Clostridium butyricum

Clostridium butyricum MIYAIRI 588 · CBM 588

Snapshot

Indications	Contraindications
Antibiotic-associated diarrhea¹ Pouchitis prevention^{2, 3} Diarrhea-predominant irritable bowel⁴ Postoperative bowel recovery⁵ Chemotherapy-induced diarrhea⁶ Hepatic encephalopathy in cirrhosis^{7, 8} Neonatal jaundice adjunct⁹ Depression adjunct¹⁰	Milk allergy¹¹ Fever or bloody diarrhea¹¹ Immune compromise¹²

Clostridium butyricum is a butyrate-producing gut bacterium used as a probiotic for decades, most often as the MIYAIRI 588 strain in Japan and Asia. It acts through butyrate and immune signaling in the gut¹³. Supplementation is used to restore gut function disrupted by antibiotics, surgery, or chemotherapy. Reported uses include preventing antibiotic-associated diarrhea in children when combined with Bifidobacterium¹, preventing pouchitis after ileal pouch-anal anastomosis in ulcerative colitis^{2, 3}, and supporting recovery after colorectal surgery⁵. It is also used in diarrhea-predominant irritable bowel syndrome and as an adjunct in treatment-resistant depression.

The evidence is mostly small trials and open-label or retrospective studies.^{14, 15} A Cochrane review rated pouchitis-prevention evidence low to very low certainty, and concluded the effects of preventive treatments are uncertain^{14, 15}. A heat-killed preparation did not beat placebo for knee osteoarthritis pain¹⁶. In advanced non-small cell lung cancer, a 2020 retrospective cohort linked probiotic C. butyricum therapy with longer progression-free and overall survival on immune checkpoint blockade; the design is observational. Five US products listing C. butyricum, mostly capsules in multi-strain blends, are labeled; see Form comparison.

US product labels ask for a physician's advice before use with a medical condition or medication¹¹.

Last updated October 16, 2026. Read how we make monographs.

In the full monograph

59 sources, 48 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources