Does Anyone Take S. Boulardii (Florastor) for Crohn's ?

[Crohn2357]

I've seen some Crohn's patients taking this probiotic yeast daily as a maintenance agent. There are studies, articles indicating this yeast helps with CD and all say it is safe. I'm thinking about taking it daily, wondering if anyone else takes it for their Crohn's.

Some studies, articles. (Edited to add some other links)

“Saccharomyces boulardii is a non-pathogenic, non-colonizing yeast with probiotic properties used in many countries as both a preventive and therapeutic agent for diarrhoea and other gastrointestinal disorders and not related to the yeast group to which Candida belongs.
Supplementation may be useful for controlling diarrhoea associated with antibiotic use and the consumption of unusual foods while travelling.
Saccharomyces boulardii taken orally produces lactic acid and some B vitamins as it becomes established. During use, friendly probiotic bacteria are allowed to colonize in the GI tract making Saccharomyces boulardii particularly beneficial in balancing intestinal microbiology. It is then eliminated after supplementation is stopped.
S. boulardii is being used both in the pharmaceutical and in nutritional industries.
----- ------
This microorganism has a bioregulatory effect on the intestinal flora helping to maintain a normal balance of friendly bacteria in the intestines modulating immunity by boosting intestinal secretion of IgA. The protective effect ofSaccharomyces boulardii involves several types of activity in the epithelial tissue of the digestive tract, including inactivation of bacterial toxins, stimulation of intestinal immune response, and release of polyamines.
The clinical activity of S. boulardii has been documented in various types of diarrhoea and is especially relevant to antibiotic-associated diarrhoea and recurrent Clostridium difficile intestinal infections; its particular capacity to survive gastric acidity and to resist all commonly used antibiotics (except anti-fungals) makes it a useful remedy for diarrhoea brought on by antibiotics.
Research has found that S. boulardii may support gut function with many conditions, including inflammatory bowel disease, irritable bowel syndrome and traveler's diarrhoea.
http://www.gnosis-bio.com/biooptima-boulardii.php

Systematic review and meta-analysis of Saccharomyces boulardii in adult patients
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868213/
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/
Prevention of Clostridium difficile infection with Saccharomyces boulardii: A systematic review
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805518/
Probiotic use in clinical practice: what are the risks?1,2,3
http://ajcn.nutrition.org/content/83/6/1256.full
S. Boulardii effects on GI diseases
http://www.horizonpress.com/cimb/v/v11/47.pdf
Protection against increased intestinal permeability and bacterial translocation induced by intestinal obstruction in mice treated with viable and heat-killed Saccharomyces boulardii.
http://www.ncbi.nlm.nih.gov/pubmed/20936479
Influence of Saccharomyces boulardii on the intestinal permeability of patients with Crohn's disease in remission.
http://www.ncbi.nlm.nih.gov/pubmed/18584523
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/
Saccharomyces boulardii in maintenance treatment of Crohn's disease.
http://www.ncbi.nlm.nih.gov/pubmed/10961730
Probiotics for Crohn's disease: what have we learned?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856223/
Anti-inflammatory effects of Saccharomyces boulardii mediated by myeloid dendritic cells from patients with Crohn's disease and ulcerative colitis.
http://www.ncbi.nlm.nih.gov/pubmed/21903765
Review article: anti-inflammatory mechanisms of action of Saccharomyces boulardii.
http://www.ncbi.nlm.nih.gov/pubmed/19706150
A pilot trial of Saccharomyces boulardii in ulcerative colitis.
www.ncbi.nlm.nih.gov/pubmed/12840682/

"when S. boulardii is given to antibiotic-shocked mice or patients with diarrhea, normal microbiota is re-established rapidly"

Molecular analysis of the digestive microbiota in a gnotobiotic mouse model during antibiotic treatment: Influence of Saccharomyces boulardii.
http://www.ncbi.nlm.nih.gov/pubmed/18511310/

Effects of Saccharomyces boulardii on fecal short-chain fatty acids and microflora in patients on long-term total enteral nutrition.
http://www.ncbi.nlm.nih.gov/pubmed/16273644/

CONCLUSION: Sb-induced increase of fecal SCFA concentrations (especially butyrate) may explain the preventive effects of this yeast on TEN-induced diarrhea.

Therapeutic effects of Saccharomyces boulardii on mild residual symptoms in a stable phase of Crohn's disease with special respect to chronic diarrhea--a pilot study.
http://www.ncbi.nlm.nih.gov/pubmed/8465554/

 

[DJW]

I had a look at the links. Thank you for posting! Always helpful.

Personally I wouldn't put too much weight on an abstract without being able to read the whole study.
That said the study from Therapeutic Advances: Gastroenterology looks interesting.

