulardii is one of the most studied types of probiotics and has been found to be effective for a wide diversity of infections. From 1976 to 2015, 90 randomized controlled trials covering 15 different types of disease conditions have been conducted with S. boulardii. The most robust evidence-based efficacy is for the treatment of acute pediatric diarrhea, for the prevention of antibiotic-associated diarrhea, for the treatment of Helicobacter pylori infections and the prevention of side effects associated with H. pylori eradication treatments. Strong evidence is also found for S. boulardii efficacy for the treatment of acute adult diarrhea and the treatment of inflammatory bowel disease” and efficacy in other disease indications include clostridium difficile, giardiasis, “traveler’s diarrhea,” and enteral nutrition-related diarrhea. We note, the experience of the Raw Feeding for IBD Cats group is that it is very effective at clearing Clostridium perfrigens infections, and it has been used by UC Davis to treat Clostridium difficile in cats. Importantly, McFarland notes: “S. boulardii was well tolerated by study participants, regardless of age, or disease condition.”
S boulardii is not a typical probiotic, as it is yeast-based, not a bacteria. As explained in the Biocodex FDA submission (last link), S boulardii is not digested and absorbed in the gut and does not exert its effect systemically. Instead, S boulardii acts locally in the lumen of the gut. During its passage through the intestine, S boulardii mimics the physiological effects of the digestive flora, stimulating healthy immune response and reducing inflammation. The research demonstrates its ability to mimic healthy intestinal walls, which attracts many pathogens (reviewed in the research, below) and results in excretion rather than colonization. This is why it must be given a minimum of twice a day. Please refer to our article Probiotics for Pets - Why and Which Ones.
Please note, Saccharomyces boulardii works synergistically with mannan oligosaccharides (MOS) (review of the science, here). This is why we stress the importance of using specifically the Jarrow brand of S boulardii. This is the only formulation we’re aware of that contains this powerful combination. Internationally, Jarrow S Boulardii + MOS can be purchased on iHerb.com.
The Review Studies:
Stier & Bischoff 2016. [S. boulardii has direct effects on pathogens and their toxins and has a positive impact on immune system response.] Influence of Saccharomyces boulardii CNCM I-745 on the gut-associated immune system https://www.dovepress.com/influence-of-saccharomyces-boulardii-cncm-i-745-on-the-gut-associated--peer-reviewed-article-CEG
West et al. 2016. Effects of Saccharomyces cerevisiae or boulardii yeasts on acute stress induced intestinal dysmotility, World J Gastroenterol. 2016 Dec 28; 22(48): 10532–10544.
More & Swidisnki 2015. [Using S boulardii in gut dysbiosis leads to the faster reestablishment of a healthy microbiome.] Saccharomyces boulardii CNCM I-745 supports regeneration of the intestinal microbiota after diarrheic dysbiosis - a review. https://www.dovepress.com/saccharomyces-boulardii-cncm-i-745-supports-regeneration-of-the-intest-peer-reviewed-article-CEG
Kelesidis & Pothoulakis 2012. Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296087/pdf/10.1177_1756283X11428502.pdf
Thomas et al. 2011. Anti-inflammatory effects of Saccharomyces boulardii mediated by myeloid dendritic cells from patients with Crohn’s disease and ulcerative colitis. http://ajpgi.physiology.org/content/ajpgi/301/6/G1083.full.pdf
McFarland 2010. Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868213/
Zanello 2009. Saccharomyces boulardii effects on gastrointestinal diseases. http://www.horizonpress.com/cimb/v/v11/47.pdf
Pouthoulakis 2009. Review article: anti-inflammatory mechanisms of action of Saccharomyces boulardii http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2009.04102.x/pdf
Point Institute Technical Report 2008. Saccharomyces boulardii in Gastrointestinal Related Disorders http://www.pointinstitute.org/wp-content/uploads/2012/10/Saccharomyces-Boulardii-in-GI-related-disorders-paper.pdf
Initial doses for cats source:
Madewell 1999. Clostridium difficile: a survey of fecal carriage in cats in a veterinary medical teaching hospital. http://journals.sagepub.com/doi/pdf/10.1177/104063879901100108
New Dietary Ingredient Notification for S boulardii (FDA submission) by Biocodex (Florastor) (includes summary table and research references) http://www.fda.gov/ohrms/dockets/dockets/95s0316/95s-0316-rpt0301-04-vol239.pdf