Saccharomyces Boulardii for IBS-D: Does it Really Help?

observational-study PMID: 36630947

Saccharomyces Boulardii for IBS-D: Does it Really Help?

Quick Summary: A recent study suggests that taking the probiotic Saccharomyces boulardii along with dietary changes may help ease symptoms of diarrhea-predominant Irritable Bowel Syndrome (IBS-D) in people with bacterial overgrowth in their small intestine. The study found it could reduce diarrhea and improve overall IBS symptoms.

What The Research Found

This research looked at how Saccharomyces boulardii (Sb), a type of probiotic, affected people with IBS-D who also had a condition called small intestinal bacterial overgrowth (SIBO). The study showed that:

Fewer IBS Symptoms: People taking Sb and following dietary advice reported a greater reduction in their IBS symptoms compared to those who only followed dietary advice.
Less Diarrhea: The group taking Sb had less diarrhea than the group that didn't take it.
Changes in Gut Bacteria: Sb seemed to help restore a healthy balance of bacteria in the gut. Specifically, it increased the levels of a beneficial bacteria called Faecalibacterium prausnitzii.

Study Details

Who was studied: 48 adults with IBS-D and SIBO.
How long: The study lasted for 15 days.
What they took: Some participants took Saccharomyces boulardii along with dietary advice. Others only received dietary advice.

What This Means For You

If you have IBS-D and experience symptoms like diarrhea, this research suggests that Saccharomyces boulardii might be a helpful addition to your treatment plan, especially if you also have SIBO. It could potentially:

Reduce your diarrhea.
Improve your overall IBS symptoms.
Help restore a healthy balance of bacteria in your gut.

Important: Always talk to your doctor before starting any new supplements, including probiotics. They can help you determine if Saccharomyces boulardii is right for you and advise you on the correct dosage.

Study Limitations

It's important to keep in mind that this was a small study, and more research is needed. Here's what to consider:

Small Group: The study only included a small number of people, so the results might not apply to everyone.
Short Duration: The study only lasted for 15 days, so we don't know if the benefits would last longer.
No Placebo: The study didn't use a placebo (a "dummy" pill), so it's hard to know for sure if the probiotic was the only reason for the improvements.
Open-Label: The participants knew they were taking the probiotic, which could have influenced their perception of the results.
Dosage Not Specified: The exact dosage of Saccharomyces boulardii wasn't specified in the summary, making it difficult to replicate the study.

Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider if you have questions about a medical condition or treatment.

Key Findings

Saccharomyces boulardii CNCM I-745 combined with dietary advice (Sb + DA) reduced hydrogen excretion (41% vs. 29% in DA alone), lowered IBS Symptom Severity Scale (IBS-SSS) scores (-134 vs. -93), and decreased diarrhea prevalence (25.9% vs. 47.6%) in IBS-D patients with small intestinal bacterial overgrowth (SIBO). The Sb + DA group showed increased Faecalibacterium prausnitzii abundance, linked to clinical improvement. Safety was excellent, with no adverse events reported.

Study Design

This was a randomized open-label pilot study conducted in 2023. Researchers assessed 54 IBS-D patients with SIBO via lactulose hydrogen breath test (LHBT), of whom 48 completed the trial (27 Sb + DA; 21 DA). Interventions lasted 15 days, with outcomes measured pre- and post-treatment. Microbiota analysis used 16S rDNA sequencing (bacteria) and ITS2 (fungi).

Dosage & Administration

The study administered Saccharomyces boulardii CNCM I-745 alongside dietary advice, though specific dosage details (e.g., CFU count) were not provided in the summary. The supplement was delivered orally, presumably in capsule form (common for probiotics), and combined with dietary adjustments targeting fermentable carbohydrates.

Results & Efficacy

Hydrogen excretion: Sb + DA reduced levels by 41% vs. 29% in DA-only (no exact p-value reported, but conclusion states significance).
IBS-SSS scores: Sb + DA improved symptoms more than DA (-134 vs. -93; p < 0.05 likely, per conclusion).
Diarrhea prevalence: Sb + DA group had half the diarrhea rate of DA (25.9% vs. 47.6%).
Microbiota changes: Sb + DA increased F. prausnitzii, a commensal bacterium associated with anti-inflammatory effects.
Safety: No adverse events reported in Sb + DA group.

Limitations

Open-label design: Lack of blinding may introduce bias.
Short duration: 15-day follow-up limits insight into long-term efficacy/safety.
Small sample size: 48 patients reduce statistical power and generalizability.
No placebo control: Dietary advice alone may have influenced outcomes.
Unspecified dosage: Hinders reproducibility and clinical application.
Lack of demographic details: Age, gender, or baseline microbiota composition were not described in the summary.

Clinical Relevance

For IBS-D patients with SIBO, S. boulardii CNCM I-745 plus dietary advice may offer superior symptom relief and microbiota restoration compared to dietary changes alone. The association between F. prausnitzii enrichment and clinical improvement suggests a potential mechanism for probiotic action. However, results should be interpreted cautiously due to the pilot nature of the study, absence of a placebo, and short duration. Larger, double-blind trials with detailed dosing and long-term follow-up are needed to confirm these findings. Supplement users should consult healthcare providers to tailor probiotic use with dietary strategies for IBS-D management.

Source: PubMed (2023)