Saccharomyces boulardii is probiotic yeast that has been shown effective in the treatment of several diarrheal intestinal illnesses including antibiotic associated diarrhea, travelers diarreha and HIV/AIDS diarrhea. Saccharomyces boulardii has been shown to be effective in preventing relapses of Crohn’s disease and treating pouchitis, a form of intestinal inflammation in surgical pouch created in the treatment of ulcerative colitis. A recent French study provides new insights and hope in the use of probiotics in the treatment of IBD. Functioning like a traffic cop, Saccharomyces boulardii prevents T lymphocyte white blood cells critical to development of Crohn's disease from migrating from lymph nodes surrounding the bowel and thereby prevents colitis in an IBD mouse model. The effect is curative relative to the amount of the yeast administered. Human studies have confirmed that a steady state of Saccharomyces boulardii is reached in the gut in about 3 days but eliminated within 2-5 days after it is no longer taken orally. Saccharomyces boulardii's inhibitory effect on interferon helps restore gut permeability to normal thereby preventing leaky gut syndrome.
Saccharomyces boulardii yeast was first isolated from lychee and mangosteen fruit in the 1920’s by a French scientist Henri Boulard after observed natives chewing the skin of these fruits to control cholera. Though in the same genus as Saccharomyces cerevisiae (Baker’s, Brewer’s or dietary yeast), Saccharomyces boulardii is not linked to Crohn’s disease or any other disease but its only use is as a probiotic. Elevated levels of antibodies to Saccharomyces cerevisiae (ASCA) are present in about 70% of people with Crohn’s disease, 10-20% with ulcerative colitis, and a few people with celiac disease and cystic fibrosis but rarely in normal people. Increased stool antibody levels have been reported by Enterolab in people who have Crohn's disease ow who are sensitive to dietary yeast and/or gluten.
Bicodex is the largest maker of Saccharomyces boulardii probiotics worldwide. Florastor is the brand name they market Saccharomyces boularii probiotic under in the U.S. while it is marketed under various names such as Ultra-Levure, Interflora, Perenterol in other countrires. The recommended dose varies from one capsule orally daily for prevention of traveler's diarrhea to up to four capsules three times daily for AIDS/HIV associated diarrhea.
A dramatic important shift in the treatment of IBD is reflected in the editorial by Claudio Fiocchi of the Cleveland Clinic published in the same issue as evidenced by his statement “... from a practical standpoint, it makes more sense to take advantage of ‘all’ beneficial properties of probiotics by giving IBD patients combinations of multiple bacteria and yeasts with anti-inflammatory and protective effects, rather than hoping a single probiotics will fight alone and win the battle against an overwhelming and hostile army of gut flora”. The presence of abnormal gut flora is emerging one of the crucial factors in the prevention and treatment of IBD, celiac disease and irritable bowel syndrome. The Food Doc believes it maybe time for all of us to take a daily probiotic in our we fight in the war on terrorism in our gut.
Saccharomyces boulardii inhibits inflammatory bowel disease by trapping T cells in mesenteric lymph nodes. Dalmasso G. et al Gastroenterology 2006; 131:1812-1825.
Probiotics in Inflammatory Bowel Disease: Yet Another Mechanism of Action? Claudio Fiocchi. Gastroenterology 2006 131:2009-2011.
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