It does say caution should be taken with immunocompromised patients.
Also keep in mind it is a small study and the authors point out larger, controlled studies are required.

I'd ask the doctor about taking S. Boulardi before starting.

Best wishes.

 

[Crohn2357]

My clinical microbiology doctor suggested it for me. He said I can take one capsule every day for maintenance.
Although the links are good, this later study says it is not effective as a maintenance agent.

http://www.crohnsforum.com/showthread.php?t=54138

As kiny said, it is a shocker.

 

[Crohn2357]

I've taken 1 capsule of florastor for ten days every day. Things were good. Stopped taking for 3 days and things aren't so good (Crohn's wise). I will keep taking this probiotic yeast. Its anti diarrheal effect and anti inflammatory effects are doing good for me.
Review article: anti-inflammatory mechanisms of action of Saccharomyces boulardii.
http://www.ncbi.nlm.nih.gov/pubmed/19706150

---
A pilot trial of Saccharomyces boulardii in ulcerative colitis.
www.ncbi.nlm.nih.gov/pubmed/12840682/

Although this is not a placebo controlled, double blind big study... They calculated the effects based on Rachmilewitz's clinical activity index which is much more accurate than UCDAI. Result is good I think.

 

[Charlotte.]

Wow, thank you for the summary of the clinical studies, Crohn2357.
I am taking S. Boulardii as well for a few weeks now and my skin looks nice and clear but I can't say it helps my flare-up. Maybe it helps when being in remission but I continue on taking it anyway.
Anyone else experience on S. Boulardii? Probably someone who is in remission and stays in remission by that?

 

[SN8888]

I've been taking S boulardii for many years along with a low starch, low sugar, no wheat, no dairy, low fiber diet. I haven't confirmed what's wrong with me (blood work and symptoms suggest Crohns, but I've been avoiding a colonoscopy for a long time - I haven't handled this right and haven't been open enough with my Dr).

I have IBS sort of symptoms now, but I haven't had a "flare" in 5 years (major abdominal pain, black watery D, fever, weight loss, pain in ankles and sometime knees and lower back). As long as I keep up my regimen (diet and S boulardii) I don't get very sick.

Three times in the last ten years, I decided to stop taking S boulardii thinking that maybe it wasn't doing anything. Each time, a week after stopping, I get sick. As soon as it starts, I stay in bed and sort of starve myself for a few days, then take a few big doses of Pepto (turns black) hoping that it will help kill whatever bacteria (or something) that my system is reacting to, then slowly try to reintroduce some food before starting back on S boulardii. I'm a scientist, but a terrible patient, so maybe you shouldn't follow anything that I do...I've ended up with vitamin deficiencies and other problems.

 

[Crohn2357]

SN8888, how much S. Boulardii do you take per day? I take 1 capsule (250 mg) every day.

 

[SN8888]

I take one capsule of Jarrow's S boulardii every evening and I also take Digestive Advantage (Bacillus Coagulans, I think) every morning. I can skip the Digestive Advantage without noticing any changes, so maybe I can stop taking that one.

 

[Charlotte.]

Thanks for sharing SN8888. Is it your only regimen for staying in remission along with diet?

I read some study results about VSL#3 and it sounds very promising. Did anyone try that as well?

 

[SN8888]

I also avoid caffeine, alcohol and probably some other stuff I don't even think about any more like artificial sweeteners. I exercise whenever I can, try to manage stress, get some fresh air and sunshine.
If I'm in good health and taking everything like usual, I can cheat a little on the low starch/carb rule, but usually not with a big meal. Maybe I'll have a gluten-free cookie or some potato chips between meals (hoping that there's a better chance that I'll break it down and absorb it on a relatively empty stomach).

 

[Charlotte.]

There are many parallels to your diet, SN8888, except the low starch/carb rule.
I was on a low carb diet but I lost so much weight and looked really unhealthy and felt weak all the time but maybe my Crohn's symptoms have improved at least a bit during that time.

I cut out sugar, I use stevia instead.

 

[irishgal]

I take Klaire labs Sacc. boulardii twice a day and VSL #3, one prescription packet a day (450 bil organisms.) I'm on Anti-MAP therapy, so have to keep those good bugs populated! I notice a negative difference when I don't take them for a few days. I don't think they're the primary thing keeping me in remission, but they help me feel a little better.

 

[d0nk3y]

I talked to a person today who said she was a microbiologist. She recommended taking the S. Boulardii to kill off the fungus/bad bacteria in the intestines and then take a probiotic to maintain afterwards. She suggested taking Ultimate Flora Extra Care (50 billion) by Renew Life (I'm new here so it won't let me post the link).


I will ask my doctor first about the Boulardiiafter reading about taking caution with immunocompromised patients. Not sure if I fall in that category.