How Antibiotics Affect Your Gut
How antibiotics can affect your gut and what you can do to support your microbiome and gut health when taking antibiotics.
You may already be aware that antibiotics can wreak havoc on our carefully balanced microbiome and can affect our gut health for months afterwards. However, when you’re faced with an infection that your immune system is struggling to overcome, antibiotics can be lifesavers.
A single course of antibiotics can cause changes to your microbiome that can last for up to least four years!
Scientific research has shown that a single course of antibiotics can cause changes to your microbiome that can last for up to least four years! (1). This is because antibiotics don’t just target bacteria that cause infections – they can also damage your native commensals (the good bacteria in your gut), negatively affecting your microbiome. It’s your commensals’ job to make it difficult for pathogens (harmful microbes such as bacteria and yeasts) to grow in your gut; a reduction in commensals can, therefore, allow pathogens to overgrow, causing an imbalance between your good and bad microbes. Known as ‘dysbiosis’, this imbalance may increase your risk of infection and uncomfortable gut symptoms.
Symptoms of Dysbiosis
Bloating
Acid reflux
Chronic fatigue
Nausea
Inflammation and aching joints
Acne and skin rashes
Gas and discomfort
Abdominal pain
Constipation/Diarrhoea
Food intolerances
Antibiotics come in different forms. Some can target a wide range of bacteria (broad-spectrum) while others will target only a few types of bacteria (narrow-spectrum). Broad-spectrum antibiotics are the most commonly prescribed because often the microorganism causing an infection is unknown. Use of broad-spectrum antibiotics have been observed to have several impacts on gut health, including:
Reducing microbial diversity in the gut
Reducing protective species such as Bifidobacterium spp.
Promoting the colonisation of opportunistic pathogens such as
Clostridium difficile that can cause antibiotic-associated diarrhea.
In infants and young children, antibiotic use has also been linked to an increased risk of asthma and weight gain. In a healthy gut microbiome, the resident microorganisms help protect against invasion by opportunistic pathogens through a process called colonisation resistance. This involves different methods to inhibit pathogens, such as:
Producing anti-microbial compounds
Outcompeting pathogens for space in the gut
Maintaining the mucus layer so pathogens cannot reach intestinal cells
Training the immune system to respond to pathogens.
When the resident gut microorganisms are reduced during antibiotic use, these protective functions may stop occurring and provide an opportunity for pathogenic bacteria to colonise.
Ten percent of the population experiences side effects when they take antibiotics, including digestive discomfort and pain, candidiasis or thrush, antibiotic-associated diarrhoea (AAD). If you only have to take antibiotics once in a while, this may not seem like such a big deal. However, repeated prescriptions can cause recurrent disruption to your commensals, meaning the side effects can become chronic. Additionally, there are strong links between long-term microbiome disruption and the development of chronic conditions like irritable bowel syndrome, chronic diarrhoea, metabolic syndrome and obesity. Yikes!
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So what can we do to counteract the side effects of Antibiotics?
Some simple support by eating the right foods and taking a strain specific probiotic can go a long way to help build those commensals back up.
Take a Probiotic
Luckily, we can use certain specific probiotic strains to reduce the risk of these side effects. Lactobacillus rhamnosus (LGG®), Saccharomyces boulardii (SB) and Bifidobacterium animalis ssplactis (BB-12®) are probiotic strains that help preserve and rebuild commensal bacteria populations and reduce antibiotic-associated side effects.
You can take a probiotic whilst on Antibiotics. Don’t wait until you are finished the antibiotic therapy. Just take your probiotic at the opposite end of the day. For example, if having antibiotic in the morning, take your probiotic in the evening before bed.
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Make sure you are getting enough Fibre
The best way to increase the diversity of the the but microbiome is to eat enough dietary fibre. Our healthy gut commensals love fibre as a food source. Around 30g of fibre per day is required for the average adult. Foods high in fibre include vegetables, fruits, nuts and seeds, wholegrain cerreals, legumes and pulses.
Aim for variety, by eating a range of colours for truit and vegetables and eating seasonally. Use different sources of wholegrains like rolled oats, dense grainy bread or rye, rice, quinoa or polenta. See here for some microbiome friendly foods
Balance
Our microbiome contains both fibre and protein loving microbes. We want to encourage the fibre digesting microbes the most as they produce short chain fatty acids which are health promoting. Diets that are poplular right now like ketogenic and high fat or high protein and low carb tend to shift the microbiome population to protein loving species that tend to release pro-inflammatory compounds. The best diet for a healthy balanced microbiome is the mediterranean diet
Limit saturated fats.
The fat loving species Bilophila wadsworthia when elevated has been obseved in individuals with intestinal inflammation and colon cancer. Foods high in saturated fats include dairy products, palm or coconut oil, pastries, biscuits and chocolates.
Consume Fermented Foods.
Fermented foods are produced by microbes and include yogurt, cheese, sauerkraut, kombucha and kimchi, among others.They contain a number of healthy bacterial species, such as Lactobacilli, which can help restore the gut microbiota to a healthy state after antibiotics.
Want to dig deeper?
If you suspect your digestive system has been affected from past use of antibiotics and an unbalanced microbiome is lurking behind your current health symptoms, there are some great testing options available that check your microbiome levels. This can then help us take a more targeted approach to restoring balance to your gut and returning it to tip tip condition.
Book here to sort that microbiome out and get back to what’s important - living your life freely!
(1) Yoon MY, Yoon SS. Disruption of the Gut Ecosystem by Antibiotics. Yonsei Med J. 2018;59(1):4–12. DOI:10.3349/ymj.2018.59.1.4