S. Boulardii Probiotics For SIBO – Do They Help?

Florastor contains a unique probiotic strain of yeast-origin, Saccharomyces boulardii CNCM I-745, which is antibiotic resistant and well-studied for a wide variety of clinical purposes.

These include:

  1. Reducing the risk/severity of acute & antibiotic associated diarrhea
  2. Restoring the microbiome after disruption from antibiotics or infection
  3. Contributing to the treatment process in infections such as H Pylori and Difficile

In today’s blog post, my scientific gaze turns towards the use of S. Boulardii as a complimentary management strategy in SIBO (small intestinal bacterial overgrowth), which is defined as a quantity of bacteria in the digestive tract beyond a threshold level.

Recent years has seen an uptick in clinical trials in this area, so I’ve teamed up with Florastor to take a closer look at what science has to say in this area.

SB For IBS-D with SIBO

A recently published trial out of Digestive Diseases journal explored the use of Saccharomyces boulardii CNCM I-745 in patients living with IBS-D and SIBO.

In this study researchers compared the effects of dietary guidance alone or in combination with probiotic supplementation.

They determined that the group receiving both S. Boulardii and dietary advice had better outcomes than the group receiving dietary advice alone.

This included:

A decrease in SIBO severity (as measured via decreases in hydrogen excretion test)

A decrease in IBS severity scores

A decrease in diarrhea frequency

In this context, with a great safety profile, S. Boulardii was demonstrated to improve outcomes in IBS-D accompanied by SIBO – with similar results also being noted in an American Gastroenterological Association pilot study.

SB For SIBO In Decompensated Cirrhosis

In a 2022 trial out of Current Developments In Nutrition, patients with decompensated (advanced) cirrhosis and SIBO were provided either S. Boulardii or placebo in combination with standard therapy.

No adverse effects were noted in the probiotic group and significantly less participants had detectable SIBO at the conclusion of the 3-month trial period in the probiotic vs control group, indicating the promise of S. Boulardii as a complimentary management strategy in SIBO eradication.

No antibiotic use was permitted during the study period.

SB for SIBO In Systemic Sclerosis

SIBO is known to affect greater than half of those living with systematic sclerosis with evidence suggesting that antibiotic use improves outcomes.

In a 2020 trial published in Digestive Disorders, researchers sought to determine whether or not the inclusion of S. boulardii would enhance the treatment process for SIBO in this population.

They found that the inclusion of S. Boulardii  in conjunction with antibiotic treatment (Metronidazole) improved SIBO eradication and reduced symptoms like diarrhea, gas and abdominal pain as compared to the antibiotic alone.

Final Thoughts

The management of SIBO has become a topic of increasing scientific interest in the last several years.

A growing number of studies looking at S. Boulardii use in different contexts of SIBO have demonstrated promising results which increase scientific interest around its use in SIBO management.

Stay tuned, I’ll continue to keep a close eye on this area of inquiry!

Andy De Santis RD MPH