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Antibiotics and gut health

While antibiotics can be highly effective in treating diseases and saving lives, misusing them can upset the balance of bacteria in the gut, leading to negative health effects.

31 March 2023 | By Glynis Horning

Our intestinal tract is home to trillions of microorganisms that play a crucial role in our health. They help control our immune system, regulate metabolism, and some even produce chemicals that can affect our mood, says Durban microbiologist Dr Abdool Peer. “A specific mixture of bacteria produces molecules that signal to gut cells to increase production of serotonin, according to a study in Nature Microbiology – and serotonin is known as the ‘feel good’ chemical.”

Studies have now linked disruption of our gut microbiome to a range of disorders, from inflammatory bowel disease to coronary heart disease, obesity, Type 2 diabetes and neurodegenerative and psychiatric disorders. And one of the major disruptors can be abuse of antibiotics. 

While antibiotics can be hugely important for fighting infection, they can kill healthy, beneficial bacteria along with the harmful ones. Taking antibiotics too frequently can change the quantity and variety of bacteria in your gut and lead to antibiotic resistance, as the harmful bacteria that survive multiply and thrive. Antibiotics can also cause diarrhoea, particularly in children.

Ways to protect your gut biome

Ask about probiotics

Studies to date on their efficacy have tended to be inconclusive, but a review (in the Journal of American Medical Association) found probiotics were associated with a reduction in antibiotic-associated diarrhoea – though more research was needed to determine which were best for which patients receiving which specific antibiotics.

Speak to your health provider about them, and how best to take them. Probiotics are usually themselves bacteria and may be killed if taken at the same time as antibiotics. You may be advised to take them several hours apart, or after completing a course of antibiotics, to replace healthy gut bacteria and restore a healthy gut biome.

Eat for your gut

You can help replenish good bacteria levels by consuming live and active cultures in the likes of plain yoghurt (read labels), fermented dairy products such as kefir, and fermented vegetable products such as sauerkraut, miso and kimchi, says Dr Peer. Also have high-fibre foods, such as whole grains, vegetables, nuts, seeds, beans and lentils: your body can’t digest fibre, but your gut bacteria feed on it and studies suggest dietary fibre may stimulate the growth of healthy bacteria, and possibly reduce growth of some harmful varieties.

Dietary fibre can slow the rate at which your stomach empties and may reduce antibiotic absorption, so it may be best to avoid high-fibre foods during treatment and focus on them when you’ve finished your antibiotics. It’s also important to avoid foods that can create a hostile environment for good bacteria and encourage bad ones, such as refined carbohydrates and sugar, and synthetic sweeteners, says Mossel Bay gastroenterologist Dr Francois Retief. “These are detrimental to microbiome health.”

Get moving

Finally, when you have completed your course of antibiotics and recovered from the condition that required them (check with your health provider), get moving. Exercise can “enhance the beneficial microbial species and enrich the microflora diversity”, notes a recent study in Oxidative Medicine and Cellular Longevity.

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