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Gut Recovery After Antibiotics

Antibiotics are the #1 reason clients end up in my office. Now of course they can be lifesaving in some situations, but unfortunately, they are often overprescribed, and often coming with pesky digestive (and other) side effects. You've probably experienced, or at least heard that chronic antibiotic use isn’t great for the gut, but in fact even one round can drastically change the microbiome –more than one round may affect it permanently. When I say microbiome, I mean the collection of beneficial bacteria primarily in the large intestine. And when that bacterial balance is altered, there is a ripple effect through different body systems, causing other imbalances that if you hadn’t attended this talk today-- might seem unrelated.

One of the main problems with overuse of antibiotics that converts strangers into my newest clients is that bacteria have essentially evolved in order to survive our usual antibiotics, and so now we have these superbugs that aren’t sensitive to traditional antibiotics. This means that sometimes one round doesn’t work, and then a second or third, successively stronger antibiotics are required which does even more damage.

Now let’s talk about the side effects of antibiotics—some of these you may be all too familiar with like bloating and diarrhea during antibiotic treatment. That’s probably pretty obvious. But did you ever think about the eczema, UTI, or kidney stone that seemed to appear out of nowhere 18 months after a round of antibiotics was related to the resulting changes in your gut microbiome?? Most people don't, but now that you're here and reading this, you know!

Now let’s talk solutions.

#1 Probiotics

A broad-spectrum probiotic is a good place to start for general prevention and restoration during and after antibiotic treatment. A good general probiotic formula will contain at least 10-15 or more strains or types of bacteria. In other words, when you look on the label there will be a list of weird long words, and there should be at least 10-15 of those with numbers next to them. Next you want to look on the label or the front for the number of CFU’s. It should say at least 15-25 billion, some will have 50-100 billion which could be better for short-term support.

This type of general probiotic will work for most people, but I’ll note a couple of additional categories as well. If you experience diarrhea when taking antibiotics or any other time really, a specific strain called Saccharomyces boulardii (Sac b for short) is especially helpful in controlling loose stool and supporting the immune system. You could take this in addition to a general probiotic in the case of antibiotic treatment, or alone on an as needed basis.

Now if the general probiotic makes you feel worse or causes severe bloating, a spore-based probiotic meaning it comes from soil-based bacteria is another option that can help to restore balance but doesn’t usually aggravate bloating.

#2 Prebiotics

Prebiotics are fermented fibers that feed beneficial bacteria. They come from fiber-rich foods such as onions, garlic, beans, asparagus, bananas, apple, and flax seeds, or there are supplement versions which are sometimes a little easier to digest if these foods make your intestines cringe just hearing their names. Now the research on taking a prebiotic supplement during antibiotic treatment isn’t super clear. Some studies show a benefit of taking a prebiotic supplement during antibiotic treatment, and some don’t. It won’t hurt to try, and some probiotics have prebiotics in them, but just know it’s not a top priority that you go out and buy a supplement for that unless it’s for you or someone who doesn’t eat fiber or can’t tolerate fiber, in which case a supplement might be easier.

However, if tolerated, prebiotic foods may be a better option. It may be challenging to be eating at your best when you’re not feeling well and taking an antibiotic, but try to keep fiber from fruits, veggies, whole grains, nuts and seeds in the diet as much as possible to feed the beneficial bacteria you’re putting back with the probiotic supplement. For specific symptoms: if you’re prone to diarrhea, banana is a great source of prebiotic fiber which can help to balance loose stool. Kiwi is a great source of easy to digest soluble fiber which won’t aggravate bloating and can help with constipation. Applesauce is another great source of prebiotics that may help to protect the gut lining from damage while on antibiotics.

#3 Fermented Foods

Fermented foods are also a good source of pro and prebiotics, so if you’re on a budget, you can still have a healthy gut and prevent problems after antibiotics. In fact, you can make any of these at home pretty easily with minimal equipment. Otherwise, most grocery stores sell raw pickles and sauerkraut, kimchi which is like a traditional Asian fermented coleslaw, and kefir or plain, unsweetened yogurt. Avoid the sugary, sweetened version as that may negate some of the benefit since the sugar can potentially feed bad germs more than the probiotics in the yogurt can support the good guys. So plain, unsweetened is the way to go. If that sounds disgusting, try adding ½ cup to a smoothie with fruit, almond milk, vanilla, maybe some protein powder that’s sweetened with monk fruit or stevia. The taste will be sweeter, and the yogurt will give it some nice texture.

So there is a pretty good list of foods and supplements to consider for gut support during and after antibiotic treatment. Just as there are supportive foods, there are also a few common irritants that may not be your best friend while on antibiotics. This doesn’t mean your diet has to be perfect, but just be aware that alcohol and added sugar can potentially feed the bad germs faster than all of these other foods can feed the good guys. So, keep to a minimum at least while on antibiotics to prevent overgrowth. Grapefruit can inhibit the absorption of antibiotics, so wait to eat until after the course of treatment is finished.

Now, the $64 million question—what if digestive symptoms, or any of these listed issues appear or come back 6, 12, 18, 24 months later?? It may be a sign that there’s trouble brewing, and we need to address. Any of these symptoms could be a result of changes to the gut microbiome because of antibiotic use. So always suspect a gut imbalance, even if the symptom doesn’t seem to originate in the gut.

In this case, probiotics alone may not be enough. There is perhaps infection or overgrowth at this point, maybe a buildup of inflammation or even damage in the intestine, and perhaps digestion has become sluggish as a result. There could be 1 or 2 issues, or five. It’s sometimes hard to tell without testing. So normally at this point, I would test. If you are trying to DIY your gut health repair, stay tuned for next month’s article on the 5R’s of gut restoration which may help you better understand what to do and in what order (and when to ask for help).

If you know that you want a structured program that takes out the guesswork of healing the gut, check out my Gut Health Freedom online program details here:

If you still have questions, think you may need more 1:1 help, or aren’t sure if this could really get your results, book a free call so we can talk through your individual scenario:

I’m happy to answer any questions, and you can always find me on social media as well for more tips and help along your gut health journey!


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