Whats The Best Probiotic To Take After Antibiotics
There are two main bacteria strains that have been studied for effectiveness in reducing digestive distress after antibiotics. They are Lactobacilli and Saccharomyces. And while there are many bacteria strains that are beneficial for healthy digestion, these two are key when it comes to rebalancing your microbiome after antibiotics.
Related Advise For What Probiotics Should I Take While On Antibiotics
How much probiotics should I take with antibiotics?
A quick rule of thumb is to take your probiotic two hours before or two hours after taking your antibiotic. This will give sufficient time for the antibiotic to work while not killing off the beneficial bacteria. You should take probiotics twice a day and on an empty stomach.
Is Yakult a good probiotic?
Yakult is a probiotic drink. It contains billions of live and active “good bacteria.” Your digestive system naturally contains trillions of bacteria — some are helpful, some are harmful.
Which is the best probiotic to take?
A general recommendation is to choose probiotic products with at least 1 billion colony forming units and containing the genus Lactobacillus, Bifidobacterium or Saccharomyces boulardii, some of the most researched probiotics.
What are the symptoms of low probiotics?
Signs of poor gut health
Antibiotics Upset Intestinal Balance
Thousands of species of bacteria, yeast, and other microorganisms live on our skin, in our intestines, and on other body surfaces. Theyre known as our normal flora. When it is in balance, these microbes stay put and many of them contribute to good health. Bacteria in the gut, for example, help break down food.
Antibiotics kill these good microbes along with bacteria that are causing an infection. This upsets the balance of the normal flora in the intestines. The result is often loose, watery stools known as antibiotic-associated diarrhea.
The idea behind using probiotics is that they may help populations of good bacteria recover more quickly and restore order to the intestines. Theres no good evidence that probiotics are helpful in otherwise healthy people. But earlier research has suggested they can be helpful in:
- treating recurrent or persistent C. difficile colitis, when repeated courses of other therapies have not been successful
- preventing complications from pancreatitis
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Can I Get Probiotics From Food
You can absolutely increase beneficial microbes in your body from the foods you eat. Certain foods have probiotics in them and can benefit the health of your microbiome.
These foods can be introduced into your diet at any point of the day. You may even be regularly eating them now and not realize that they contain probiotics. You will want to check the food label for live and active cultures. A few suggestions for just some of the probiotic-rich foods you can add to your diet and some times to try them include:
For breakfast, try:
- Powders.
- Liquids.
Probiotic supplements may be combined with a prebiotic. Prebiotics are complex carbohydrates that feed the microorganisms in your gut. Basically, prebiotics are the food source for the good bacteria. They help feed the good bacteria and keep it healthy. Prebiotics include inulin, pectin and resistant starches.
When you have a supplement that combines a probiotic and prebiotic, its called a synbiotic.
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Taking Probiotics With Antibiotics Is Beneficial
Taking probiotics is a simple and highly effective way to improve your health outcomes when you need to take antibiotics.
Probiotics can not only help antibiotics be more effective at clearing an infection, but they can significantly reduce the incidence of undesirable side effects of antibiotics, most commonly diarrhea and gut dysbiosis.
In order to have the most beneficial effects with your antibiotic treatment, follow these simple steps to adding a probiotic:
- Start a high-quality probiotic as soon as you start antibiotics.
- Take the probiotics for about three to four weeks, and once your gut is doing well and you are not having gastrointestinal symptoms, keep on the probiotics for another month to allow your gut to get used to its new microbiome.
- After a month, you can decrease the dose to find your minimal effective dose for your optimal health outcomes.
We hope that this article helps you maintain a good gut balance and feel well during your course of antibiotic treatment and after.
If you have been struggling with the effects of taking antibiotics, especially if you have had repeated or long-term antibiotic treatment and would like individualized help, please contact our clinic.
References
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Why Diarrhoea Occurs And How Probiotics May Prevent It
Antibiotics disrupt the normal colonic microflora and consequently alter carbohydrate metabolism and antimicrobial activity in the colon, potentially leading to osmotic diarrhoea or diarrhoea caused by pathogenic bacteria . In the first case, reduced metabolism of fermentable carbohydrate leads to reduced short-chain fatty acids and increased nonabsorbable carbohydrate in the lumen of the gut. The increased osmotic pressure reduces water absorption from the gut, liquefying the stools . Secondly, the protective barrier provided by the normal intestinal microflora is disrupted and this leads to a reduction in the ability of the gut to resist colonization by pathogens. As a result opportunistic growth of pathogens occurs, for example C. difficile, Salmonella, Staphyloccus aureus, or Clostridium perfringens, and toxins result in mucosal damage and inflammation leading to diarrhoea. In addition to these effects, drugs which increase gut motility can exacerbate the situation and worsen or cause diarrhoea. Examples include the action of erythromycin and clavulanate /Co-Amoxiclav ) .
Probiotics And Diarrhea Reduction
Antibiotic-associated diarrhea is estimated to affect up to 30% of all patients who undergo antibiotic treatment and while its not a large concern in the majority of patients, it can have serious implications in some instances. Among hospitalized patients suffering from antibiotic-associated diarrhea, there is an increased risk of infections and higher mortality rate.
