Antibiotics and digestive problems

Effects of antibiotic use on the digestive system

Antibiotic resistance is perhaps the most well-known side effect of long-term use of antibiotics – a type of drug resistance, where a micro-organism can eventually withstand exposure to the antibiotic as a result of over-prescription and reliance.

However, there are actually many other side effects that can result from the long-term application and unnecessary use of antibiotics. Even short-term use (while often essential), can lead to issues.

One of the most significant effects is their impact on the digestive system, and the balance of microflora in the gut (a community of beneficial bacteria).

Can antibiotics cause digestive issues?

The simple answer is, yes they can.

Antibiotics work by either wiping out bacteria (bacteriocidal antibiotics) or by stopping bacteria from growing (bacteriostatic antibiotics).

Undoubtedly, they can be effective in overcoming bacterial infections. However, as mentioned above, the cost associated with such treatment is the risk of unwanted side effects and complications.

One of the main difficulties with antibiotic use is that, while they’re intended to destroy bacterial cells, they cannot be programmed to kill only harmful bacteria (i.e. the pathogen causing the condition). They also destroy friendly bacteria, which is vital to the proper workings of the digestive system.

As a result, antibiotics commonly lead to an imbalance of good and bad bowel flora (dysbiosis), which can in turn lead to symptoms such as constipation, diarrhoea, bloating, Irritable Bowel Syndrome (IBS), bad breath, nausea and upset tummy.

Perhaps, more worryingly, antibiotics can also have a direct and negative impact on the immune system. Good bacteria exist in their millions throughout the body – on the skin, in openings like the oral cavity, nose area and genitals and, arguably most importantly, in the intestines of the digestive system. They undertake essential functions in all of these areas, however their most important role is to protect our bodies against prospective pathogens. The antibiotics are therefore damaging our bodies’ natural ability to defend itself.

Imbalance of intestinal flora and immune function

Healthy intestinal flora is important for numerous functions in the body, including forming stools, sustaining a healthy digestive system and generating important vitamins (such as B vitamins). Yet, they’re most crucial to the ideal functioning of our immune systems.

You may be surprised to learn that the most important part of our immune system is located in the gut. 70% of all antibody-producing cells within the body are situated in what is termed “Gut Associated Lymphoid Tissue” or GALT. This represents the biggest group of immune cells in the body.

Imbalances of gut flora can have a number of unpleasant side effects and manifest itself in many ways. For example, fungi (like Candida albicans) and bacteria like pathogenic strains of Staphylococcus aureus (MRSA) and C difficile tend to make the most of the opportunity presented by the body’s reduced resistance, which means that they are then better able to grow more easily. This is a primary reason why antibiotic courses normally lead to thrush (a yeast infection caused by Candida overgrowth).

Similarly, C difficile infections have become prevalent in hospital wards and rest homes over the years. This is because, after antibiotic treatments, C difficile organisms can grow rapidly in the absence of the body’s natural defences. The bacteria produce toxic compounds that inflame and kill the cells that line the large intestine, which can in turn cause intense diarrhoea and internal bleeding. Several other digestive ailments and complaints are also quite typical, such as dysbiosis, toxic bowels and IBS to name just a few.

How to balance your gut bacteria

Research indicates that the damage caused by antibiotics to the gut can last for a far longer period than was previously believed.

In 2013*, Stanford University experts in the USA examined the friendly gut bacteria in 3 healthy adult women both before and after each of 2 cycles on an antibiotic. After the first round, they discovered that the medication affected the level of the women’s friendly bacteria in the gut drastically, perhaps even permanently. After the second cycle half a year later, they discovered that the impact was even greater.

As a result, it is advisable to take antibiotics only when absolutely necessary, i.e. when an infection is bad enough to cause discomfort and distress, or is life threatening or a risk to others. They should never be used as a repeated “quick fix” for small afflictions and lengthy programmes ought to be avoided wherever reasonably practicable.

