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Browse Top 100 HerbsSaccharomyces 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.
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.
Uses |
Grade* |
Diarrhea (antibiotic associated)There is good evidence that concurrent use of Saccharomyces boulardii with antibiotic therapy reduces the incidence of developing antibiotic-associated diarrhea (AAD) (Clostridium difficile and other). In general, positive results occur only when Saccharomyces boulardii is 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. |
A |
Diarrhea in childrenSeveral trials suggest efficacy of Saccharomyces boulardii in the treatment of diarrhea in childhood. Further studies are still required. Use of Saccharomyces boulardii may be advantageous in both the reduction of stool frequency per day and the duration of diarrhea in this age group. |
B |
Antibacterial (amebiasis)Evidence from one clinical trial supports improvement of symptoms and in patients with amebiasis treated with Saccharomyces boulardii, in addition to standard therapy. Further clinical trials are required before a firm recommendation can be made. |
C |
Crohn's diseaseEvidence supports mild improvement of symptoms and quality of life in patients with Crohn's disease who use Saccharomyces boulardii. More clinical trials are required before a firm recommendation can be made in this area. |
C |
Diarrhea (Clostridium difficile)With the introduction of broad-spectrum antibiotics into clinical practice, Clostridium difficile infection has become a common cause of infectious diarrhea in hospitalized patients. For treatment of recurrent Clostridium difficile-associated diarrhea, Saccharomyces boulardii may decrease recurrences by about 50%, especially when combined with high-dose vancomycin. Further studies are still required. |
C |
Diarrhea (HIV associated)While only small studies have been performed, treatment with Saccharomyces boulardii may improve quality of life for AIDS patients with chronic diarrhea. As fungemia has been associated with Saccharomyces boulardii administration in patients with central lines, care should be exercised in treating these patients. |
C |
Diarrhea (prevention during tube feeding)Preliminary evidence supports the use of Saccharomyces boulardii for this indication. However, the role of antibiotics in the results is unclear. More studies should be performed before a strong recommendation can be made. |
C |
Diarrhea (traveler's)Although evidence supports the use of Saccharomyces boulardii for other forms of diarrhea, little evidence exists to support standard treatment with Saccharomyces boulardii for traveler's diarrhea. More studies need to be performed. |
C |
Irritable bowel syndrome (IBS)One clinical trial exists to support treatment with Saccharomyces boulardii for irritable bowel syndrome. Additional study is required before a firm recommendation can be made. |
C |
Nutritional support (premature infants)One clinical trial exists investigating the addition of Saccharomyces boulardii to 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. |
C |
*Key to grades
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Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
Allergies
Avoid in individuals with a known allergy or hypersensitivity to yeast, Saccharomyces boulardii, Saccharomyces cerevisiae, or other species in the Saccharomycetaceae family. Saccharomyces boulardii use may be associated with itching, urticaria ("hives"), and generalized skin eruptions.
Side Effects and Warnings
Saccharomyces boulardii has been generally well tolerated in human studies for treatment of various diarrheal disorders. Symptoms of Saccharomyces cerevisiae infection included septic shock in more than one patient and fever in another. Symptoms of sepsis (infection) included increased white blood cell count, abdominal meteorism (swelling from gas), and respiratory insufficiency. In general, contamination occurred in patients with an indwelling vascular catheter.
Constipation, increased thirst, flatulence (gas), and bloating have been associated with Saccharomyces boulardii use. Use cautiously in patients with constipation.
Saccharomyces boulardii fungemia (fungal infection) has occurred. Avoid in patients with a yeast infection. Symptoms included septic shock in more than one patient and fever in another. Symptoms of sepsis include white blood cell count increase, abdominal meteorism, and respiratory insufficiency. In general, contamination occurred in patients with an indwelling vascular catheter.
Saccharomyces boulardii use may also cause Quincke's edema (swelling) or increases or decreases in blood pressure when used with MAOIs.
Pregnancy and Breastfeeding
Saccharomyces boulardii is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.
Adults (18 years and older):
In large multicenter trials, few (if any) side effects have been noted in patients taking Saccharomyces boulardii for up to 15 months. Regardless of diarrhea type, Saccharomyces boulardii is often taken in doses of 500-2,000 milligrams in divided daily doses (three or four times daily). The brand name product, Ultra-Levure®, has been studied in doses of 2-4 capsules daily for up to eight months. For antibiotic-associated diarrhea, 1 gram daily for three days following completion of antibiotics has been used. Two sachets per day containing 5x109 colony forming units (CFU) per sachet has also been used for four weeks. One capsule twice daily has been used; duration was not noted. 250-500mg twice daily for up to two weeks following antibiotics has been used. Four capsules Ultra-Levure® daily for eight months has been used.
Children (younger than 18 years):
The most commonly used dose for Saccharomyces boulardii in children for the treatment of diarrhea is 250-600 milligrams daily for up to five days. This has been given alone and in combination with antibiotics.