Product Review


The use of probiotics for acute and chronic digestive diseases has been gaining popularity in the North American medical community for the past 5 years. From the Greek “for life”, “probiotics” are live bacteria or yeast cells that aid the damaged, dysfunctional, or inflamed bowel in digestion and absorption. Russian scientist Ilia Metchnikov, later awarded the Nobel Prize for his work, first discovered probiotics in the early part of the 20th century. In 1923, French scientist Henri Boulard was one of the first to discover a yeast-based probiotic while he was searching for yeast to make wine. During his travels to Indonesian countries, he met a local doctor who was using the peels of the litchi fruit as an anti-diarrhea agent. This yeast, now available in Canada as Florastor™ has sold 10 billion doses worldwide and is used to safely treat the broad spectrum of intestinal diseases found today.

How Does Florastor Work?

In a normal gut, there are billions of live bacteria and yeast organisms that line the bowel, aid in digestion, and maintain the body’s defense system. This ecosystem within the bowel is known as colonic flora. This flora is constantly combating pathogens (viruses, bad bacteria, and yeast) and it is only when there is an overgrowth of pathogens within the bowel that a problem occurs.

Probiotics such as Florastor – the most clinically researched probiotic worldwide – temporarily line the bowel with billions of live non-pathogenic (good) cells that aid in fighting the overgrowth of pathogens (bad cells) and return balance to the lining of the gut, thereby allowing the bowel to function normally.

Florastor enters the bowel and lines it with billions of harmless live yeast cells. These cells act as a temporary gut lining by naturally increasing the body’s immune system, which overpowers the toxins released by bad bacteria. Florastor also naturally increases the body’s production of digestive enzymes, which aid in digestion and nutrient absorption within the gut.

Florastor is helpful to:

Mechanism of Action

Bacteria exert their pathogenicity via toxins they introduce into the intestines. Important examples are cholera toxin, Escherichia coli (E. coli) enterotoxins, and Clostridium Difficile (C. Diff.) toxins. Florastor secretes a 54 KDa protein protease that neutralizes these toxins.

The toxin produced by vibrio cholera, cholera toxin, is known to increase the intercellular level of adenylate cyclase in intestinal epithelial cells. This triggers active secretion of chloride and bicarbonate resulting in diarrhea. Florastor was shown to inhibit approximately 50% of the water and sodium secretion. The bacterium C. Diff. produces two different toxins that have shown an up to 1,000-fold reduction in mice that are treated with Florastor.

Florastor has more than just an anti-toxic effect, however. It also increases the absorptive transport of chloride in intestinal electrolyte transport. As well, Florastor releases Polyamines (spermine, spermidine and putrescine), which help increase the activity of disaccharidases (enzymes such as lactase, maltase, and sucrase). This increase in the enzymatic activity could help with lactose intolerance. Finally, Florastor stimulates the production of Immunoglobulin A and Immunoglobulin G in the intestinal mucosa, which may help reduce the effects of the toxins.

Inflammatory Bowel Disease (Crohn’s disease, ulcerative colitis)

Inflammatory bowel disease (IBD) affects approximately 200,000 Canadians. This group of diseases includes Crohn’s disease and ulcerative colitis. Today we have many products that help improve symptoms in patients who are suffering from IBD. Unfortunately, most drugs used have a high number of side effects.

Florastor has been proven effective in treating symptoms of Crohn’s disease and ulcerative colitis when taken twice daily. Ask your doctor about adding Florastor to the products he or she has already recommended to help decrease the amount of gas, bloating, and diarrhea you may be experiencing. There are no known side effects or harmful drug interactions from using Florastor. Florastor is able to naturally restore the flora in the bowel, which helps reduce bowel inflammation.

Irritable Bowel Syndrome (IBS)

IBS affects approximately 20% of the North American population. The syndrome results in increased symptoms of abdominal pain, bloating and gas, constipation, and diarrhea. In clinical trials, taken twice daily, Florastor reduced the amount of diarrhea four fold in IBS patients. There was also an improvement in the feeling of overall ‘well being’ when Florastor was used.

Antibiotic Associated Diarrhea (AAD) and Clostridium Difficile

AAD occurs in approximately 30% of patients who are prescribed antibiotics. The purpose of taking antibiotics is to prevent or eliminate a bacterial infection in the body. Unfortunately, antibiotics not only kill the bacterial infection, but will also damage the naturally occurring good bacterial flora within your gut, causing an imbalance, which may lead to diarrhea. The use of Florastor once daily during your course of antibiotics will significantly reduce the incidence of diarrhea.

A further complication of taking antibiotics is the development of C. Diff, a particularly difficult bacterial strain that damages the colon and in some cases can result in hospitalization and death. Recent outbreaks of C. Diff in Calgary and Montreal have increased the need for proper prevention from AAD and proper treatment of C. Diff using probiotics.

Traveller’s Diarrhea

Approximately 50% of travellers visiting warm exotic climates suffer from diarrhea caused by the change in food and water in their new environment. You can prevent traveller’s diarrhea easily and safely by taking Florastor prior to going on – and throughout the duration of – a trip. The live cells line the bowel and protect the gut from an overgrowth of bacteria such as E. coli.

Pediatric Diarrhea

The World Health Organization – as part of a treatment program – has recommended probiotics like Florastor with standard oral re-hydration for children with acute diarrhea. Florastor, with a proven safety profile for children as young as 3 months, has been able to notably decrease the length of time a child suffers from diarrhea.
Not All Probiotics Are Created Equal

There are many probiotics available at your local pharmacy but, unfortunately, most are not manufactured under GMP (Good Manufacturing Practice) guidelines. This is a strict manufacturing process that all ethical pharmaceutical products must follow. It is a costly process for the manufacturer but results in the highest quality products. Florastor is produced under GMP guidelines and is certified as a pharmaceutical grade product in France. In addition, it is manufactured using a freeze-drying process, which ensures a three-year shelf life at the end of which the product is still effective. In addition, the company guarantees that the number of yeast cells in each capsule matches the claim on the label.

There have been many studies testing the ingredients in probiotics, and a recent study from the University of British Columbia found that most probiotics on the market do not contain the number of live cells their labels claim. In fact, most of them had no live cells at all, essentially making them as effective as a placebo.

Florastor, a pharmaceutical grade probiotic has a specialized formulation that protects the cells and allows for proper delivery of the live cells into your bowel.


Gastroenterologists, family doctors, pediatricians, and pharmacists across North America currently recommend probiotic therapies. Patients have successfully used these worldwide for the better part of this century. Florastor is a probiotic with proven efficacy and is produced in state-of-the-art manufacturing facilities that guarantee the final product. It is likely the use of probiotics will continue to grow in the future as more and more data are presented.

Par Nijhawan, MD, FRCPC, FACG
First published in the Inside Tract® newsletter issue 145 – September/October 2004
Note: The GI Society has received no remuneration from Florastor® or its affiliates for this review.
1. Brenda A. Huff, MD, CCFP “Probiotics” might not be what they seem. Can Fam Physician 2004; 50:583-587
2. R. Reimer. Pre and Probiotics: Significance and Clinical Impact in Clinical Practice. Clinical Nutrition Round March 2004