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From the National Institutes of HealthNational Institutes of Health

Saccharomyces boulardii


What is it?

Saccharomyces boulardii is a yeast, which is a type of fungus. Saccharomyces boulardii was previously identified as a unique species of yeast, but is now believed to be a strain of Saccharomyces cerevisiae (baker's yeast). Saccharomyces boulardii is used as medicine.

Saccharomyces boulardii is used for treating and preventing diarrhea, including infectious types such as rotaviral diarrhea in children, diarrhea caused by gastrointestinal (GI) take-over (overgrowth) by “bad” bacteria in adults, traveler's diarrhea, and diarrhea associated with tube feedings. It is also used to prevent and treat diarrhea caused by the use of antibiotics.

Saccharomyces boulardii is also used for general digestion problems, irritable bowel syndrome (IBS), inflammatory bowel syndrome (IBD, Crohn's disease, ulcerative colitis), Lyme disease, a bowel disorder called relapsing Clostridium difficile colitis, and bacterial overgrowth in short bowel syndrome.

Some people use Saccharomyces boulardii for lactose intolerance, urinary tract infections (UTIs), vaginal yeast infections, high cholesterol levels, hives, fever blisters, canker sores, and teen-age acne.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for SACCHAROMYCES BOULARDII are as follows:

Possibly effective for...

  • Prevention of diarrhea associated with antibiotics.
  • Prevention of traveler's diarrhea.
  • Treating diarrhea in infants.
  • Prevention of HIV-associated diarrhea.
  • Preventing recurring intestinal disease caused by a bacterium called Clostridium difficile.
  • Treating acne, in combination with other treatments.
  • Reducing side effects of treatment for the ulcer-causing bacterium Helicobacter pylori.

Insufficient evidence to rate effectiveness for...

  • Crohn's disease. There is some evidence that Saccharomyces boulardii combined with mesalamine can help people with Crohn’s disease stay in remission longer. Remission is a period of time during which symptoms of disease are controlled. Taking Saccharomyces boulardii also seems to reduce the number of bowel movements in people with Crohn’s disease.
  • Preventing yeast infections in the digestive tract of patients with cystic fibrosis.
  • Urinary tract infections (UTIs).
  • Yeast infections.
  • High cholesterol.
  • Lyme disease.
  • Hives.
  • Fever blisters.
  • Canker sores.
  • Irritable bowel syndrome (IBS).
  • Ulcerative colitis.
  • Lactose intolerance.
  • Other conditions.
More evidence is needed to rate Saccharomyces boulardii for these uses.

How does it work?

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Saccharomyces boulardii is called a "probiotic," a friendly organism that helps to fight off disease-causing organisms in the gut such as bacteria and yeast.

Are there safety concerns?

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Saccharomyces boulardii is LIKELY SAFE for most adults when taken by mouth. It can cause gas in some people. Rarely, it might cause fungal infections that can spread through the bloodstream to the entire body (fungemia).

Saccharomyces boulardii is POSSIBLY SAFE for children. However, diarrhea in children should be evaluated by a healthcare professional before using Saccharomyces boulardii.

Special precautions & warnings:

Pregnancy and breast-feeding: Not enough is known about the use of Saccharomyces boulardii during pregnancy and breast-feeding. Stay on the safe side and avoid use.

Weakened immune system: There is some concern that critically ill people, people who have a weakened immune system, and people who are taking medicines that alter the immune system might have an increased risk for developing a yeast infection that spreads to the bloodstream and the rest of the body (fungemia) if they take Saccharomyces boulardii. Although Saccharomyces generally doesn’t cause disease, there have been numerous cases of fungemia following its use, primarily in people with a weakened immune system.

Yeast allergy: People with yeast allergy can be allergic to products containing Saccharomyces boulardii, and are best advised to avoid these products.

Are there interactions with medications?

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Minor

Be watchful with this combination.

Medications for fungal infections (Antifungals)
Saccharomyces boulardii is a fungus. Medications for fungal infections help reduce fungus in and on the body. Taking Saccharomyces boulardii with medications for fungal infections can reduce the effectiveness of Saccharomyces boulardii.

Some medications for fungal infection include fluconazole (Diflucan), terbinafine (Lamisil), itraconazole (Sporanox), and others.

Are there interactions with herbs and supplements?

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There are no known interactions with herbs and supplements.

Are there interactions with foods?

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There are no known interactions with foods.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • For diarrhea associated with the use of antibiotics: 250-500 mg of Saccharomyces boulardii two to four times a day.
  • For diarrhea caused by Clostridium difficile: 1 gram of Saccharomyces boulardii daily for 4 weeks along with antibiotic treatment.
  • For Crohn's disease:
    • 250 mg of Saccharomyces boulardii three times daily has been used for up to 9 weeks.
    • 1 gram of Saccharomyces boulardii daily in combination with usual treatment has also been used.
  • For ulcerative colitis: 205 mg of Saccharomyces boulardii three times daily.
  • For treatment of infections due to the ulcer-causing Helicobacter pylori bacterium: a dose of 5 billion colony-forming units (CFUs) of Saccharomyces boulardii daily in addition to usual treatment.

Other names

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Brewer's Yeast (Hansen CBS 5926), Hansen CBS 5926, Levure de Boulangerie (Hansen CBS 5926), Probiotic, Probiotique, Saccharomyces, Saccharomyces boulardii, Saccharomyces Cerevisiae, S. Boulardii.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Saccharomyces boulardii page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/332.html.

