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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How do I balance my gut flora?

Do I have dysbiosis?

Dysbiosis refers to a microbial imbalance on or within the body; in other words, an imbalance of good versus bad bacteria.

It most often occurs in the digestive tract (leading to unpleasant symptoms, such as bloating, excessive wind, IBS symptoms etc). However, it can also present on any exposed surface or mucous membrane, such as in the vagina, lungs, nose, sinuses, ears, nails or eyes.

For the purposes of this post, we will focus on intestinal dysbiosis, where digestion is compromised.

Toxic bowels and overall declining health can often be caused by diminishing levels of friendly bowel flora, coupled with and caused by the overgrowth of harmful bacteria and parasites, such as Candida albicans.

Bacterial enzymes can deactivate digestive enzymes in the gut (essential for the proper digestion of food and absorption of nutrients) and convert human bile or components of food into chemicals, which promote the development of diseases. Some by-products of bacterial enzyme activity, like ammonia, also hinder normal brain function and various other essential processes in the body. These by-products, when absorbed, need to be processed by the liver, placing it under additional strain.

What can cause this imbalance?

An imbalance in bowel flora can be caused by the proliferation of pathogenic parasites, yeast and/or bacteria and can have any number of specific causes. For example:

  • stress
  • illness
  • poor digestion (including low levels of digestive enzymes, constipation and other bowel disorders)
  • chemical exposure
  • poor diet
  • overuse of medication (including antibiotics and birth control pills)
  • mercury, for instance, in dental amalgams, may also have a role to play. It is thought that mercury can cause mutations in intestinal bacteria. These bacteria (either directly or indirectly) can then lead to the formation of small holes in the gut lining, which in turn has the potential to lead to dysbiosis and “leaky gut syndrome”.   

Dysbiosis is also often an underlying condition in people who are generally unwell, but is either misdiagnosed, not diagnosed at all or simply dismissed as a non-existent condition. However, natural health experts are generally in agreement that the health of your gut has a direct impact on your overall health. How can it not, when your digestive tract is where you take in nutrients and eliminate waste which, if left in the body too long, can become toxic and a breeding ground for harmful bacteria.

As such, dysbiosis has been associated with a number of health conditions, such as inflammatory bowel diseases (IBDs) (e.g. Crohn’s disease and ulcerative colitis), chronic fatigue syndrome, yeast infections and rheumatoid arthritis.

How do you know if your intestines are healthy?

If you have intestinal dysbiosis, you are likely to experience one or more of the following signs:

  • fatigue
  • headaches
  • intestinal upsets
  • stomach ache
  • bloating
  • cramping
  • wind
  • heartburn
  • burping
  • constipation
  • and/or diarrhoea. 

One of the main reasons for mis- or non-diagnosis of this condition is that these symptoms fit with many other conditions. For example, Candida albicans (also known as “the yeast syndrome”). This is because Candida is actually a form of dysbiosis.

Dysbiosis is just an umbrealla term, which reflects the fact that yeast organisms aren’t the only intestinal parasites that can cause these symptoms. In fact, intestinal bacteria or viruses may be the primary cause of some of these illnesses, not yeast. However, the most serious dysbiosis cases are likely to involve both yeast and harmful bacteria in the intestines.

How do you reset your gut?

It is perfectly achievable to re-balance your bowel flora, with careful attention to your diet (including supplementation) and lifestyle.

However, it should be noted that after suffering intestinal diseases, the body may be vulnerable to other infections, both bacterial and viral. As such, treatment of dysbiosis would be sensible as part of any overarching treatment of intestinal infections.

One suggested approach is to remove all sources of carbohydrates from the diet, as the molecular structure of these foods is too large for direct entry into the bloodstream.

When diseased intestines are inflamed from the effects of dysbiosis, they cannot break down the molecules that are too large to be transported across the small intestinal surface into the bloodstream. Instead of entering the bloodstream, the undigested starch and sugar molecules serve as a continual source of food for bacteria and fungi. By removing starches and sugars, dysbiosis may possibly be corrected.

However, it is important not to make any drastic dietary changes (such as the complete elimination of a food group) without first consulting a nutritionist, dietitian or GP.

It is also recommended to “crowd out” bad bacteria and other pathogens, by taking in high amounts of friendly bacteria in the form of probiotic supplements. While probiotic foods can certainly be beneficial as part of the revised diet, these probiotics do not tend to colonise the digestive tract (unlike probiotic supplements, which do). It is important to increase numbers of healthy bowel flora for the long-term; not just during the process of digestion.

