Posted 11/8/2010 2:18 PM (GMT -6)
The short story...
I'm a 43 year old male, suffering from CD symptoms since high school, diagnosed in Sept 2010. I've run the gamut of prednisone, humira, pentasa, azathioprine, entocort, and cimzia. Until three weeks ago, I've been in a fairly stable "remission" for the last year, with periodic flares. "Remission" for me means that every morning consists of several urgent trips to the bathroom, but the rest of the day is usually pretty good. I've been treating the occasional flares with short courses of prednisone. My current daily meds are: 100 mgs. azathioprine, 9 mgs entocort, 2 gms Pentasa.
12 years ago, I started getting a rash on my chest. The dermatologist diagnosed recurring bacterial foliculitis. I've had to use an acne wash (10% benzoyl peroxide) every day since then to keep it under control. It never clears completely, but the benzoyl peroxide keeps it from getting really nasty.
In Jan of this year, I was diagnosed with rosacea. I've been using a cream once a day (even though twice a day is recommended. My face can't tolerate twice daily application) to keep it under control. Just like the rash on my chest, I'm not able to keep it under control to the point that you can't see it; every day some red spots are noticeable on my face.
So recently I've been diving into the internet, reading up all I can find about Crohn's disease, as well as rosacea.
According to wikipedia, there is some very interesting things about rosacea. Treating rosacea patients to control various intestinal bacteria has cured many rosacea patients. So kinda keep that thought in mind for a sec.
Now according to wikipedia and many other Crohn's disease information sources, it is believed that part of the immune systems problems in those with Crohn's is the inability to keep intestinal bacteria in check, and an inflammation response caused by the toxins those bacteria release. "Intestinal bacteria overgrowth" is something that probably every Crohns sufferer has heard from his/her GI at some point.
Continued studying brought me to some rather interesting information on Saccharomyces boulardii. Saccharomyces boulardii is a yeast strain that has been used for hundreds of years to help control symptoms of D.
Please take a minute to read the following:
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."
I'm gonna summarize the information from Here (http://www.ncbi.nlm.nih.gov/pubmed/20440854) to say that this study found Saccharomyces boulardii to be among the most effective of the yeasts and bacteria tested in this study at controlling inflammation.
BACKGROUND: Saccharomyces boulardii, a well-studied probiotic, can be effective in inflammatory gastrointestinal diseases with diverse pathophysiology, such as inflammatory bowel disease (IBD), and bacterially mediated or enterotoxin-mediated diarrhoea and inflammation.
AIM: To discuss the mechanisms of action involved in the intestinal anti-inflammatory action of S. boulardii.
METHODS: Review of the literature related to the anti-inflammatory effects of this probiotic.
RESULTS: Several mechanisms of action have been identified directed against the host and pathogenic microorganisms. S. boulardii and S. boulardii secreted-protein(s) inhibit production of proinflammatory cytokines by interfering with the global mediator of inflammation nuclear factor kappaB, and modulating the activity of the mitogen-activated protein kinases ERK1/2 and p38. S. boulardii activates expression of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) that protects from gut inflammation and IBD. S. boulardii also suppresses 'bacteria overgrowth' and host cell adherence, releases a protease that cleaves C. difficile toxin A and its intestinal receptor and stimulates antibody production against toxin A. Recent results indicate that S. boulardii may interfere with IBD pathogenesis by trapping T cells in mesenteric lymph nodes.
CONCLUSIONS: The multiple anti-inflammatory mechanisms exerted by S. boulardii provide molecular explanations supporting its effectiveness in intestinal inflammatory states."
Now what my experience has been so far:
Every fall, I can count on two things: several nasty Crohn's flares, and a few colds thrown in for good measure. Three weeks ago, I had a serious crohns flare, two days into which I got a nasty cold. So I started taking 1 gm. of Saccharomyces boulardii, as four 250 mg capsules whenever I took my Pentasa. In three days, I started to notice my CD symptoms getting better.
In order to try and shorten this wall of text a bit, I'll fast forward to today. I'm now in the best form of Remission I've ever had. Mornings still consist of BM's, but with great improvements. Please excuse the graphic-ness of this, but I figure since we're all Crohnies here, I'm allowed a bit of leeway... Normally, daily BM's for me are either loose, or with pencil thin or flat stools. Clear evidence of inflammation making the tubes smaller in diameter. They're also urgent and crampy. As of today, I haven't had cramps for a week now. Morning BM's have much better caliber, and I haven't had a loose one for over a week, as well.
In many places I've read, it is thought that Saccharomyces boulardii helps the GI tract by inhibiting the growth (or overgrowth) of bacteria (hence hindering their total released toxins and the associated inflammation response), as well as releasing chemicals that directly reduce inflammation, and indirectly reduce inflammation.
Now back to the chest rash. I mentioned that I had to use benzoyl peroxide to keep my rash under control. My chest rash is gone. It completely cleared up about 1.5 weeks after starting the S. boulardii. I haven't used benzoyl peroxide on it in over a week. I have had this rash every day for over ten years now. And now it is completely gone. (it's my belief that the rash on my chest is actually rosacea, as well, since rosacea does occur on the chest occasionally).
Now back to the Rosacea. All the bumps on my forehead are gone. One application of my rosacea cream every morning now has my rosacea rashes *completely* cleared up.
Remembering that it is thought that one cause of Rosacea is GI tract intestinal over growth, and one cause of some CD symptoms is bacterial overgrowth. S. boulardii (as shown in the above referenced studies) helps to control bacterial overgrowth in the GI tract. My CD symptoms have improved, and my Rosacea is almost completely cleared up.
I'm not a doctor, and I certainly am not recommending that anyone go out and swallow a box of S. Boulardii while flushing their Crohns meds. However, I certainly think that anyone with CD should at least do some research, read up on it, talk to your GI about it, and consider giving it a shot.
Aside from azathioprine and soluble fiber, S. boulardii has done more for me than any other treatment so far. I'm feeling just about as good now as I did after my very first course of prednisone made me feel like I'd been let out of jail.
For me, S. boulardii has been a valuable addition to my azathioprine, entocort and pentasa.