If antibiotic intake is unavoidable, many individuals find it helpful to supplement their diets with additional friendly bacteria (probiotic supplements), before, during and after the programme of antibiotics is finished. It is believed that this will help to re-populate the digestive tract with the healthy bacteria that the antibiotics have decimated.

* https://med.stanford.edu/news/all-news/2013/09/scientists-show-how-antibiotics-enable-pathogenic-gut-infections.html

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Probiotics benefits

What are probiotics?

Probiotics are live micro-organisms (often bacteria) that are thought to have a positive effect on the health of the host organism (i.e. our bodies) and, in particular, digestive tract health. They are more commonly referred to as “friendly bacteria” or “good bacteria.”

Most probiotics are bacteria similar to those naturally found in the gut, especially in those of breastfed infants (who have natural protection against many diseases). Lactic acid bacteria (LAB) and bifidobacteria are the most common types of microbes used in probiotic supplements, but certain yeasts and bacilli are also used.

Probiotics are commonly consumed as part of fermented foods with specially added active live cultures, such as in yoghurt, soy yoghurt fermented, unfermented milk, miso, tempeh and some juices and soy beverages or as dietary supplements. In probiotic foods and supplements, the bacteria may have been present originally or added during preparation.

Probiotics are not the same thing as prebiotics, which are non-digestible food ingredients that selectively stimulate the growth and/or activity of beneficial microorganisms already in people’s colons – in other words, provide food for the good bacteria. When probiotics and prebiotics are mixed together, they form a synbiotic.

Benefits of probiotics

The world is full of microorganisms and so are our bodies – in and on the skin, in the gut, and in other orifices. Friendly bacteria are crucial to proper development of the immune system, to protection against microorganisms that could cause disease and to the digestion and absorption of food and nutrients. Each person’s mix of bacteria varies. Interactions between a person and the microorganisms in their body, and among the microorganisms themselves, can be crucial to the person’s health and well-being.

Investigations into the benefits of probiotic therapies suggest a range of potentially beneficial uses.

Managing lactose intolerance
Some people use probiotics to ease symptoms of lactose intolerance, a condition in which the gut lacks the enzyme needed to digest large amounts of the major sugar in milk and which also causes gastrointestinal symptoms. As lactic acid bacteria actively convert lactose into lactic acid, ingestion of certain active strains may help lactose intolerant individuals tolerate more lactose than they would have otherwise.

Lowering cholesterol
Studies have demonstrated the effectiveness of a range of lactic acid bacteria (LAB) in lowering serum cholesterol levels, presumably by breaking down bile in the gut, thus inhibiting its re-absorption (which enters the blood as cholesterol).

Lowering blood pressure
Clinical trials have indicated that consumption of milk fermented with various strains of LAB may result in reductions in blood pressure. It is thought that this is due to the ACE inhibitor-like peptides produced during fermentation.

Improving immune function and preventing infections
There are cells in the digestive tract connected with the immune system. One theory is that if you alter the microorganisms in a person’s intestinal tract (e.g. by introducing probiotic bacteria), you can affect the immune system’s defences.

A 2010 study suggested that the anecdotal benefits of probiotic therapies as beneficial for preventing secondary infections, a common complication of antibiotic therapy, may be because keeping the immune system primed by eating foods enhanced with “good” bacteria may help counteract the negative effects of sickness and antibiotics. It was thought that antibiotics may turn the immune system “off” while probiotics turns it back on “idle”, and more able to quickly react to new infections.

LAB foods and supplements have been shown to aid in the treatment and prevention of acute diarrhoea and in decreasing the severity and duration of rotavirus infections in children and travellers’ diarrhoea in adults.

Helicobacter pylori
LAB are also thought to aid in the treatment of Helicobacter pylori infections (which cause peptic ulcers) in adults, when used in combination with standard medical treatments.