As such, high-strength multi-strain probiotics can offer support.

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How antibiotics affect the gut

Good health begins in the gut

Many health experts agree that good health begins with balance in the body, particularly in the digestive system.

Inside our bodies there are twenty times more bacteria than living cells, and maintaining the correct balance of good bacteria versus bad bacteria is a crucial part of avoiding illness and supporting long-term health and vitality.

Having the right kind of bacteria (so-called “friendly bacteria”), in sufficient quantities, is essential for everything from healthy digestion and nutrient absorption, to immunity and defence against infections.

What can disrupt the balance of gut flora?

The delicate balance of healthy bowel flora can be disrupted by a number of things, including excess intake of alcohol, a diet high in sugar, poor digestion, stress, as well as exposure to toxins and environmental pollutants. For the purposes of this article, we will look in more detail at one of the most common causes of bowel flora imbalance – the long-term or frequent use of antibiotics.

How do antibiotics affect the gut?

It is now generally accepted that antibiotics have historically been prescribed and used far more than they should be. While this is in the process of slowly changing, the result has sadly been an upsurge in antibiotic resistance – a type of drug resistance where a microorganism is able to survive exposure to an antibiotic.

What’s more, one of the most notable effects of antibiotics is their adverse impact on the digestive system and the balance of gut flora – they indiscriminately destroy both good and bad bacteria in the body. They work by either killing bacteria or by preventing bacteria from growing – obviously good in terms of bad bacteria, but bad in terms of friendly bacteria.

This is somewhat ironic, when you consider that people are taking antibiotics in the first place because they are ill, but their medicine is destroying one of the body’s primary lines of natural defence. In fact, what is arguably the most important part of the immune system resides in the gut – Gut Associated Lymphoid Tissue (special antibody-producing cells) work hard to prevent unwanted micro-organisms (such as bacteria and viruses) from entering the body.  

Of course, antibiotics have their role to play and can certainly be highly effective in resolving bacterial infections. However, it is important to use them sensibly, in moderation and to support your levels of beneficial bacteria both during and after a course.

Too many bad bugs

If your levels of good bacteria fall, you provide opportunistic ‘nasties’ (like bacteria, parasites and yeasts) with an excellent environment in which to thrive and spread.

An overgrowth of harmful gut flora (called dysbiosis), for example, increases gut toxicity and can result in a number of unpleasant symptoms and conditions, including:

  • bloating
  • constipation
  • diarrhoea
  • abdominal pains after eating
  • wind
  • Irritable Bowel Syndrome (IBS)
  • Leaky Gut Syndrome
  • and Candida overgrowth.

This is one of the reasons why antibiotic courses often result in thrush (a fungal infection caused by Candida overgrowth).

How to support the good guys

Research has shown that the damage done to the digestive tract by antibiotics can last far longer than was previously thought.

Stanford University researchers in America analysed the levels of friendly bacteria in three healthy adult women both before and after each of two cycles on the antibiotic Cipro. Following the first cycle, they found that the drug had altered the population of the subjects’ friendly gut bacteria significantly, perhaps even permanently. Following the second cycle, six months later, they discovered that the effect was exponentially greater.

As such, antibiotics should never be used as a regular “quick fix” for minor ailments and, wherever possible, long courses should be avoided. Where a course of antibiotics is unavoidable, you can support your levels of friendly bacteria through diet and probiotic supplements.

For instance, many cultures have observed the health-supporting effects of fermented foods (often referred to as “probiotic foods”) and so include them as a regular part of their diet. These foods include kefir, sauerkraut, miso, tofu and tempeh to name just a few. Including these foods in your diet on a daily basis is a good way to promote healthy intestinal flora.

However, it is worth noting that most of these foods do not contain strains of bacteria that can actually colonise the digestive tract. Instead, they do good work for a week or two and then pass through.

Supplementing with strains of good bacteria that can colonise the digestive tract (such as L. acidophilus, L. salivarius, B. infantis, B. bifidum, B. brevis and B. longum) is arguably a more effective and powerful means of supporting healthy levels of gut flora for the long term.

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Why do I have bad breath?

What is bad breath?

Bad breath can come in many forms, levels of severity and can even be triggered by many a wide range of factors.

Simply speaking, it is an unpleasant odour eminating from the breath of a person. Chronic bad breath is referred to as halitosis. Less commonly, it is also called fetor oris, ozostomia or stomatodysodia.

