The impact antibiotics have on your gut health
Tis the season of illness, which for many could involve a trip to the doctors and a course of antibiotics.
While antibiotic use in England declined from 2014 to 2020, with large falls in 2020 related to the pandemic, latest data now shows a reversal in this downward trend, with antibiotic use in all settings (apart from dental) increasing in 2022.
And the festive period with its busy-ness, lack of sleep and opportunities to mix indoors can bring with it a dose of sickness, some of which could require the taking of antibiotics to get better.
While antibiotics are sometimes necessary to treat a bacterial infection, in a bid to kill harmful bacteria they can also damage the beneficial bacteria that live in the gut.
"There’s still a lot of research ongoing in this area," explains GP Dr Nazreen Morley. "However, essentially what happens is that while the antibiotics are killing off the harmful bacteria causing your infection, they can also kill off some of the 'friendly' bacteria that the gut requires."
There are a number of factors which could impact the effects of antibiotics on gut health including:
the type of antibiotic taken
the length of the antibiotic course
how many previous courses of antibiotics have been taken
gut health before taking the antibiotics
The age of the person taking the antibiotics can also play a role in the impact on gut health.
A recent Danish study, published in the journal Nature, found that the effects of antibiotic treatments on the gut microbiome last longer in adults than in infants, and different antibiotics are associated with distinct impacts.
3 ways antibiotics can impact gut health
Gut related illnesses
A 2020 study of previous research found that antibiotic use reduces overall gut flora diversity and disrupts the balance between species.
"Antibiotic use can have several negative effects on the gut microbiota, including reduced species diversity, altered metabolic activity, and the selection of antibiotic-resistant organisms, which in turn can lead to antibiotic-associated diarrhoea and recurrent Clostridioides difficile (C.diff) infections," study authors explain.
C. diff is a harmful type of bacteria that lives in the intestines and while other microbes can keep C. diff under control, taking antibiotics can allow the bacterium to grow, which can lead to diarrhoea.
A 2017 review reports that even a short course of antibiotics may disrupt the gut microbiome for up to one year or more afterward.
Antibiotic resistance
Studies have shown antibiotic treatments could lead to antibiotic resistance.
New research, lead by Imperial College London scientists, has found that antibiotic-resistant bacteria get extra nutrients and thrive when the drugs kill ‘good’ bacteria in the gut.
Professor Rob Galloway, a consultant in emergency medicine based in Brighton, is worried about the rise in antibiotic resistance.
"The risks of antibiotic resistance is real and growing," he tells Yahoo Life. "There is a risk that what was once routine cancer treatments or operations could be a distant memory because the infections which so often follow these treatments will no longer be so easily treatable."
Digestive health
Taking antibiotics could also impact digestion with a previous study of Danish children reporting that the likelihood of developing inflammatory bowel diseases (IBD) was highest in the first three months after taking antibiotics.
Turns out the risk was highest in children who had received at least seven courses of antibiotics.
Protecting gut health while taking antibiotics
Thankfully there are some practical steps people can take to protect their gut health while taking a course of antibiotics.
Taking probiotics
"Studies have shown that taking probiotics can help to minimise the negative effect that antibiotics by partially restoring gut flora," explains Dr Morley.
According to the Health and Food Supplements Information Service (HSIS) probiotics interact with the rest of the gastrointestinal system to inhibit the growth of harmful bacteria by:
Speeding up gastrointestinal transit and reducing the ability of bad bacteria to proliferate and attach themselves to the gut lining causing potential health and wellness issues
Increasing production of bioactive metabolites (for example, short-chain essential fatty acids), which makes the pH in the colon more acidic and repels pathogens from taking hold
Making vitamins in the gut, improving absorption of minerals, supporting bile salt metabolism and enzyme activity, and neutralising toxins
Assisting communication between cells
Improving the gut barrier function to keep pathogens out of the sterile parts of the body
Reducing production of pro-inflammatory compounds that drive inflammation
Improving immune function.
However, the type and dose of probiotics are important.
A 2021 study found that a combination of Lactobacillus rhamnosus and Saccharomyces boulardii were effective, but further research is necessary to confirm this.
It is also worth noting that taking probiotics isn't without risk so it is advisable to seek medical advice about the pros and cons before taking them.
Prebiotics
The HSIS defines prebiotic as "a substrate that is selectively used by host microorganisms conferring a health benefit". Put simply, they are foods for the strains of gut bacteria that we want to encourage, in the form of carbohydrates, fermentable dietary fibre, or some types of polyphenols and unsaturated fatty acids.
A 2015 study found that a high fibre diet and prebiotics can help stimulate the growth of Bifidobacterium - a group of bacteria that normally live in your intestines and stomach and help your body perform essential functions such as digestion and staving off harmful bacteria.
Maintaining good gut health
Keeping your gut healthy will help to ensure that, even if you do require antibiotics, you’ve the best chance of minimising any impact on the gut.
"A high fibre diet with plenty fruit and vegetables, a balance of required vitamins and minerals and staying well hydrated will all help," Dr Morley adds.
Prof Galloway also advises avoiding processed foods because they can also interact with the changes in gut flora after taking antibiotics and lead to the proliferation of bad bacteria which affects gut health.
Gut health: Read more
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