Antibiotic-associated diarrhoea
Antibiotics kill friendly bacteria in the gut along with unfriendly bacteria. Probiotics are sometimes used to try to offset side effects from antibiotics like gas, cramping, or diarrhoea. Antibiotic-associated diarrhoea (AAD) results from an imbalance in the colonic microbiota caused by antibiotic therapy. Probiotic treatment can reduce the incidence and severity of AAD as indicated in several meta-analyses.

Reducing inflammation
LAB and supplements have been found to modulate inflammatory and hypersensitivity responses. Clinical studies suggest that they can prevent reoccurrences of inflammatory bowel disease in adults, as well as improve milk allergies.

Improving mineral absorption
It is thought that probiotic lactobacilli may help correct malabsorption of trace minerals, found particularly in those with diets high in phytate content from whole grains, nuts, and legumes.

Preventing harmful bacterial growth under stress
In a study done to see the effects of stress on intestinal flora, rats that were fed probiotics had little occurrence of harmful bacteria latched onto their intestines compared to rats that were fed sterile water.

Irritable bowel syndrome and colitis
Certain probiotics have been found to improve symptoms of IBS and to be safe in treating ulcerative colitis.

Managing urogenital health
Several in vitro studies have revealed probiotics’ potential in relieving urinary tract infections and bacterial vaginosis.

Other facts about probiotics

Did you know:

  • There are 10x more bacteria in our gut than there are cells in our body and if you gathered together all of your gut bacteria they would weigh approximately 1 kg or 2.2 lb.
  • An imbalance in our gut bacteria can sometimes occur during times of stress.
  • In order to protect us from getting food poisoning, our bodies are designed to stop the bacteria that we eat from getting into our gut. This is one reason why our stomach is very acidic.
  • Probiotics are considered safe for people of all ages unless they have a condition that has harmed their immune system such as cancer or HIV. Specific advice should be sought from a doctor or dietician.

How do probiotics work?

When we consume probiotics they start to compete with bad bacteria and pathogens for space and for food – therefore evicting them from our gut. Probiotics also stimulate our own immune system to enable it to fight infections better, as well as help us to digest fibre from our diet and in doing so they produce acid compounds that keep the lining of our gut healthy.

“Unfriendly” microorganisms (such as disease-causing bacteria, yeasts, fungi and parasites) can upset the balance of bacteria in our bodies. At the start of the 20th century, probiotics were thought to be beneficial to the host by improving its intestinal microbial balance, thus inhibiting pathogens and toxin producing bacteria. Today, specific health effects are being investigated and documented including alleviation of chronic intestinal inflammatory diseases, prevention and treatment of pathogen-induced diarrhoea, urogenital infections and atopic diseases.

Researchers are exploring whether probiotics could halt these unfriendly agents in the first place and/or suppress their growth and activity in conditions like:

  • infectious diarrhoea
  • Irritable Bowel Syndrome (IBS)
  • inflammatory bowel disease (e.g., ulcerative colitis and Crohn’s disease)
  • infection with Helicobacter pylori (H. pylori), a bacterium that causes most ulcers and many types of chronic stomach inflammation
  • tooth decay and periodontal disease
  • vaginal infections
  • stomach and respiratory infections that children acquire
  • skin infections
  • and many others.

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What are colon cleansers?

About the colon

To understand the role of the colon, it is important to first understand how the digestive tract (of which the colon is a part) is formed and functions in the body.

The digestive tract is the group of organs through which food and liquids pass when they are swallowed, digested and finally eliminated. These organs include the mouth, oesophagus, stomach, small intestine, large intestine, rectum and anus.

The large intestine consists of the colon and the rectum. The colon is approximately 5-6 feet long and has an ascending, transverse and descending portion. From there, it joins the rectum. It takes food around 18 to 24 hours to pass along the entire length of the colon.

The main functions of the large intestine are: the formation and excretion of faeces; the absorption of water and minerals; and beneficial bacteria in the colon manufacture vitamins B1, B2, B12 and K. They also help to prevent the overgrowth of harmful bacteria.