In this regard, the discovery and study of probiotics are having some wide-reaching positive implications.
Among the available medical and scientific literature, studies on probiotics showed a decrease in the incidence of antibiotic-associated diarrhea among study participants aged 0-65. This is partly why doctors from the University of North Carolina advise fellow doctors to suggest taking probiotics along with their patients antibiotics.
In a meta-analysis of the available literature in 2002 on probiotics and antibiotic-associated diarrhea, researchers came to the conclusion that the data suggests that probiotics are effective in the prevention of AAD. However, they were hesitant to make any concrete declarations as to the efficacy of probiotics in the treatment of diarrhea as a result of antibiotics at the timethings have changed since though.
A meta-analysis of randomized controlled trials of the effects of probiotics in children found that probiotics reduced the risk of antibiotic-associated diarrhea from 28.5% to 11.9%.
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Take Probiotics During And After Treatment
Taking antibiotics can alter the gut microbiota, which can lead to antibiotic-associated diarrhea, especially in children.
Fortunately, a number of studies have shown that taking probiotics, or live healthy bacteria, can reduce the risk of antibiotic-associated diarrhea .
One review of 23 studies including nearly 400 children found that taking probiotics at the same time as antibiotics could reduce the risk of diarrhea by more than 50% .
A larger review of 82 studies including over 11,000 people found similar results in adults, as well as children .
These studies showed that Lactobacilli and Saccharomyces probiotics were particularly effective.
However, given that probiotics are usually bacteria themselves, they can also be killed by antibiotics if taken together. Thus, it is important to take antibiotics and probiotics a few hours apart.
Probiotics should also be taken after a course of antibiotics in order to restore some of the healthy bacteria in the intestines that may have been killed.
One study showed that probiotics can restore the microbiota to its original state after a disruptive event, such as taking antibiotics .
If taking probiotics after antibiotics, it may be better to take one that contains a mixture of different species of probiotics, rather than just one.
Do Prebiotics Help Return The Gut Microbiome To Normal
Prebiotics are foods for probiotics and include fiber-rich foods such as fruits, vegetables, cereals.
Mixing prebiotics with probiotics, such as yogurt with fruit and cereal or sauerkraut with a vegetable stir fry could be helpful for your gut, although there is no scientific evidence to support this.
Good prebiotic foods include vegetables such as artichokes, asparagus, garlic, onions, and any green vegetable fruits such as bananas, berries, and tomatoes herbs such as chicory or garlic grains like barley, oat, and wheat and other fibers such as inulin that may be available on its own or added to foods such as granola bars, cereal, and yogurt.
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When To Take Antibiotics Before Or After Food
When you are given them, it usually clearly states whether you need to take antibiotics with food. Taking them correctly is key to their effectiveness. You should take them with water because this doesnt interfere with their effectiveness as some fruit juices do.
Some types will need to be taken with food to reduce the risk of side effects like nausea and vomiting. After all, antibiotics are potent medicines, so its not really surprising that they can irritate your digestive system too.
If youre going to take probiotics with antibiotics, it is best to take them a few hours apart so this medication doesn’t affect the probiotic bacteria too.
The Lack Of Consistency In The Findings On Probiotics Comes In Part Because They Are Being Treated Like Conventional Drugs
This opens the door to developing personalised probiotic treatments based on someones genetic profile. Such a system is realistic and could be developed relatively soon, says Elinav, but at this stage it remains a proof of concept. To become a reality, it will need more research on probiotic tailoring and testing more bacterial strains in larger groups of people.
This kind of personalisation may release the full potential of probiotic treatments for gut health. At the moment, the lack of consistency in the findings on probiotics comes in part because they are being treated like conventional drugs. When you take a paracetamol tablet, you can be more or less sure that the active component will do its job and work on receptors in your brain, dulling your sensation of pain. This is because most peoples pain receptors are similar enough to react in the same way to the drug.
But the microbiome is not just a receptor it is closer to an ecosystem, and sometimes likened to a rainforest in its complexity.
As a result, finding and tailoring a probiotic treatment that will work on something as intricate and individual as your own internal ecosystem is no easy task. And with that in mind, its not so surprising that a dried-out pack of bacteria from a supermarket shelf may well not do the trick.
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The Safety Implications Of Probiotic Use In Patients At Risk Of Antibiotic
Probiotic bacterial strains used in food products are generally regarded as safe in healthy populations, demonstrated by their extensive use over centuries, with few reported adverse consequences. However, by definition, healthy populations are not at risk of developing AAD, and so it is important to consider the risks of probiotic administration in the at risk group. Risk factors for AAD and CDAD include duration and type of antibiotic course, increasing age, severity of underlying illnesses, duration of hospital stay, presence of a nasogastric tube, and use of proton pump inhibitors . In short, the population at greatest risk is old, hospitalized patients treated with antibiotics.
