Evidence
Whilst travelling in Indochina during the early 1920’s, a Cholera outbreak had French microbiologist, Henri Boulard observe the local population drink a tea that they had made from macerating tropical fruits (lychee and mangosteen) in order to prevent and treat diarrhoea.
Boulard continued his investigation and in 1923 was able to isolate the yeast strain responsible and named this Saccharomyces boulardii.
Saccharomyces boulardii is a non-pathogenic, non-systemic, eukaryotic microorganism that can grow under both aerobic and anaerobic conditions and at a high temperature of 37°C.
The strain Saccharomyces boulardii has been the subject of many pharmacological and clinical studies and is used today around the world as a probiotic in the treatment of diarrhoea.
Yomogi® as a probiotic drug contains 250 mg lyophilized yeast of Saccharomyces cerevisiae (boulardii) HANSEN CBS 5926 / CNCM I-745 with minimum of 2.5 billion CFU at product batch release.
Lyophilization is a process of ‘freeze drying’ whereby ice is directly turned into vapour without first melting into a liquid state. This manufacturing process results in Yomogi® maintaining its integrity, quality and stability, so no cool storage of Yomogi® is necessary.
Once ingested Saccharomyces boulardii exerts its intraluminal effects but will not colonise the gastrointestinal tract. Rather, it is a transient yeast that provides benefits to the host as it moves. Approximately 4-6 days after cessation of Yomogi® administration, S boulardii yeast can no longer be detected in the stool.
Yomogi can bind to pathogens, makes their bacterial toxins harmless and helps to excrete them from the gastrointestinal tract.
Saccharomyces boulardii has shown to have many properties:
Antimicrobial Effect.
Within the lumen of the digestive tract Saccharomyces boulardii has antagonistic and antitoxic effects against pathogenic bacteria and yeasts.
S.boulardii is able to secrete a protein/microcin that inhibits the growth of these microorganisms.
S.boulardii has been shown to bind pathogenic bacteria such as Salmonella and specific fimbriae expressing Escherichia coli on their surface. In doing so S.boulardii reduces their adhesion to the intestinal epithelium and eliminates them from the intestine.
Bacterial toxins, such as those produced by Clostridium difficile are enzymatically neutralized by S.boulardii
S.boulardii displays beneficial effects against other pathogenic bacteria such as Salmonella and Yersnia.
Effect on the intestinal mucosa and immune system.
The antisecretory effect of S.boulardii helps normalise the water and electrolyte homeostasis. Administration of S.boulardii leads to an increase in the disaccharidase activity which improves the absorption of carbohydrates.
S.boulardii stimulates the production the production of secretory immunoglobulin A (sigA) in the gut associated lymphoid tissue and thereby helps strengthen the digestive tract defences against infections.
Diarrhoea
Efficacy of S.boulardii in adults (hochter etal. Munch med Wschr 1990;132:188-192) and children (Cetina-Sauri G et al. Der kinderarzt 1991; 12:2095-2097) with acute diarrhoea
Diarrhoea is often caused by bacteria or viruses. Apart from the increased frequency of bowel movements and a more liquid stool consistency, fluid and electrolytes are lost to various degrees which can cause life-threatening dehydration. As causal therapy is often impossible, symptomatic treatment becomes important. This includes the normalisation of the water and electrolyte homeostasis. Clinical studies on both children and adults demonstrated the efficacy of the administration of S. boulardii for the treatment of diarrhoea.
Antibiotic-associated diarrhoea
Prevention of antibiotic-associated diarrhea by administration of S. boulardii A) Adam J et al. Gazette Medicale de France 1977; 84:2072-2078,B) Surawicz CM et al. Gastroenterology 1989; 96:981-988, C) McFarlandL et al. Gastroenterology 1995;90:439-447
Antibiotic-associated diarrhoea occurs in about 30% of patients who undergo antibiotic therapy. Patients of advanced age, with compromised immune status or prolonged hospital stays are at higher risk of developing these symptoms. For this indication, S. boulardii has protective and therapeutic effects on the intestinal mucosa. Several clinical studies have demonstrated the yeast reduces the frequency, duration and severity of an antibiotic-associated diarrhoea and helps prevent relapses.
Traveller’s diarrhoea
Antidiarrheal effect of S. boulardii on traveler’s diarrhea. (Kollaritsch HH et al. Münch med Wschr 1988;38:671-674)
Tourists are exposed to higher infectious risk in areas with low hygiene status. Common pathogens in traveller’s diarrhoea include enterotoxigenic E. coli and Salmonella. The main source of infection is food and water contamination. Therefore, the first and most effective prophylaxis is good hygiene, e.g. eating only peeled or cooked food and drinking boiled water. S. boulardii exerts prophylactic therapeutic effects on traveller’s diarrhoea as demonstrated in clinical studies.
