saccharomyces boulardii and Reduced Abdominal Pain

Research synthesisModerate evidenceMixed effect size5 studies · 4 beneficial · 1 neutral · 0 harmful

Across 5 studies, 4 reported beneficial effects of Saccharomyces boulardii on reducing abdominal pain, with effect sizes ranging from small to large. The median study duration was 44 days, and the most common population studied was patients with Helicobacter pylori infection. The predominant evidence points to a moderate-to-large benefit, particularly in clinical populations with H. pylori eradication therapy.

Studied populations: patients with Helicobacter pylori infection, children with H. pylori infection, patients with non-ulcer dyspepsia, patients with systemic sclerosis and small intestinal bacterial overgrowth

Caveats: Available evidence is overwhelmingly positive — clinical literature in this area is subject to publication bias (null-result studies are less likely to be published or indexed). Additionally, the neutral meta-analysis from 2025 did not find a significant reduction in abdominal pain, introducing some uncertainty. Doses and forms were inconsistently reported across studies, limiting the ability to define an effective dose range.

Generated Jun 20, 2026

Time to effect

Median: 6.3 weeks · IQR 4.1 weeks–7.4 weeks · Range 2 weeks–8.6 weeks — Reported in 3 of 5 studies

Safety in these studies

abdominal painIncreased riskOR=3.21
In Group S, the chance of developing symptoms of ... abdominal pain (OR=3.21) ... was significantly lower than in the control group (p<0.05).
from: Investigating the effect of quadruple therapy with Saccharomyces boulardii or Lactobacillu
anxietyIncreased riskOR=3.58
In Group S, the chance of developing symptoms of ... anxiety (OR=3.58) was significantly lower than in the control group (p<0.05).
from: Investigating the effect of quadruple therapy with Saccharomyces boulardii or Lactobacillu
diarrheaIncreased riskOR=3.01
In Group S, the chance of developing symptoms of ... diarrhea (OR=3.01) ... was significantly lower than in the control group (p<0.05).
from: Investigating the effect of quadruple therapy with Saccharomyces boulardii or Lactobacillu
headacheIncreased riskOR=10.51
In Group S, the chance of developing symptoms of ... headache (OR=10.51) ... was significantly lower than in the control group (p<0.05).
from: Investigating the effect of quadruple therapy with Saccharomyces boulardii or Lactobacillu
nauseaIncreased riskOR=2.74
In Group S, the chance of developing symptoms of nausea (OR=2.74) ... was significantly lower than in the control group (p<0.05).
from: Investigating the effect of quadruple therapy with Saccharomyces boulardii or Lactobacillu
Overall tolerabilityNo significant difference
The addition of S. boulardii to traditional therapy significantly improved the H. pylori eradication rate [RR=1.11, 95% confidence interval (CI): 1.08-1.15] and reduced the incidence of total adverse effects (RR=0.49, 95% CI: 0.37-0.66)
from: Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication
abdominal distensionNo significant differenceRR=0.49, 95% CI: 0.33-0.72
abdominal distension (RR=0.49, 95% CI: 0.33-0.72)
from: Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication
abdominal painNo significant difference
However, it did not reduce the occurrence of abdominal pain, vomiting, or taste disorders.
from: Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication
constipationNo significant differenceRR=0.38, 95% CI: 0.26-0.57
constipation (RR=0.38, 95% CI: 0.26-0.57)
from: Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication
diarrheaNo significant differenceRR=0.36, 95% CI: 0.26-0.48
reduced the incidence of total adverse effects (RR=0.49, 95% CI: 0.37-0.66), diarrhea (RR=0.36, 95% CI: 0.26-0.48)
from: Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication
nauseaNo significant differenceRR=0.50, 95% CI: 0.37-0.68
nausea (RR=0.50, 95% CI: 0.37-0.68)
from: Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication
taste disordersNo significant difference
However, it did not reduce the occurrence of abdominal pain, vomiting, or taste disorders.
from: Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication
vomitingNo significant difference
However, it did not reduce the occurrence of abdominal pain, vomiting, or taste disorders.
from: Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication
Overall tolerabilityReported
this approach demonstrated advantages in alleviating symptoms, exhibited favorable tolerance, and maintained a high level of clinical safety.
from: Saccharomyces boulardii combined with triple therapy alter the microbiota in the eradicati
adverse reactionsReported
Microbial composition, eradication rates, symptom alleviation, and adverse reactions were monitored on the 14th and 44th days post-treatment.
from: Saccharomyces boulardii combined with triple therapy alter the microbiota in the eradicati
flatulence/diarrheaReported22% in SB
Adverse effects were epigastric burning and constipation in M (53%) and M+SB (36%), and flatulence/diarrhea in SB (22%).
from: Effectiveness of Saccharomyces boulardii and Metronidazole for Small Intestinal Bacterial
gastrointestinal side effectsReported
the combination of Saccharomyces boulardii powder with triple therapy displayed notable efficacy and smaller gastrointestinal side effects in eradicating initial H. pylori infections among non-ulcer dyspepsia patients.
from: Saccharomyces boulardii combined with triple therapy alter the microbiota in the eradicati

