December 9, 2022

How to restore your gut health after a course of antibiotics

You might be a fan of kefir, kombucha, or kimchi, but a surefire way to disrupt your microbiome — gut health fan or not — is to go on a course of antibiotics. They may be life-saving drugs that have revolutionized medicine, but it’s an undeniable fact that antibiotics can cause unintended damage to our intestines. And that’s because antibiotics are designed to kill bacteria – all bacteria.

“There are many types of bacteria; some cause diseases (pathogens) for which we have developed antibiotics and thousands of others that are either beneficial or benign to our health,” explains Teacher Jack Gilbertaward-winning microbiome scientist at the University of California, San Diego.

“The immune system is like a gardener trying to get rid of weeds (pathogens) and grow the right vegetables and fruit plants (beneficial bacteria). But antibiotics don’t discriminate, so they kill a lot of good bugs.

Antibiotics can wreak havoc in our intestines, especially if you don’t complete the course

Obliterating the good bacteria can have undesirable effects. “Not all good guys repopulate after the course of antibiotics,” says Jo Cunningham, dietitian and clinical director at Gut Health Clinic. “This can lead to diarrhea, bloating, abdominal pain and fatigue.”

A totally decimated system may have other problems, according to Dr. Jenna Macciochi, immunologist and author of Your plan for strong immunity. “The downstream impact can include anything from metabolic changes and (weakened) body barriers like the gut, lungs, skin, to colonization of bad bacteria – which risks antibiotic resistance.”

Pot of kimchi on table
You may be fine with your kimchi, but a course of antibiotics can still wipe out your gut bacteria.

This is not to say that you should refuse to take them if your GP advises you to take a course, but Cunningham stresses that it is always worth discussing with your GP whether they are absolutely necessary. When they are, follow them as instructed and always complete the course. If you don’t, Gilbert says, “Pathogens can replicate so quickly that new mutations in their genome appear and they can become resistant to antibiotics.”

How to rebuild your gut health after antibiotics

Take the right types of probiotics and time them around the antibiotic

You might assume that taking high-strength probiotics would be the best course of action, but the experts we spoke to say the jury is still out on the effectiveness and safety of gut superfeeders.

“There is some evidence that probiotics can be helpful in preventing diarrhea and other uncomfortable digestive symptoms, but they don’t necessarily help us recover gut microbes that have been killed by antibiotics,” says Dr. Macciochi.

“In fact, a small study suggested that probiotics may slow your microbiome’s recovery.” Dr. Macciochi, however, recommends that people take a targeted strain during and after antibiotics, unless they have a medical reason not to (such as inflammatory bowel disease).

She suggests taking something like lactobacillus rhamnosus GG Where saccharomyces boulardii twice a day between two meals while taking antibiotics and for 10 days after the end of the course. Take them a few hours after taking the antibiotics “so you don’t cancel them out”, says Professor Tim Spector, author of Spoon fed and co-founder of ZOE, the personalized nutrition company.

Cunningham also suggests that the research supports these strains, explaining that “not all probiotics have been shown to survive if taken with an antibiotic, so the right strain is important not only to see an effect but also for you. save money”.

These strains have evidence behind them, but rather than taking pills or cutting back on formulated drinks, you should focus on your diet because, as Dr. It’s a bit like trying to grow up. seeds without soil.

Choose Herbs Over Pills If You Are Looking For Long-Term Effects

Each of the good “bugs” in our microbiome have different needs and different functions – and food is the best way to support them. “Each microbe in the gut feeds on different types of plant chemicals (polyphenols), and each plant contains hundreds of different chemicals, so variety is crucial,” says Professor Spector. Stylist.

The key is to make sure the plants you eat contain fiber, so that they reach the lower part of the colon. “That’s why real food is better (than supplements),” he says.

Aim to eat 30 plants per week

The sweet spot is to aim to consume 30 types of plants per week. “Eat plenty of plant foods filled with prebiotic fiber,” says Dr. Macciochi. They will feed the good bacteria that you have already accumulated in your digestive system. Think:

  • Artichokes
  • Asparagus
  • Bananas
  • Berries
  • Garlic
  • Green vegetables
  • Onions
  • Legumes (beans/peas)
  • Tomatoes
  • Whole grain cereals

“Aim for 30g of fiber a day and 30 different plant foods over a week – not just fruits and vegetables, but also nuts, seeds, beans, legumes, herbs and spices,” Dr. Macciochi continues.

Find your fermented favorite

“Finally, include fermented foods like sauerkraut, kimchi, and kefir.” The reason these fermented foods – along with sauerkraut and Greek yogurt – are so useful is because, according to Professor Spector, “there are many more different species in fermented foods than in probiotic tablets”. Ten billion of one strain sounds good, but isn’t as good as billions of different strains.

Sleep and stress are important when it comes to rebuilding a strong gut

Of course, it’s not just antibiotics that can mess up our guts. These very important microbes are also impacted more generally by our biological clock. “We have known for a long time that our gut microbiota is closely linked to our circadian rhythm,” explains Professor Spector. “There is evidence of eating within a time-limited window of around eight to 10 hours, to give her a clear break to repair the gut lining.”

So, eat your dinner, then allow a “fast” of at least eight hours until breakfast. This pause reduces inflammation – too much of which can upset the balance of your gut, as microbes that like to live in inflammation crowd out the good bugs, producing more inflammation themselves and thus setting off a vicious cycle. . That’s why it’s a good idea to reduce our intake of “pro-inflammatory foods” like ultra-processed foods, excess sugar and alcohol when taking antibiotics. It’s also a good idea to focus on good sleep, staying active, and reducing stress.

How to know if your gut is healing

Once you have these principles in place, the next thing to know is when you are on the right track. How are you supposed to know if your gut is repairing itself?

“You should have reduced gastrointestinal issues and generally feel more energized and clear-headed,” says Gilbert. Dr. Macciochi adds that beyond that, more noticeable benefits should follow: “Over time, the positive effects will extend beyond your digestion and you may see further improvements in the appearance of skin and a better mood.”

She also warns of another potential post-antibiotic problem – loss of tolerance to dairy or other foods. “Keep eating a very small amount, increasing slowly over time,” she advises. “Eliminating foods for good without a medical reason, such as a diagnosed allergy, can make food intolerances worse.”

Because we have a totally personalized gut microbiota, recovery will also be totally personal. “We share 99.5% of our genes, but only about a quarter of our microbes – even in identical twins,” says Professor Spector. Some people’s gut microbiota can repopulate in days, others in weeks, but no matter how long it takes, “you can be sure your microbes will thank you for feeding them,” says Cunningham. It’s the best approach after a course of antibiotics, but it’s a model for good gut health for life.