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Limited evidenceGut health

Clostridium Butyricum

A spore-forming probiotic that produces butyrate in the colon, used mainly in Japan and China. One reasonably sized trial in diarrhoea-predominant IBS is positive, but the overall human evidence base is thin.

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What the science says

  • Diarrhoea-predominant IBS symptoms Limited evidence

    A multicentre, double-blind, placebo-controlled trial in 200 patients with IBS-D found modest improvements in overall symptom score, stool frequency and quality of life over 4 weeks, with a responder rate of 45% versus 31% on placebo. It is a single trial and the absolute differences were small.

  • Colorectal adenoma recurrence Limited evidence

    A randomised crossover trial in 398 patients with a history of adenomatous polyps found lower polyp counts and recurrence with CBM588, but only in the per-protocol analysis; the intention-to-treat comparison was not statistically significant.

  • General gut health and butyrate production Limited evidence

    The rationale is that the strain produces butyrate, the main fuel for colonocytes, but no trial has shown that supplementing this species improves a hard clinical outcome in healthy people.

Dosage & safety

Studied doseTrials used commercial preparations (CBM588 / MIYAIRI 588) taken three times daily with meals, for 4 weeks up to 2 years. Typical label doses are in the range of 10^7–10^8 CFU per day.
SafetyWell tolerated in trials, with no serious adverse events reported. As with any live probiotic, people who are severely immunocompromised, have central venous catheters or are critically ill should avoid it unless a doctor advises otherwise.

How to take it

TimingThree times a day with meals, as in the trials.
With food?With meals, which buffers stomach acid.
Worth knowingThe CFU count looks low next to other probiotics because it is a spore former that multiplies in the colon, so do not compare counts across products.

Interactions

With medications

  • antibiotics

    Antibiotics kill the live organisms, though it is often given deliberately alongside them in Japanese practice. separate by at least 2 hours

  • immunosuppressants and chemotherapy

    Live organisms carry an infection risk in severely immunocompromised patients and those with central lines. do not start without medical advice

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Does Clostridium butyricum help IBS?

The evidence is limited: one placebo-controlled trial in 200 patients with IBS-D found modest improvement, with a responder rate of 45% versus 31% on placebo over 4 weeks. It is a single trial with small absolute differences.

Does Clostridium butyricum prevent colon polyps?

Not established: a trial of CBM588 in 398 patients found lower polyp recurrence only in the per-protocol analysis, and the intention-to-treat result was not statistically significant.

How do I take Clostridium butyricum?

Trials gave Clostridium butyricum preparations such as CBM588 three times daily with meals; label doses are around 10^7–10^8 CFU per day. The count looks low because it is a spore former, so do not compare counts across products.

Is Clostridium butyricum safe?

Clostridium butyricum was well tolerated in trials, with no serious adverse events reported. Avoid it if you are severely immunocompromised, have a central venous catheter or are critically ill unless a doctor advises otherwise.

Scientific references

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