What Is the Impact of Antibiotics on Gut Health, Really?

And should you take probiotics with antibiotics?

Probiotics have been the talk of the town lately in the media world and come with all kinds of claims like improved digestion, better immune function, reduced inflammation, increased diversity and more. We’ll get into all of this and more in future blogs but today I want to discuss the impact of antibiotics on gut health and answer a question that I hear ALL the time – “how can I best support my gut while I’m taking antibiotics?”

The Impact of Antibiotics on Gut Health

First off, what are antibiotics and what is the impact of antibiotics on gut health? Antibiotics are medications prescribed by doctors that are used to treat many types of bacterial infections. They work by targeting and killing bacteria. Inside of our gastrointestinal tract, especially in our large intestine (colon), we house all kinds of bacteria that contribute to the digestion and absorption of food particles – these bacteria are essential to having good digestion and regular bowel movements! They also contribute to MANY other aspects of our health including contributing to a strong immune system.

Unfortunately, antibiotics can also target and kill our healthy bacteria. This can commonly lead to antibiotic-associated diarrhea – a super uncomfortable experience when you’re already feeling down from an infection! (1) However, antibiotics are essential when prescribed by a doctor. So, if you need to take an antibiotic, you should also know how to support your gut during antibiotic use and how to restore gut health after antibiotics.

Should You Take Probiotics With Antibiotics?

This is where probiotics come into play. Probiotics are live microorganisms (bacteria and yeast) that are intended to have health benefits (2). Each probiotic supplement is formulated differently and contains specific strains of bacteria that are indicated for specific reasons. Taking probiotics while taking antibiotics can help your body maintain a healthy community of microorganisms in your gut and prevent pathogenic (bad) bacteria from settling in (1). It has been shown that taking probiotics with antibiotics reduces the risk of antibiotic-associated diarrhea by 37% in adults (1). There has been a lot of research into what is the best probiotic to take with antibiotics to support your gut health during an antibiotic regime. 

There are three main strains of probiotics that are proven to be beneficial in antibiotic associated diarrhea (see product suggestions containing these strains below!) (3, 4)

1. Lactobacillus rhamnosus GG 
2. Saccharomyces boulardii
3. Lactobacillus casei 

If you choose to take a probiotic, you should take it for the duration of your antibiotic regime and for 1 week afterward (5). Plan to take it 2 hours before or after your antibiotic. (Note: Continuing for longer than 1 week may have a negative impact on your gut microbiota’s recovery! (5))

Examples of the best probiotics to take with antibiotics (3)

• Bio-K+ ©  – Antibio Pro (1-2 capsules/day), BiomePro Drinkable Probiotic (0.5-1.0 bottles/day), Drinkable Probiotics (1 bottle/day), 
• Culturelle © – Digestive Daily Probiotic Chewables (1 tablet), Digestive Health Daily Probiotic Capsules (1 capsule)
• DanActive © (1-2 servings)
• FlorastorMax © (1 sachet), Florastor © (1-2 capsules/1-2 sachets)

How to restore gut health after antibiotics

The best way to restore and support your gut health in the long term is through a varied and fibre-rich diet! Focus on having a variety of fruits and vegetables, whole grain foods (brown rice/pasta, sprouted breads, sweet potatoes, etc), legumes, nuts and seeds. 

The bacteria in our gut LOVE variety – increase the variety in your diet by making easy swaps – look for products that contain multiple kinds of plants instead of just one. Some examples of this:

• Frozen mixed berries instead of frozen strawberries
• Mixed beans instead of kidney beans
• Spring mix instead of spinach

If you don’t usually have a lot of fibre in your diet, increase the amount of fibre you’re having slowly (otherwise you might see some GI upset!) and drink lots of water (at least 8-10 cups/day).

References:

1. https://pubmed.ncbi.nlm.nih.gov/34385227/
2. https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know
3. http://probioticchart.ca/PBCAdultHealth.html?utm_source=adult_ind&utm_medium=civ&utm_campaign=CDN_CHART
4. https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0209205&type=printable
5. https://www.theguthealthdoctor.com/antibiotics-your-questions-answered/