For many types of acute and chronic diarrhea, the probiotic Florastor can be recommended as the best natural approach. Florastor is the tradename of Saccharomyces boulardi lyo (lyo = freeze dried, the best means for preserving the effectiveness of this probiotic species; also means that Florastor is shelf-stable at room temperature).
Here are the main indications/conditions for which Florastor/Saccharomyces boulardii has been investigated:
A controlled study found a significant reduction in symptoms of diarrhea in adults taking 250mg of S. boulardii twice a day for five days or until symptoms were relieved.
Irritable Bowel Syndrome
A placebo-controlled study found that patients with diarrhea due mainly to irritable bowel syndrome (IBS) had a significant reduction in number and consistency of bowel movements.
Suggested dosage is 250mg twice daily.
Inflammatory Bowel Disease
Florastor benefits for inflammatory bowel disease (IBD) include: 1) prevention of relapse in Crohn’s disease patients currently in remission and 2) improvement for ulcerative colitis patients with moderate symptoms. Suggested dosage is three 250mg capsules a day.
Some evidence for its usefulness in the prevention of antibiotic-associated diarrhea (AAD) in adults. Suggested dosage: 250mg twice a day with the standard antibiotic course.
Saccharomyces boulardii was shown to significantly increase the recovery rate of stage IV AIDS patients suffering from diarrhea. On average, patients receiving S. boulardii gained weight while a placebo group lost weight over the 18 month study. There were no reported adverse reaction observed in these immunocompromised patients.
Recurrent Clostridium difficile Infection
Two 500mg doses per day of Saccharomyces boulardii when taken with one of two antibiotics (vancomycin or metronidazole) were found to significantly reduce the rate of recurrent Clostridium difficile (pseudomembranous colitis) infection. However, note that significant benefit was not found for prevention of an initial episode of Clostridium difficile-associated disease.
For more on Saccharomyces boulardii, see the NYBC entry:
Note that non-member price is $30, but member price is NOW ONLY $29. (NYBC Membership costs $5, $10, or $25 per year, depending on income.)
Some references (there are many more, since Saccharomyces boulardii is among the most-studied probiotics):
–Höcher W, Chase D, Hagenhoff G (1990). “Saccharomyces boulardii in acute adult diarrhoea. Efficacy and tolerance of treatment”. Münch Med Wochenschr 132: 188–92.
–McFarland L, Surawicz C, Greenberg R (1994). “A randomised placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease”. J Am Med Assoc 271: 1913–8.
–Maupas J, Champemont P, Delforge M (1983). “Treatment of irritable bowel syndrome with Saccharomyces boulardii: a double blind, placebo controlled study”. Medicine Chirurgie Digestives 12(1): 77–9.
–Guslandi M, Mezzi G, Sorghi M, Testoni PA (2000). “Saccharomyces boulardii in maintenance treatment of Crohn’s disease”. Dig. Dis. Sci. 45 (7): 1462–4. PMID 10961730.
–Guslandi M, Giollo P, Testoni PA (2003). “A pilot trial of Saccharomyces boulardii in ulcerative colitis”. Eur J Gastroenterol Hepatol 15 (6): 697–8. doi:10.1097/01.meg.0000059138.68845.06. PMID 12840682.
–Saint-Marc T, Blehaut H, Musial C, Touraine J (1995). “AIDS related diarrhea: a double-blind trial of Saccharomyces boulardii”. Sem Hôsp Paris 71: 735–41.