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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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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Could I have Candida?

What is Candida albicans?

Candida (also sometimes referred to as a thrush, yeast or fungal infection) is a single cell, plant-like fungi. It starts life as a yeast, which everybody has in their digestive systems and other mucous membranes from birth. It also lives on the skin.

In terms of how it acts in the body, Candida is an overgrowth of yeast (referred to as Candidiasis) that usually starts in the gastrointestinal (GI) tract and 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.

You might be surprised to learn that recorded incidences of Candida overgrowth date back as far as the 1700s. Hippocrates identified the presence of yeast infections as thrush in patients.

What are some of the known causes of Candida?

When all is well, the Candida yeast is kept under control by the healthy flora that we have in our bodies and, more particularly, in our digestive tract (sometimes referred to as “friendly” or “good” bacteria). In this way, it normally co-exists with many other types of bacteria, in a state of balance.

For instance, Candida albicans is part of the normal flora of the mucous membranes of the female genital areas, gastrointestinal and respiratory tracts, which cause no disease. However, overgrowth of this species may be the cause of infections that could include thrush (oropharyngeal Candidiasis) and vaginal Candidiasis (vulvovaginal candidiasis).

Unfortunately, the modern diet, lifestyle and environment are not always conducive to healthy bacterial growth. We are exposed to an ever-increasing amount of toxins and junk foods on a daily basis, as well as stress in our lifestyles and pollution and chemicals in the air we breathe and the water we drink.

It is thought that overgrowth of yeast tends mainly to occur in those with weakened immune systems or those whose levels of good bacteria have diminished as a result of some external factor (e.g. through stress, disease (such as diabetes), pregnancy and/or the use of antibiotics, birth control pills, steroids or other long-term medication).

When the body’s defences are weakened, it provides fungus with optimum conditions to grow. This allows Candida to enter the bloodstream, travelling through the body to colonise areas such as the urinary tract, vagina, tissue, nails, mouth, skin and other organs.

Once such overgrowth has begun, if not diagnosed and treated appropriately and promptly, it can result in a chronic systemic problem. It is thought that large numbers of yeast germs can weaken the immune system further, thereby perpetuating the problem.

Candida has the ability to produce around 75 toxic substances that can poison the human body. These toxins are believed to contaminate tissue and weaken the immune system, glands, kidneys, bladder, lungs, liver, brain and then the nervous system.

What are some of the symptoms of Candida?

Overgrowth of Candida can lead to a number of unpleasant symptoms, including:

  • fatigue
  • sugar cravings
  • brain fog
  • allergies
  • blurred vision
  • depression
  • digestive problems
  • joint discomfort
  • muscle pain
  • chronic diarrhoea
  • yeast vaginitis
  • bladder infections
  • menstrual problems
  • and constipation.

A Candida diet

It is widely advocated by natural health practitioners that people suffering from a Candida overgrowth might benefit from eliminating certain foods from their diet, restoring gut health and altering their lifestyle.

Some yeast is always present in the digestive system, but its growth is kept in check by way of the balance of good and bad bacteria in the gut. This is thought to be assisted by a diet which maintains correct acid/alkaline characteristics.

Therefore, a diet dominated by high sugar intake (which the yeast demands to maintain its presence and growth) and foods containing yeasts or fungi (such as mushrooms, cheese and milk) can lead to a disturbance of this delicate balance.

Supplements can also offer much needed support. For instance, to alkalise the body, remedy disbiosis (by helping to increase numbers of good bacteria) and to elimiate parasites and other pathogens. High-strength, multi-strain probiotics, anti-fungals, digestive enzymes and plant-based powders are all possible additions to support a Candida diet.

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