Probiotic bacteria can cause infective episodes if they translocate from the gastrointestinal tract to extraintestinal sites, such as regional lymph nodes, spleen, liver, bloodstream, heart valves, or other tissues. Bacterial translocation is caused by a defective intestinal barrier, immunosuppression, or gut prematurity, and may result in bacteraemia, sepsis, and multiple organ failure . However, cases of probiotic administration leading to bacteraemia or fungaemia are rare. In 2003 an expert panel concluded that Current evidence suggests that the risk of infection with probiotic Lactobacilli or Bifidobacteria is similar to that of infection with commensal strains, and that consumption of such products presents a negligible risk to consumers, including immunocompromised hosts .
The Surprising Finding Was That The Group Who Received The Probiotic Had The Poorest Response In Terms Of Their Microbiome
As expected, a lot of major changes occurred in the function of the microbes many of which died because of the antibiotics, says Elinav.
The volunteers were divided into three groups. The first was a wait-and-see group, with no intervention after the antibiotics. The second group was given a common probiotic for a month. The third was given perhaps the least savoury option: a faecal transplant. This group had a small sample of their own stool taken before the antibiotic treatment returned to their colon once the treatment was over.
The surprising finding was that the group who received the probiotic had the poorest response in terms of their microbiome. They were the slowest group to return to a healthy gut. Even at the end of the study after five months of monitoring this group had not yet reached their pre-antibiotic gut health.
Probiotics won’t work exactly the same for everyone because gut biomes are different
We have found a potentially alarming adverse effect of probiotics, says Elinav.
The good news, incidentally, is that the group who received a faecal transplant did very well indeed. Within days, this group completely reconstituted their original microbiome.
So many people are taking antibiotics all over the world, says Elinav. We can aim to better understand this potentially very important adverse effect that we didnt realise existed.
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Morbidity And Mortality Are High
AAD is associated with several pathogens, including Clostridium difficile, Clostridium perfringens, Klebsiella oxytoca, and Staphylococcus aureus, and varies widely in severity. Pseudomembranous colitis secondary to C difficile is the main cause of AAD-related mortality, which more than doubled from 2002 to 2009.,C difficile infections cost the US health care system up to $1.3 billion annually. With such high rates of morbidity and mortality and high health care costs associated with AAD, even a small reduction in the number of cases would have a big impact.
Probiotics replenish the natural GI flora with nonpathogenic organisms. A 2006 meta-analysis of 31 randomized controlled trials assessing the efficacy of probiotics for both the prevention of AAD and treatment of C difficile found a pooled relative risk of 0.43 for AAD in the patients taking probiotics. However, many of the studies included in that meta-analysis were small. As a result, in 2010, the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America recommended against the use of probiotics for the prevention of primary C difficile infection, citing a lack of high-quality evidence.
How Do You Take Probiotics With Antibiotics
Have you ever been concerned that if you take probiotics while on antibiotics, it will just cancel out the probiotics?
Its a really common question that I get from my clients.
And frankly, your head is in the right place if you worry about this because we know that antibiotic exposure does decrease even good gut bacteria which can include the probiotics that you take.
The answer to this question is YES if you take antibiotics and probiotics too close together, the probiotics will essentially be canceled out.
So taking them together will not help .
The general recommendation is to take probiotic supplements 2-3 hours before or after a dose of antibiotics.
This timing rule also includes spore-based probiotics like Megasporebiotic.
The only exception to this rule would be S. boulardii .
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Which Probiotics Should You Take With Antibiotics
Your pharmacy probably has shelves filled with different bottles of probiotics. How do you choose the right probiotics to take with your antibiotics? Dr. Bryan Tran, cofounder of DrFormulas, recommends looking for probiotics that have the three Ds:
Dose: The amount of active micro-organisms in a probiotic is measured in colony-forming units, or CFUs. You want a dose with 10 billion CFUs or higher, Dr. Tran says. This dose may appear on the product label as 1 x 1010. And while you may see probiotics with 100 billion or more CFUs, according to Dr. Hoberman, you generally stop reaping added benefits after about 20 billion.
Diversity: The label on a bottle of probiotics will also tell you which bacteria strains the capsules contain. Look for probiotics that have five to 10 unique strains. Studies that compare single-strain probiotics to multi-strain probiotics have found that a variety of strains is more effective at reducing diarrhea, Dr. Tran says.
Delayed-release mechanism: Finally, look for probiotics that use delayed-release capsules. When you take probiotics orally, you expose them to your stomach acid and that reduces the effective dosage that makes it to the gut, Dr. Tran says. Probiotics with delayed-release mechanisms wont release the microorganisms until they go past the stomach.
How Badly Do Antibiotics Damage Our Gut Flora
There are around 100 trillion bacteria in our guts, so its impossible to know the precise composition of anyones microbiome before they start a course of antibiotics, or after they finish. But modern gut testing can give us a good idea.
Research has revealed that antibiotics have the potential to decimate our gut bacteria. That means that the round you took for your sinus infection could have cut your gut flora down to one tenth of its previous level. Not by one tenth, to one tenth: thats a 90 percent reduction .
The damage done appears to depend on a few factors.
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