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  2. Szajewska H, Mrukowicz J. Meta-analysis: non-pathogenic yeast Saccharomyces boulardii in the prevention of antibiotic-associated diarrhoea. Aliment Pharmacol Ther 2005;22:365-72.
  3. Can M, Besirbellioglu BA, Avci IY, et al. Prophylactic Saccharomyces boulardii in the prevention of antibiotic-associated diarrhea: A prospective study. Med Sci Monit 2006;12:PI19-22.
  4. Guslandi M, Giollo P, Testoni PA. A pilot trial of Saccharomyces boulardii in ulcerative colitis. Eur J Gastroenterol Hepatol 2003;15:697-8.
  5. Guslandi M, Mezzi G, Sorghi M, Testoni PA. Saccharomyces boulardii in maintenance treatment of Crohn's disease. Dig Dis Sci 2000;45:1462-4.
  6. McFarland LV. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease. Am J Gastroenterol 2006;101:812-22.
  7. Marteau P, Seksik P. Tolerance of probiotics and prebiotics. J Clin Gastroenterol 2004;38:S67-9.
  8. Borriello SP, Hammes WP, Holzapfel W, et al. Safety of probiotics that contain lactobacilli or bifidobacteria. Clin Infect Dis 2003;36:775-80.
  9. Cremonini F, Di Caro S, Covino M, et al. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol 2002;97:2744-9.
  10. Muller J, Remus N, Harms KH. Mycoserological study of the treatment of paediatric cystic fibrosis patients with Saccharomyces boulardii (Saccharomyces cerevisiae Hansen CBS 5926). Mycoses 1995;38:119-23.
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  4. Weber G, Adamczyk A, Freytag S. [Treatment of acne with a yeast preparation]. Fortschr Med 1989;107:563-6.
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  7. Czerucka D, Roux I, Rampal P. Saccharomyces boulardii inhibits secretagogue-mediated adenosine 3',5'-cyclic monophosphate induction in intestinal cells. Gastroenterol 1994;106:65-72.
  8. Elmer GW, McFarland LV, Surawicz CM, et al. Behaviour of Saccharomyces boulardii in recurrent Clostridium difficile disease patients. Aliment Pharmacol Ther 1999;13:1663-8.
  9. Hennequin C, Kauffmann-Lacroix C, Jobert A, et al. Possible role of catheters in Saccharomyces boulardii fungemia. Eur J Clin Microbiol Infect Dis 2000;19:16-20.
  10. Fredenucci I, Chomarat M, Boucaud C, et al. Saccharomyces boulardii fungemia in a patient receiving ultra-levure therapy. Clin Infect Dis 1998;27:222-3.
  11. Pletinex M, Legein J, Vandenplas Y. Fungemia with Saccharomyces boulardii in a 1-year-old girl with protracted diarrhea. J Pediatr Gastroenterol Nutr 1995;21:113-5.
  12. Buts JP, Corthier G, Delmee M. Saccharomyces boulardii for Clostridium difficile-associated enteropathies in infants. J Pediatr Gastroenterol Nutr 1993;16:419-25.
  13. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: a prospective study. Gastroenterology 1989;96:981-8.
  14. Surawicz CM, McFarland LV, Elmer G, et al. Treatment of recurrent clostridium difficile colitis with vancomycin and Saccharomyces boulardii. Am J Gastroenterol 1989;84:1285-7.
  15. McFarland LV, Surawicz CM, Greenberg RN, et al. Prevention of beta-lactam associated diarrhea by Saccharomyces boulardii compared with placebo. Am J Gastroenterol 1995;90:439-48.
  16. McFarland LV, Surawicz CM, Greenberg RN, et al. A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA 1994;271:1913-8.
  17. Elmer GW, McFarland LV. Comment on the lack of therapeutic effect of Saccharomyces boulardii in the prevention of antibiotic-related diarrhea in elderly patients. J Infect 1998;37:307-8.
  18. Lewis SJ, Potts LF, Barry RE. The lack of therapeutic effect of Saccharomyces boulardii in the prevention of antibiotic-related diarrhea in elderly patients. J Infect 1998;36:171-4.
  19. Bleichner G, Blehaut H, Mentec H, et al. Saccharomyces boulardii prevents diarrhea in critically ill tube-fed patients. Intensive Care Med 1997;23:517-23.
  20. Castagliuolo I, Riegler MF, Valenick L, et al. Saccharomyces boulardii protease inhibits the effects of clostridium difficile toxins A and B in human colonic mucosa. Infection and Immun 1999;67:302-7.
  21. Saavedra J. Probiotics and infectious diarrhea. Am J Gastroenterol 2000;95:S16-8.
  22. McFarland LV. Saccharomyces boulardii is not Saccharomyces cerevisiae. Clin Infect Dis 1996;22:200-1.
  23. McCullough MJ, Clemons KV, McCusker JH, Stevens DA. Species identification and virulence attributes of Saccharomyces boulardii (nom. inval.). J Clin Microbiol 1998;36:2613-7.
  24. Niault M, Thomas F, Prost J, et al. Fungemia due to Saccharomyces species in a patient treated with enteral Saccharomyces boulardii. Clin Infect Dis 1999;28:930.
  25. Bassetti S, Frei R, Zimmerli W. Fungemia with Saccharomyces cerevisiae after treatment with Saccharomyces boulardii. Am J Med 1998;105:71-2.
  26. Scarpignato C, Rampal P. Prevention and treatment of traveler's diarrhea: A clinical pharmacological approach. Chemotherapy 1995;41:48-81.
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Last reviewed - 01/04/2012

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Page last updated: 06 September 2012