10 Ways to Protect Your Gut Health if You Need Antibiotics
The microbiome is the community of microorganisms that lives in your gut. It mostly resides in the large intestine with some of the population living in the furthest end of the small intestine before it turns into to the colon.
There are more than 1,000 bacterial species that make up your microbiome – this results in 360 bacterial genes for every single human gene in the body. (In a sense, we are more microorganism than human!) There are also varying numbers of viruses, archaea, and fungi that make up the microbiome.
The microbiome serves multiple functions:
It digests food parts that our body is unable to handle on its own, such as tough plant fibers and complex carbohydrates.
It regulates metabolism and plays a role in hormonal regulation. (It stores more than 90% of the body’s serotonin!)
It trains and regulates the immune system to protect us against invading pathogens.
Most of the microorganisms living in our gut serve us in beneficial ways. A healthy gut is one that is rich in a variety of beneficial bacterial species, and more diversity and abundance equates to better health outcomes. An unhealthy gut is one that lacks abundance and diversity in its microorganism species.
In addition to the beneficial bugs, there are opportunistic ones that can wreak havoc or cause infection when the environment is right for them to thrive. These might be microorganisms that normally reside in your gut in smaller numbers, or they might be something that you pick up from your external environment such as with eating contaminated food. When there is an imbalance between the beneficial and the harmful bacteria, it is referred to as dysbiosis.
Factors that affect the health and wellness of the microbiome include: diet, stress, sleep, certain medications, and lifestyle factors like exercise, meditation, mindfulness, alcohol and smoking.
Signs of dysbiosis may include excessive gas and burping, bloating, constipation or diarrhea, food sensitivities, allergies, frequent colds, brain fog, recurrent yeast or urinary tract infections, anxiety, depression, sugar cravings, obesity/overweight, and autoimmune disorders.
Unfortunately, many commonly used medications can disrupt the microbiome and have lasting impacts for some people. Let’s take a look at antibiotics in part 1 of this 3-part series where we examine 3 commonly used medications that can disrupt the microbiome and contribute to chronic gut issues.
Antibiotics
Most people today understand that antibiotic use causes changes in the microbial composition of the gut. This is supported through many research studies.
The type of antibiotic used also has an impact.
There are broad-spectrum antibiotics which target many different bacteria, and there are narrow-spectrum antibiotics which target a few types of bacteria. Broad-spectrum drugs may impact the total number and diversity of bacterial species, while narrow-spectrum drugs may wipe out specific strains of beneficial bacteria.
Some examples of broad-spectrum antibiotics include: doxycycline, minocycline, amoxicillin/clavulanic acid, azithromycin, ampicillin, ciprofloxacin, metronidazole, and trimethoprim/sulfamethoxazole.
Decreased diversity or reduction of beneficial strains of bacteria can lead to leaky gut, yeast overgrowth, dysbiosis, and slowed gut motility. And, you can say hello to symptoms like bloating, constipation, recurrent infections, hormonal problems, and all the other symptoms that accompany a compromised gut.
In addition, antibiotics may also…
contribute to development of obesity and type 2 diabetes
cause a reduction in bacterial strains responsible for keeping inflammation in check
allow for recolonization of the gut with antibiotic-resistant bacteria if misused or overused
The impact antibiotics have on your microbiome also depends on the state of the microbiome prior to treatment (related to factors such as diet, stress, foreign travel, and pre-treatment diversity) as well as the dosage and type of antibiotic being used along with the duration of use (e.g. a few days versus months of treatment).
All this to be said, it’s important to remember that antibiotics are not the bad guys. After all, this type of medication has saved countless lives its discovery in 1928. Antibiotics do have their time and place – and deserve to be treated with respect.
Unfortunately, Western medicine has often misused or overused antibiotics.
I remember a childhood where a prescription of penicillin or amoxicillin was the first line of treatment for the common cold or flu – both of which are viral infections and do not actually respond to antibiotics. (In case you didn’t know: antibiotics are only effective against bacterial infections).
As an adult, I was treated with antibiotics for months to help with acne. This did not work in my favor as I was also a long-time sufferer of chronic gut issues – and it didn’t really help the acne either!
On the other hand, I have also seen antibiotics save lives for patients with a bad case of pneumonia or a wound infection.
What happens if you need to take antibiotics?
The first question I would recommend asking your prescribing healthcare professional is: “Is this medication necessary?” and “Are there any alternative treatments?” You may also want to ask about narrow- vs. broad-spectrum antibiotics, and if it’s possible to opt for a narrow-spectrum (this will depend on the infection being treated).
It’s important to weigh the risks and the benefits of any treatment decision as the choice to take medication is a very personal one. Being educated can help you make the right decision for you.
If it turns out you need to take antibiotics, there are a few things you can to do protect your gut health during treatment.
It’s important to note that having a strong foundation is important. Regardless of antibiotic use, I encourage everyone to follow a whole foods diet with a wide variety of plant-foods to feed your good gut bugs. If your microbiome is healthy to begin with, antibiotics will have less of an impact on your microbiome and your microbiome is more likely to bounce back after use.
During antibiotic treatment:
Use a broad-spectrum, multi-strain probiotic with your antibiotic (one that contains different strains of Lactobacillus and Bifidobacterium).
Take your probiotics with food, and as far away from your antibiotics as possible, allowing at least two hours, so as not to kill off the probiotics with the medication.
Science has varying opinions on how long you should continue probiotics after antibiotic treatment, and recommendations range anywhere from one week to 6 months or longer. Talk to a trained professional, or gauge how you feel after treatment. You may choose to continue taking your probiotics until any unwanted gut symptoms have resolved.
Consider using Saccharomyces boulardii – a probiotic strain derived from yeast grown on the skin of lychee and mangosteen fruits. This is well studied and has the ability to crowd out harmful bacteria while leaving space for the good gut bugs. It also reduces the incidence of antibiotic-associated diarrhea.
Eat a well-balanced diet rich in fresh vegetables and fiber sources from a variety of plant foods to continue to feed and support your good gut bugs.
Add fermented foods to your diet through cultured yogurt, fermented vegetables like kimchi, kefir, or miso.
Bone broths, and hearty soups and stews are also very nourishing for your gut lining.
Stay well hydrated – your beneficial bugs need hydration to function optimally.
Reduce consumption of refined/processed sugars and animal fats, which can feed opportunistic and harmful bacteria.
Be mindful of your stress levels and ensure adequate sleep – this is especially important if you are recovering from an illness.
For the unfortunate few, the effects of antibiotic use may impact the microbiome for up to 4 years, according to one study. If you are struggling to get back to baseline following antibiotic use, enlisting the help of a trained professional may help to speed along the recovery process.
Stay tuned for part 2 where we unpack the impacts of the birth control pill and its effects on your microbiome.