Cells of the colon secrete mucus, which lubricates and protects the walls. Inflammation or irritation of the intestinal wall causes the release of large amounts of mucus, as well as water and electrolytes. In this case, mucus can be seen in the stools and there may also be diarrhoea.

On the other hand, if faeces remain in the colon for longer than is desirable, causing constipation, large amounts of toxins can be reabsorbed back into the bloodstream. This is called auto-intoxication or self-poisoning.

Waste matter is filled with bacteria, so it is important to get it out of the body as quickly as possible. If the colon isn’t working efficiently, problems such as bloating, wind and pain are likely to present.

The digestive system is under pressure to perform very important functions all day, every day. Generally, digestive system problems are caused by a toxic build-up in the body, so it can be beneficial to flush the body of such toxins and waste from time to time. It is widely held by many natural health practitioners that one of the best means of achieving this is with so-called “colon cleansers”.

What are colon cleansers?

Colon cleansers fall into two broad categories: oral/rectal supplements and colonic irrigation.

As the name suggests, they are all intended to cleanse or clean the colon of toxins and other substances that can lead to disease and/or the accumulation of fat.

They come in the form of supplements, laxatives or procedures / devices used to stimulate the bowels into producing a bowel movement. The idea is that, by stimulating the colon to expel its contents, this helps rid the body of the toxins and waste matter that has built up in the colon.

As mentioned above, the colon is the part of the digestive tract that stores the waste material that we would rather not think about (and most of us don’t, until our health starts to deteriorate or we experience digestive issues). Over time the colon has a tendency to get clogged with food particles, especially if the diet includes a high level of processed foods and insufficient fresh fruit and vegetables. This leads to an accumulation of parasites and toxins that can have a detrimental effect on health.

If the colon is repeatedly abused and neglected, it can become a cesspool of toxins. If these are not eliminated from the body, they can keep building up over time and may even be reabsorbed. This can lead to bloating, constipation, irritable bowel symptoms, fatigue and various other health issues.

Colon cleansers may therefore offer support for conditions such as constipation, irritable bowel syndrome, bloating, chronic fatigue, acid reflux and even skin and hair problems. Users of colon cleansers often say that they feel “cleaner” and healthier after cleansing, that they experience weight loss and increased bowel regularity.

Colon cleansing is not a new therapy. In fact, colonic irrigation was used by the Egyptians as far back as 1500 BC, was taught in Ancient Greece’s medical schools and was practised by Chinese medicine more than 3000 years ago. Even then, it was already recognised that water can be a highly effective cleansing agent that purifies, softens and neutralises.

In more recent years (and particularly as a result of the added pressure placed on our digestive systems by the modern-day diet), colonics and colon cleansing health supplements have seen a resurgence in popularity, as potential tools that can support digestive health and general well-being.

It is generally accepted that the colon is an important digestive organ in terms of our overall health. Colon cleansers have therefore become a popular means of detoxification, ridding the body of dangerous parasites that may have otherwise found a home in the digestive tract, and promoting colon health and a healthy balance of intestinal flora.

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Why am I always bloated?

The most common causes of bloating

Stomach bloating is a common condition that affects as many as 1 in 5 people. While it’s most commonly associated with women, men can be just as prone.

Bloating can be very unpleasant, with the stomach swelling up like a balloon and making it difficult to wear tight-fitting clothes or uncomfortable to carry out normal daily activities. Excessive wind may also be present, adding to the sense of embarrassment.

But what causes bloating? If there’s no other bowel disturbance (like diarrhoea or constipation), underlying disease is unlikely – although, if in doubt, always visit your GP.

Bloating is most often caused by gas in the bowel, the volume and odour of which can depend on a number of factors, including:

  • diet
  • how much air you swallow
  • and the mix of bacteria in your gut.

Below are listed some of the most common causes of bloating, many of which are connected or inter-dependent.

Did you know?

We produce up to four pints of gas a day and release it by either burping or passing wind (14 times per day on average).

