Prophylaxis and therapy of diarrhea with Yomogi®
Acute Diarrhea
Acute diarrhea is often caused by bacterial or viral infections.4 Besides an increased frequency in passing stools and a reduction in their consistency, the loss of water and electrolytes to differing extent may even lead to life-threatening dehydration. This often makes admission to the hospital and the parenteral substitution of fluids by infusion unavoidable. Children and the elderly are particularly vulnerable to dehydration. Oral rehydration therapy in acute diarrhea is therefore fundamental with these patients. However, this symptomatic therapeutic intervention is hardly able to shorten the duration of diarrhea substantially.
The treatment of infectious diarrhea in infants using motility-inhibiting preparations (such as loperamide) or secretion inhibitors (e. g. racecadotril) is not recommended, because they suppress intestinal motility, and as a result, delay the excretion of the pathogen responsible for the infection. Thus, damage of the gut mucosa may increase.
Treatment of acute diarrhea
On the other hand, the value of the active ingredient S. boulardii has been shown time and again in the symptomatic treatment and prevention of acute diarrhea. The efficacy and safety of this probiotic substance has been proven in many clinical studies.
Htwe et al.5 demonstrated in a controlled clinical study that a 5-day treatment period with S. boulardii in addition to administering electrolyte solution to hospitalised children (N = 100; aged between 3 months and 10 years) with acute watery diarrhea significantly reduced the mean duration of diarrhea by 1.5 days (S. boulardii group: 3.08 days, control group: 4.68 days, p < 0.05). Already on day 2, there was a significant reduction in the daily frequency of passing stools in the children in the S. boulardii group, compared to the control group.
Stool consistency improved one day later. A study from Höchter et al.6 confirmed the efficacy of S. boulardii in acute diarrhea in adults.
Efficacy of S. boulardii in adults with acute diarrhea 6
Meta-analyses confirm the therapeutic efficacy of S. boulardii
The meta-analysis of Szajewska et al.7 comes to a similar result. They evaluated, amongst other things, the data of 944 patients from 7 clinical studies. The main conclusion was that S. boulardii reduced the mean duration of acute diarrhea in children by approximately 1 day compared to placebo.
The clinical response to S. boulardii in acute diarrhea in children is currently very much in the news as the meta-analysis of Feizizadeh et al.8 shows. Here the data from 17 studies with a total of 2102 patients aged between 1 month and 15 years were evaluated. In comparison to controls, S. boulardii significantly
reduced the mean duration of diarrhea by about 20 hours.
Another result of this meta-analysis was that S. boulardii lowered the risk of diarrhea on day 3 by 59 % (relative risk, 0.41; 95 % CI, 0.27–0.60) and on day 4 (relative risk, 0.38; 95 % CI, 0.24–0.59) by as much as 62 percent.
4) Guarino A, Albano F, Ashkenazi S, Gendrel D, Hoekstra JH, Shamir R, Szajewska H. European Society for Paediatric Gastroenterology, Hepatology and Nutrition/ European Society for Paediatric Infectious Diseases: Evidence-based Guidelines for the Management of acute Gastroenteritis in Children in Europe. J Pediatr Gastroenterol Nutr. 2008;46 (Suppl. 2): S81–S122.
5) Htwe K, Yee KS, Tin M, Vandenplas Y. Effect of Saccharomyces boulardii in the treatment of acute watery diarrhea in Myanmar children: a randomized controlled study. Am J Trop Med Hyg. 2008;78(2):214–216.
6) Höchter W, Chase D, Hagenhoff G. Saccharomyces boulardii bei akuter Erwachsenendiarrhö. Wirksamkeit und Verträglichkeit der Behandlung. Münch Med Wschr. 1990;132:188–192.
7) Szajewska, H. Skorka, A. Saccharomyces boulardii for treating acute gastroenteritis in children: updated meta-analysis of randomized controlled trials. Aliment Pharmacol Ther. 2009;30(9):960–961.
8) Feizizadeh S, Salehi-Abargouei A, Akbari V. Efficacy and safety of Saccharomyces boulardii for acute diarrhea. Pediatrics. 2014;134(1): e176–191.