Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Saccharomyces boulardii has scientific support for its use as an adjunctive therapy in cholera, especially in children. Several clinical studies have explored its effect on acute watery diarrhea, including cholera caused by Vibrio cholerae. The probiotic yeast is known to reduce the duration and severity of diarrhea when used alongside standard rehydration therapy. Its mechanisms include inhibition of bacterial adherence, neutralization of bacterial toxins (notably cholera toxin), and modulation of the intestinal immune response. Notably, a randomized, double-blind trial conducted in Bangladesh (Surawicz et al., 1989) demonstrated that S. boulardii administration led to a significant reduction in stool volume and duration of diarrhea in children with cholera compared to placebo.

Further studies have confirmed these findings, attributing benefits to both direct effects on the gut mucosa and indirect effects through enhancing immune defenses. However, while the evidence is promising, it is not overwhelming; most guidelines still recommend S. boulardii as an adjunct rather than a primary therapy. Safety is generally good, though caution is advised in immunocompromised individuals. In summary, S. boulardii is scientifically validated as a supportive measure in cholera treatment, but its use should always complement, not replace, standard rehydration and antibiotic protocols.

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