Irritable Bowel Syndrome (IBS)

Previously known as “mucous colitis” and “spastic colitis”, IBS involves the colon being in spasm. The two main symptoms are abdominal pain / bloating and altered bowel habits. The pain is usually relieved on passing stool or wind. Diarrhoea with watery stools on wakiing in the morning may alternate with constipation. It is often accompanied with the sensation that the bowel is incompletely emptied and excessive flatulence. IBS is often linked to emotional factors (such as stress) rather than allergies / intolerances (although it is thought that cow’s milk and antigens in beef can precipitate the condition), with around one-third of cases being linked to diet. Women are more susceptible than men.

Bowel disease

Bloating is one of the symptoms of an inflamed bowel, which can be caused by a wide variety of conditions and diseases, including Crohn’s disease and ulcerative colitis, as well as severe food sensitivity (as is seen with coeliac disease for example – an autoimmune disorder triggered by gluten intake).

Poor digestion

All too often, people eat their food too quickly because they are stressed, in a hurry or on the go etc. This is a bad start. Hydrochloric acid and digestive enzymes are secreted in the stomach in order to digest protein. Stress inhibits all enzyme secretion and the levels of hydrochloric acid in the stomach decline as we get older. As a result, many people routinely take antacids and other stomach acid blockers. These people are unlikely to be digesting protein properly and may therefore experience abdominal bloating, reflux and burping.

In the small intestine, bile from the liver, pancreatic juices and enzymes secreted by the intestinal lining act to digest food. Once again, stress, poor diet and nutritional deficiencies can all impair enzyme production which can in turn cause bloating of the stomach, wind and cramps.

Constipation

Constipation can have a number of underlying causes, but if food is only partially digested (e.g. because there has been a lack of digestive enzymes) and that food reaches the colon, it can putrefy and ferment. The problem is compounded if there is a lack of fibre and water in the diet.

The longer food sits in the bowel, the longer toxins inside your intestines are in contact with the intestinal wall and gas-forming bacteria have to work, meaning more gas can be formed.

Food allergy / intolerance

Any food that we are allergic or intolerant to acts like a poison in our bodies. In the majority of cases (+-95%), food allergies develop over time, so that a food that you once tolerated well might now be making you ill.

If our digestion is poor, there is an imbalance of gut flora (dysbiosis) or we have nutritional deficiencies, we may develop what is known as “leaky gut syndrome”. The intestinal lining can become more permeable than it should be, allowing toxins and partially digested food molecules to enter the bloodstream. This challenges the immune system and, over time, may contribute to food intolerances and/or allergies that can produce wide-ranging symptoms (including bloating, fluid retention, IBS, weight gain, cravings and fatigue).

Eating foods that you are allergic / intolerant to can create a lot of inflammation in the body, weakening your immune system. If you continue to eat these foods, your body will try to dilute them to minimise their harmful effects – this congests your lymphatic system, which can leave you looking bloated and puffy.

Dysbiosis

It’s estimated that there are more than 500 different species of bacteria present in the human gut in concentrations of between 100 billion to 1 trillion microbes per gram. This amounts to around 95% of the total number of cells in the human body.

The friendly bacteria in the stomach and intestines can quite easily become unbalanced (dysbiosis), making the body more vulnerable to yeast overgrowth (Candida), fungi, parasites and harmful bacteria. Poorly digested food, a high sugar diet and medication (like antibiotics) can all alter the intestinal pH, destroy good bacteria and then lead to bloating.

Beat the bloat with a healthy diet

A diet packed with fresh, enzyme-rich raw foods, fruit and vegetables, quality dietary fibre and fermented foods; low in saturated fats, salt and sugar; and with plenty of pure water, coupled with an active lifestyle, is the best way to keep your digestive system healthy and therefore beat the bloat.

You can also help to ensure healthy bowel function by:

  • eating slowly and chewing well (to avoid fermentation, gas formation and bloating)
  • eating only when calm and relaxed (to encourage the secretion of digestive enzymes).

