Repopulate! Keeping Your Gut Healthy On Antibiotics

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My house has the Two Week Rule: no doctor unless the illness is getting worse after two weeks. Unfortunately, both my daughter and I passed that two-week mark for completely different bacterial infections, and found ourselves taking antibiotics. I was worried.

Both of us have digestive problems and antibiotics are harsh on that system. So I read some of my nutrition books, chatted with friends and family, and flipped through the web for advice. Here is what I found:

Yes, antibiotics can cause stomach pain, nausea, diarrhea, and exacerbate existing intestinal problems. Why? Because antibiotics kill bacteria, but they don’t stop with just the infection plaguing you, they wipe out the beneficial bacteria in other parts of your body as well.

Our gut is filled with an effective and diverse population of microorganisms (also called flora) that help us digest our food to get the nutrients we need. You can put all the healthy food in your mouth you want, but unless your body is breaking it down and absorbing the vitamins and minerals, you will become ill and eventually die. Killing off our natural digestive ecosystem with antibiotics is a dangerous side effect, especially for those prone to stomach upset.

Also, certain antibiotics target specific bacteria. According to my nurse friend, “This gives other bacteria the opportunity to take over their territory and cause illness. For example, C. Difficile is a bacteria many people have and it doesn’t cause a problem. But when someone is on long term antibiotics, its competition is killed off and it can cause a terrible intestinal infection and kill your intestines (literally).”

The key to gut health during and after a course of antibiotics is probiotics. Probiotics are active live cultures of beneficial bacteria. They can repopulate your intestinal track during and after a course of antibiotics. The National Institute of Health acknowledges several studies that show their effectiveness on health, but there is still much research to be done. The easiest way is to take a probiotic supplement. Be sure to check the label for its intended purpose, that the front label matches the ingredient list on the back, and the expiration date. But since there are no strict regulations on these supplements, there is a safer and yummier way to keep your gut healthy. Probiotic food!

Probiotics are in fermented foods- living food that goes right to your intestines to keep it active and healthy. Fermentation is an anaerobic (without oxygen) cellular process where sugars are converted into acids, gas, or alcohol. Since early human days, fermentation was a way to preserve food. It is still a tasty and healthy way to eat, used in many cultures around the world. There is an excellent chapter explaining the science behind fermentation in Culinary Reactions: The Everyday Chemistry of Cooking.

According to the latest research we should be incorporating probiotics into our regular diets, on meds or not. “…it’s clear that they have at least some positive effects on human health, ranging from the enhanced nutritional contents of the foods themselves, to alleviation of inflammatory bowel conditions, to restoring normal gut microbiota after antibiotics, to enhancement of the immune system, and possibly even weight loss.”

Yogurt is a good one, but kefir is better because it has more strands of the beneficial bacteria. The flavor tingles your tastebuds. You can find kefir in most supermarkets by the yogurt section. Cowbella is my favorite brand.

Fermented vegetables have been a part of most global cuisine, except the American diet (go figure.) Sauerkraut is from cabbage and most of us know it as a hot dog topping. But not all sauerkraut is fermented the traditional way, so be sure to check the label on this common condiment. Here is a good recipe if you want to make your own. Fermented pickles and olives are also the traditional way of preserving, but sadly, most brands on the grocery shelf use a quick method that does not have any probiotics in it. Again, read the labels, ask your store manager to stock some true fermented pickles and olives. They taste better too!

Miso soup is from a fermented soy based paste. Kimchi is Korean, spicy fermented cabbage. Pak Dong is the Thai version of fermented vegetables. Puckers is my family’s brand- very addictive.

And finally, tea! Specifically dark teas, which are fermented, dried, and then pressed into cakes. Pu-erh is the most common one in America, but Dark Rose is my favorite.

Sourdough bread is from an active culture, but there isn’t any evidence I could find that the cultures stay alive after the high heat of baking. So, although it is on lists of probiotic foods, my biologist husband is skeptical about this one.