What causes bad breath?

Often identifying the cause of bad breath is the first step towards treating this entirely preventable condition. As mentioned above, it can be caused by a wide variety of things. For example, smoking, dry mouth, a medical condition (such as diabetes) or diet (for example, a diet high in protein or other acid-forming foods, eating garlic and onions or drinking too much coffee or alcohol).

The most common causes of bad breath are preventable and easily treated. However, in some cases, chronic halitosis may indicate an underlying problem in the stomach or digestive system. It is this potential cause that will be considered below.

The digestive system

The digestive tract extends all the way from the mouth right through to the anus. It therefore makes sense that any problems in the digestive tract (such as Irritable Bowel Syndrome, for example – see below), can result in bad breath. As such, it is possible for anyone to suffer from halitosis (including both vegetarians and those who eat meat).

Stomach, intestinal and bowel problems may all be a contributing factor to bad breath. Digestion begins in the mouth. Saliva has digestive enzymes which begin the digestion process, and the type of food eaten can affect the food chemistry of the mouth. Saliva will also pick up odours from food within several hours after it has been eaten. Odours are strongest from carbohydrates (sugars, starches and cellulose), less strong from proteins and non-existent from fats. Bacteria in the mouth react with the decaying food and drink residue and can be the source of foul odour.

Digestive enzymes and nutrition

Digestive enzymes become more important as we get older, because their production by the body decreases as we age. A high level of the naturally-occurring digestive enzymes in foods is also destroyed when they are cooked.

If our bodies are enzyme deficient, they must divert nutrients to manufacture those digestive enzymes, which would otherwise be used to make intracellular enzymes such as catylase and SOD, which protect cells as antioxidants. Lower levels of digestive enzymes can also potentially lead to excess gas formation and putrefaction in the intestines. For some, this can contribute to bad breath gases travelling through the bloodstream and to the lungs, where they are exhaled.

Dairy allergy, lactose intolerance and gluten sensitivity

A dairy allergy or lactose intolerance could also be the cause of bad breath. If you think that this could be the case, you could try eliminating all dairy products from the diet temporarily to see if they are the culprit.

Even if you do not suffer from a dairy allergy or intolerance, some people find that the elimination of dairy products can nonetheless help with the control of bad breath odours. This is because dairy products can thicken mucous in the mouth and contribute to the anaerobic environment bacteria thrive in, leading to the production of volatile sulfur compounds (VSCs). It also supplies lots of protein used in the breakdown by bacteria to form VSCs.

For those individuals who are intolerant to gluten (a protein composite found in foods processed from wheat and related cereals) and are also suffering from halitosis, it is important to ensure that you are drinking a great deal of water to wash away thick mucous and bacteria and to keep the mouth flowing freely with saliva. This decreases mouth pH and increases oxygen, both of which help control halitosis.

Candida albicans

Candida is an overgrowth of yeast (referred to as candidiasis), which usually starts in the gastrointestinal tract and then gradually spreads to other parts of the body. It is a resilient and invasive parasite, which usually attaches itself to the intestinal wall and can (if left untreated) become a permanent resident of the internal organs. One of the known symptoms of candida is bad breath. This is because an abnormally high level of fungal organisms in the intestines may result in increased fermentation of the carbohydrates you eat. This produces a variety of toxins and gases.  

Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, which results in unusual sensitivity and muscle activity. It is sometimes referred to as spastic colon, spastic colitis, mucous colitis or nervous stomach and is a functional disorder, where the function of the bowels may be abnormal, but no structural abnormalities exist.

It is widely accepted amongst naturopathic practitioners and other complimentary and alternative health therapists that bad breath can be a sign of long-term problems in the colon. They believe the health of the gastrointestinal system is integral to overall well-being, and support for IBS (and bad breath symptoms) often involves seeking to restore gut health (including a healthy balance of bacteria).

Dysbiosis

In adults, bad breath is often one of the first signs that normal bacteria levels in the gut are imbalanced. Dysbiosis (also sometimes called dysbacteriosis) refers to a microbial imbalance on or within the body; in other words, an imbalance of “good” versus “bad” bacteria. When levels of friendly bacteria in the digestive system are low, partially digested food decays, producing foul gas and toxemia.

Certain health foods, organic products and food-based supplements (such as herbal colon cleansers, high-strength multi-strain probiotics, digestive aids and cleanse and detox supplements) can offer support in resolving bad breath, particularly where this is linked to digestive health.

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