Repairing the gut post-antibiotics

Ever had to take a round of antibiotics for one condition and then end up with other gut or systemic issues because of them? 

Common issues post-antibiotics are:

• Gut dysbiosis - as the antibiotics also wiped out your beneficial bacteria it leads to a microbial imbalance. This may present as antibiotic-associated diarrhoea (AAD), constipation, abdominal pain, bloating or gas [1, 2, 3].

• Skin issues like acne, rashes/dermatitis - due to disturbing the beneficial microbiome on your skin [4].

• Candida (oral or vaginal thrush) - due to an overgrowth of Candida albicans [5]. 

• Mood disorders - some antibiotics are associated with psychiatric side effects such as depression and anxiety due to the decrease in microbial diversity and reduced levels of brain-derived neurotrophic factor, oxytocin and alteration of vagal tone[6]. The gut and brain share a bi-directional communication pathway so it would make sense that if your gut is not functioning optimally, then your mood is going to suffer!   

What can be done to repair the gut post-antibiotics: 

 Activated Probiotics Biome Advanced Probiotic

• Helps to prevent and reduce the symptoms of antibiotic-associated diarrhoea [1, 7, 8]. 

• Helps to restore the balance of beneficial bacteria after antibiotic use [1, 7, 8]. 

• Promotes healthy digestion and bowel regularity [1,7, 8].  

*If taking probiotics such as this one alongside antibiotics it should be taken two hours away from the antibiotic. 

Saccharomyces boulardii

This is a yeast microbe that cannot be killed by antibiotics so therefore it is the best one to take during your course of antibiotics. It may be helpful to prevent antibiotic associated diarrhoea caused by an overgrowth of strains such as Staphylococcus spp. and Escherichia coli and Clostridium difficile [1, 9].

Fermented foods

Consuming fermented foods such as natural yogurt, kefir, sauerkraut, kimchi, kombucha, fermented vegetables, miso and tempeh will also support the return of a healthy microbiome [10, 11]. 

Prebiotics

Prebiotics are a type of non-digestible fibre which feed the good bacteria (e.g. inulin, fructooligosaccharides and galacto-oligosacchardies). They help to produce short-chain fatty acids (acetate, protonate, butyrate and lactate) which in turn, may help to prevent the colonisation of acid-sensitive pathogens whilst also improving the gut lining [12]. Good food sources include: Jerusalem artichokes, chicory, garlic, onion, leek, shallots, asparagus, beetroot, fennel, cabbage, legumes, apples, white peaches, pomegranate, barley, rye, oats, nuts [13]. 

Before you try any of these…  

Before trying any new probiotics, prebiotics or supplements I highly advise working with a naturopath or other healthcare professional to help to personalise your treatment plan so that you can get the best outcomes. Not all of the probiotics here are suitable for everyone - some may cause unwanted side effects so it’s always best to be prescribed a specific strain to target your symptoms or condition.

 References: 

1. Guo, Q., Goldenberg, J. Z., Humphrey, C., El Dib, R., & Johnston, B. C. (2019). Probiotics for the prevention of pediatric antibiotic‐associated diarrhea. Cochrane Database of Systematic Reviews, (4). https://doi.org/10.1002/14651858.CD004827.pub5  

2. Kopacz, K., & Phadtare, S. (2022, August). Probiotics for the prevention of antibiotic-associated diarrhea. In Healthcare (Vol. 10, No. 8, p. 1450). MDPI. https://doi.org/10.3390/healthcare10081450 

3. Goldenberg, J. Z., Yap, C., Lytvyn, L., Lo, C. K., Beardsley, J., Mertz, D., & Johnston, B. C. (2017). Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. The Cochrane database of systematic reviews, 12(12), CD006095. https://doi.org/10.1002/14651858.CD006095.pub4

4. Shenoy, E. S., Macy, E., Rowe, T., & Blumenthal, K. G. (2019). Evaluation and management of penicillin allergy: a review. Jama, 321(2), 188-199. doi:10.1001/jama.2018.19283

5. Kunyeit, L., KA, A. A., & Rao, R. P. (2020). Application of probiotic yeasts on candida species associated infection. Journal of Fungi, 6(4), 189. https://doi.org/10.3390/jof6040189 

6. Dinan, K., & Dinan, T. (2022). Antibiotics and mental health: The good, the bad and the ugly. Journal of internal medicine, 292(6), 858–869. https://doi.org/10.1111/joim.13543 

7. Engelbrektson, A., Korzenik, J. R., Pittler, A., Sanders, M. E., Klaenhammer, T. R., Leyer, G., & Kitts, C. L. (2009). Probiotics to minimize the disruption of faecal microbiota in healthy subjects undergoing antibiotic therapy. Journal of medical microbiology, 58(5), 663-670. 

8. McFarland, L. V., Evans, C. T., & Goldstein, E. J. (2018). Strain-specificity and disease-specificity of probiotic efficacy: a systematic review and meta-analysis. Frontiers in medicine, 5, 124. https://doi.org/10.1099/jmm.0.47615-0 

9. Kelesidis, T., & Pothoulakis, C. (2012). Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders. Therapeutic advances in gastroenterology, 5(2), 111-125. DOI: 10.1177/1756283X11428502 

10. Hadjimbei, E., Botsaris, G., & Chrysostomou, S. (2022). Beneficial effects of yoghurts and probiotic fermented milks and their functional food potential. Foods, 11(17), 2691. https://doi.org/10.3390/foods11172691

11. Leeuwendaal, N. K., Stanton, C., O'Toole, P. W., & Beresford, T. P. (2022). Fermented Foods, Health and the Gut Microbiome. Nutrients, 14(7), 1527. https://doi.org/10.3390/nu14071527

12. Wilson, B., & Whelan, K. (2017). Prebiotic inulin‐type fructans and galacto‐oligosaccharides: definition, specificity, function, and application in gastrointestinal disorders. Journal of gastroenterology and hepatology, 32, 64-68.  https://doi.org/10.1111/jgh.13700 

13. Monash University (2024). Prebiotic diet. https://www.monash.edu/medicine/translational/gastroenterology/prebiotic/faq