Wild Fermentation: The Flavor, Nutrition, and Craft of Live-Culture Foods is a great resource for making your own fermented foods. I made my first batch of kimchi using the author’s recipe and it was very delicious!

According to Tieraona Low Dog, M.D’s book Healthy at Home, my trusted resource, “Take your probiotic two hours after each antibiotic dose and continue taking them for four to eight weeks after finishing treatment to encourage the growth of healthy bacteria.” Aloe Vera Juice can be very soothing for your throat, especially if antibiotics cause indigestion (I suffer from GERD so the aloe is really helpful.) And finally, cut down on refined sugar (this includes white flour.) Bacteria loooove sugar and the bad-infection bacteria don’t need any more encouragement. Your nice, gut bacteria will get everything they need from a healthy diet.

I finished my short course of antibiotics while constantly repopulating. My daughter is on long-term care, and I’m happy to report both of us have not had any stomach problems. Even if you don’t have pre-existing gut issues, adding probiotics to your diet while on antibiotics will help you stay healthy. And keeping them in your diet afterward will ensure you have repopulated with the beneficial flora we all need.

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5 thoughts on “Repopulate! Keeping Your Gut Healthy On Antibiotics

  1. As a pharmacist, I’m disappointed in this article. Even though the NICCH is *technically* part of the NIH, it is not a credible source. When it was established, is intended goal was to “gather evidence that airbags alternative medicine works”. That’s not how you do science. Science is supposed to investigate *whether* something works, evaluating ALL the evidence, not just cherry picking there conclusions you prefer. The scientific evidence is far from conclusive regarding the evidence for/against probiotics and I would REALLY be hesitant to start supplementation without the recommendation of your own doctor, the one prescribing the antibiotic. A major issue with OTC probiotics is the total lack of regulation. There is zero guarantee the strains labeled ON the bottle are actually the strains found IN the bottle. An even bigger problem: since they’re not refrigerated, it’s almost guaranteed that the bacteria in the capsule is dead and no longer viable. Another issue with probiotics, whether in supplement or food, is there still isn’t enough research to determine which strains, if any, are actually beneficial, and based on they complexity of it microbiome, I doubt we’ll every be able to say “strain X is best for all people, no matter what”. Not to mention the fact that since yogurt companies flat out lie and make up bacterial names out of thin air for marketing purposes

    1. Thank you for taking the time to comment. I hope you checked out the half-dozen links within the article that show the research that has been done on this topic, and where I drew many of my conclusions.

      Yes, that is how science is supposed to work, but it often doesn’t. As a science-literate citizen, I understand that the research literature on the drugs we take also have a bias to prove they work. Science News (a trusted source) has had numerous articles in the past couple years on the serious problems in research literature both purposeful and accidental. Yet, we still take these drugs. I take these drugs that may have questionable research! The point is to have more research done on both western-medicine drugs, AND the complimentary and alternative therapies out there. Writing this article can bring attention to the problems of taking antibiotics, and hope that the more attention it gets, the more research can be done to help.

      Yes, talking to your doctor about any other supplements while on antibiotics (or any medication) is always a good idea. And the unregulated herbal and alternative supplements is a HUGE issue, but that is not the focus of this post, which is why I spent most of it on the fermented foods.

      Although there are not enough studies to conclusively prove probiotics are the cure-all to intestinal distress, we do know that 1. Gut bacteria are important to digestive health, 2. Antibiotics are harmful to digestive health, 3. Fermented foods have been part of cultures for thousands of years. Although many people in science may discredit #3 as anything worthy of mention, often western-based science takes longer to “prove” what humans have known through cultural trial over time.

      I hope more research will be done to help those of us who have to weigh the benefits of antibiotics vs the harmful side-effects.

  2. Quite agree that science is supposed to investigate whether something works, evaluating ALL the evidence, not just cherry picking there conclusions you prefer. The scientific evidence is far from conclusive regarding the evidence for/against probiotics.

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