5 of 5 papers

The effect of Saccharomyces boulardii supplementation on Helicobacter pylori eradication in children: a systematic review and meta-analysis of Randomized controlled trials.
- 2023-12-15
- Meta-Analysis · n = 2,156
- BMC infectious diseases 23(1)
- - Lian-Hua Liu
  - Bin Han
  - Jing Tao
  - Kai Zhang
  - Xi-Ke Wang
  - Wen-Yu Wang
- PubMed: 38102568
- DOI: 10.1186/s12879-023-08896-4
10 Insights on
- Reduced Abdominal Pain
- High evidence
- Clinical
Similar results were also observed in the incidence of ... abdominal pain
Effect
Beneficial
Effect size
Large
Significant
Yes
Investigating the effect of quadruple therapy with Saccharomyces boulardii or Lactobacillus reuteri strain (DSMZ 17648) supplements on eradication of Helicobacter pylori and treatments adverse effects: a double-blind placebo-controlled randomized clinical trial.
- 2022-03-07
- RCT · n = 156
- BMC gastroenterology 22(1)
- - Nooshin Naghibzadeh
  - Fatemeh Salmani
  - Samira Nomiri
  - Tahmine Tavakoli
- PubMed: 35255819
- DOI: 10.1186/s12876-022-02187-z
6 Insights on
- Reduced Abdominal Pain
- High evidence
- Large Human Trial
- Clinical
In Group S, the chance of developing symptoms of ... abdominal pain (OR = 3.21) ... was significantly lower than in the control group (p < 0.05).
Effect
Beneficial
Effect size
Moderate
Significant
Yes
Dose
not stated
Saccharomyces boulardii combined with triple therapy alter the microbiota in the eradication of Helicobacter pylori infection.
- 2024-06-07
- RCT · n = 144
- Scientific reports 14(1)
- - Yan Zhang
  - Bingyun Lu
  - Yu Dong
  - Yifeng Zhang
  - Qianming Du
  - Ye Chen
  - Zhenyu Zhang
- PubMed: 38849408
- DOI: 10.1038/s41598-024-63894-z
2 Insights on
- Reduced Abdominal Pain
- High evidence
- Large Human Trial
- Rigorous Journal
- Clinical
patients receiving Saccharomyces boulardii treatment exhibited an overall reduction in initial dyspepsia symptoms by the end of the treatment period.
Effect
Beneficial
Effect size
Small
Significant
Yes
Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication of Helicobacter pylori: a meta-analysis.
- 2025-02-12
- Meta-Analysis
- Frontiers in cellular and infection microbiology 15
- - Manning Li
  - Ying Xie
- PubMed: 40012609
- DOI: 10.3389/fcimb.2025.1441185
9 Insights on
- Reduced Abdominal Pain
- High evidence
- Clinical
it did not reduce the occurrence of abdominal pain
Effect
Neutral
Effect size
Small
Significant
No
Effectiveness of Saccharomyces boulardii and Metronidazole for Small Intestinal Bacterial Overgrowth in Systemic Sclerosis.
- 2019-09-23
- Clinical Trial
- Digestive diseases and sciences 65(4)
- - Grettel García-Collinot
  - Eduardo Osiris Madrigal-Santillán
  - Michel A Martínez-Bencomo
  - Rosa A Carranza-Muleiro
  - Luis J Jara
  - Olga Vera-Lastra
  - Daniel H Montes-Cortes
  - Gabriela Medina
  - María Pilar Cruz-Domínguez
- PubMed: 31549334
- DOI: 10.1007/s10620-019-05830-0
5 Insights on
- Reduced Abdominal Pain
- High evidence
- Rigorous Journal
- Clinical
The SB and M + SB groups had decreased diarrhea, abdominal pain, and gas/bloating/flatulence, but M remained unchanged.
Effect
Beneficial
Effect size
Moderate
Significant
Yes

saccharomyces boulardii and Reduced Abdominal Pain

The effect of Saccharomyces boulardii supplementation on Helicobacter pylori eradication in children: a systematic review and meta-analysis of Randomized controlled trials.

Investigating the effect of quadruple therapy with Saccharomyces boulardii or Lactobacillus reuteri strain (DSMZ 17648) supplements on eradication of Helicobacter pylori and treatments adverse effects: a double-blind placebo-controlled randomized clinical trial.

Saccharomyces boulardii combined with triple therapy alter the microbiota in the eradication of Helicobacter pylori infection.

Efficacy and safety of Saccharomyces boulardii as an adjuvant therapy for the eradication of Helicobacter pylori: a meta-analysis.

Effectiveness of Saccharomyces boulardii and Metronidazole for Small Intestinal Bacterial Overgrowth in Systemic Sclerosis.