Digestive Diseases and Sciences

, Volume 45, Issue 7, pp 1462–1464 | Cite as

Saccharomyces boulardii in Maintenance Treatment of Crohn’s Disease

  • Mario Guslandi
  • Gianni Mezzi
  • Massimo Sorghi
  • Pier Alberto Testoni
Article

Abstract

The possible role of Saccharomyces boulardii, a nonpathogenic yeast with beneficial effects on the human intestine, in the maintenance treatment of Crohn’s disease has been evaluated. Thirty-two patients with Crohn’s disease in clinical remission (CDAI < 150) were randomly treated for six months with either mesalamine 1 g three times a day or mesalamine 1 g two times a day plus a preparation of Saccharomyces boulardii 1 g daily. Clinical relapses as assessed by CDAI values were observed in 37.5% of patients receiving mesalamine alone and in 6.25% of patients in the group treated with mesalamine plus the probiotic agent. Our results suggest that Saccharomyces boulardii may represent a useful tool in the maintenance treatment of Crohn’s disease. However, in view of the product’s cost, further controlled studies are needed to confirm these preliminary data.

Crohn’s disease mesalamine probiotics relapses Saccharomyces boulardii 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. 1.
    Messori A, Brignola C, Trallori G, Rampazzo R, Bardazzi G, Belloli C, D'Albasio G, DeSimone G, Martini N: Effectiveness of 5-aminosalicylic acid for maintaining remission in patients with Crohn's disease: a meta-analysis. Am J Gastroenterol 89:692–698, 1994Google Scholar
  2. 2.
    Steinhart AH, Hemphill D, Greenberg GR: Sulfasalazine and mesalazine for the maintenance therapy of Crohn's disease: A meta-analysis. Am J Gastroenterol 89:2116–2124, 1994Google Scholar
  3. 3.
    De Franchis R, Omodei P, Ranzi T, Brignola C, Rocca R, Prada A, Pera A, Vecchi M, Del Piano M, Ferrara A, Belloli C, Piodi L, Framarin L, Astegiano M, Riccioli FA, Meucci G: Controlled trial of oral 5-aminosalycilic acid for the prevention of early relapse in Crohn's disease. Aliment Pharmacol Ther 11:845–852, 1997Google Scholar
  4. 4.
    Prantera C, Pallone F, Brunetti G, Cottone M, Miglioli M: Oral 5-aminosalicylic acid (Asacol) in the maintenance treatment of Crohn's disease. Gastroenterology 103:363–368, 1992Google Scholar
  5. 5.
    Rutgeerts P, Ghoos Y, Van Trappen E: Ileal dysfunction and bacterial overgrowth in patients with Crohn's disease. Eur J Clin Invest 11:199–206, 1981Google Scholar
  6. 6.
    Chiodini RJ: Antimicrobial agents and Crohn's disease: Do they have a therapeutic role? Ital J Gastroenterol Hepatol 30:593–598, 1998Google Scholar
  7. 7.
    Spirt MJ: Antibiotics in inflammatory bowel disease: New choices for an old disease. Am J Gastroenterol 89:974–978, 1994Google Scholar
  8. 8.
    Bengmark S: Ecological control of the gastrointestinal tract. The role of probiotic flora. Gut 42:2–7, 1988Google Scholar
  9. 9.
    Castagliuolo I, Riegler MF, Valenick L, LaMont JT, Pothoulakis C: Saccharomyces boulardii protease inhibits the effects of Clostridium difficile toxins A and B in human colonic mucosa. Infect Immun 67:302–307, 1999Google Scholar
  10. 10.
    Dias RS, Bambirra EA, Silva ME, Nicoli JR: Protective effect of Saccharomyces boulardii against the cholera toxins in rats. Braz J Med Biol Res 28:323–325, 1995Google Scholar
  11. 11.
    McFarland LV, Surawicz CM, Greenberg RN, Fekety R, Elmer GW, Moyer KA, Melcher SA, Bowen KE, Cox JL, Noorani Z: A randomized placebo-controlled trial of Saccharomyces boulardii in combination with standard antibiotics for Clostridium difficile disease. JAMA 271:1913–1918, 1994Google Scholar
  12. 12.
    Bleichner G, Blehaut H, Mentec H, Moyse D: Saccharomyces boulardii prevents diarrhea in crically ill tube-fed patients. A multicenter, randomized double-blind placebo-controlled trial. Intens Care Med 23:517–523, 1997Google Scholar
  13. 13.
    Kimmey KB, Elmer GW, Surawicz CM, McFarland LV: Prevention of further recurrences of Clostridium difficile colitis with Saccharomyces boulardii. Dig Dis Sci 35:897–901, 1990Google Scholar
  14. 14.
    Plein K, Hotz J: Therapeutic effects of Saccharomices boulardii on mild residual symptoms in a stable phase of Crohn's disease with special resopect to chronic diarrhea-a pilot study. Z Gastroenterol 31:129–134, 1993Google Scholar
  15. 15.
    Buts JP, Bernasconi P, Van Craynest MP, Maldague P, De Meyer R: Response of human and rat small intrestinal mucosa to oral administration of Saccharomyces boulardii. Pediatr Res 20:192–196, 1986Google Scholar
  16. 16.
    Buts JP, Bernasconi P, Vaerman JP, Dive C: Stimulation of secretory IgA and secretory component of immunoglobulins in small intestine of rats treated with Saccharomyces boulardii. Dig Dis Sci 35:251–256, 1990Google Scholar
  17. 17.
    Izadnia F, Wong CT, Kocoshis SA: Brewer's yeast and Saccharomyces boulardii both attenuate Clostridium difficile-induced colonic secretion in the rat. Dig Dis Sci 43:2055–2060, 1998Google Scholar
  18. 18.
    Quinton JF, Sendid B, Reumaux D, Duthilleul P, Cortot A, Grandbastien B, Charrier G, Targan SR, Colombel JF, Poulain D: Anti-Saccharomyces cerevisiae mannan combined with antineutrophil antibodies in inflammatory bowel disease. Prevalence and diagnostic role. Gut 42:788–791, 1998Google Scholar
  19. 19.
    Sendid B, Quinton JF, Charrier G, Goulet O, Cortot A, Grandbastien B, Poulain D, Colombel JF: Anti-Saccharomyces cerevisiae mannan antibodies in familial Crohn's disease. Am J Gastroenterol 93:1306–1310, 1998Google Scholar

Copyright information

© Plenum Publishing Corporation 2000

Authors and Affiliations

  • Mario Guslandi
    • 1
  • Gianni Mezzi
    • 1
  • Massimo Sorghi
    • 1
  • Pier Alberto Testoni
    • 1
  1. 1.Gastroenterology UnitS. Raffaele HospitalMilanItaly

Personalised recommendations