When increasing the level of fibre in your diet, be sure to opt for naturally occurring fibre that is part of a whole food (e.g. in grains, fruit and vegetables etc). Try to avoid extracted bran, which is can have an irritant action on delicate membranes in the gut, leaving them open to inflammation (which will only aggravate bloating).

Also be sure to increase your water intake accordingly, otherwise any constipation could be worsened.

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Is dairy bad for me?

Some people swear by dairy, claiming that it’s essential for strong bones and teeth and a generally strong constitution. Others feel that their bodies react poorly to dairy, with resulting increased mucous levels, stomach pains and congestion. So is dairy good or bad for you?

Well, as with most things, the answer depends on a number of factors, including the make-up of your own individual body, as well as whether you are consuming dairy in moderation. There is no denying the fact that dairy is, for one thing, acid-forming in the body, which can lead to inflammation and, as such, you should not be consuming dairy in excess. It is also high in saturated fat and, unless you are careful, can often contain contaminants (such as hormones and medication).

Dairy allergy

In this modern age of dietary awareness, many people may jump to the conclusion that they have a full-blown dairy allergy if they have a negative response to dairy. However, this may not always be the case. If in doubt, consult your doctor or an allergy-testing clinic.

A true dairy allergy is when the body goes into shock (or has an anaphylactic reaction) after ingesting dairy and is the response of the immune system to the proteins found in dairy products. Casein and whey are the two main components. Casein is the curd that forms when milk is left to sour, while the watery part that is left after the curd is removed is the whey.

A dairy allergy is an extreme sensitivity to these proteins and should not be confused with lactose intolerance.

Most symptoms of a dairy allergy (commonly hives, congestion and eczema) manifest within minutes after the person consumes dairy products. A dairy allergy can be mild or serious and varies among individuals. For example, the reaction can range from mild indigestion to anaphylaxis, which is an acute reaction.

Dairy allergies are a common problem, particularly amongst young children. Since children affected by dairy allergies are often too young to tell you when they are having a reaction, it is important for parents to be able to recognise the symptoms and have a proper understanding of foods and ingredients to avoid. Fortunately, it is one of the food allergies that has alternatives and is not always a permanent problem.

Lactose intolerance

A dairy allergy is commonly mistaken for lactose intolerance because they share similar digestive symptoms, but in actuality, a dairy allergy is very different to a lactose intolerance.

In contrast to a true dairy allergy (where there is an immune system response whenever exposed to cow’s milk proteins), people with a lactose intolerance can’t tolerate the sugar in milk (called lactose), because they don’t have the corresponding digestive enzyme – lactase – to cope with lactose sugar. An intolerance is not an allergy, because it does not involve the immune system.

A lactose intolerance is less threatening than an allergy. Triggered by the digestive system, the body can respond in a number of ways to the ingestion of lactose, but it usually involves a significant stomach upset. Symptoms can include extreme gas, bloating, diarrhoea, vomiting and stomach cramps, but not usually hives or breathing difficulties.

Living with a dairy allergy or lactose intolerance

The primary treatment for a dairy allergy is avoidance. Depending on severity, this will be either total elimination or limited consumption of dairy products.

However, there are a number of other techniques that can be used to live with both dairy allergies and lactose intolerances.

As with all food allergies and sensitivities, it is important to take allergy tests or go on an elimination diet to confirm that dairy is responsible for the reactions. Confirmation is extremely useful, because a wide array of foods can cause reactions and it is important to narrow down the true allergen.

Clearly, having a dairy allergy or lactose intolerance can present a very real day-to-day challenge in terms of ensuring a varied diet and optimum intake of nutrients. As with any restricted diet (for example, vegetarians, vegans and coeliacs) it is important to take proactive steps to ensure that the person with the allergy or intolerance is getting sufficient vitamins, minerals and other nutrients.

One of the easiest ways to do this is through careful dietary planning and supplementation. Dairy-free and lactose-free meal shakes and protein powders can be particularly beneficial, especially if they have been fortified with other nutrients.

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