Most people will have completed a course of antibiotics at some point, and I’m no exception.
I recently had to take some for an infection in my thumb and a few days into the course, my gut responded badly.
My stomach, sensitive at the best of times, had me visiting the restroom multiple times a day, sometimes in the same hour.
I was curious to know if this is a universal experience, so I spoke with registered dietitian Avery Zenker.
“Different types of antibiotic medications influence the body and gut microbiome differently, and their impacts can vary depending on the individual,” Zenker explains.
“Some antibiotics cause minimal symptoms and changes to the gut microbiome, while others have significant impacts.”
Our expert says that antibiotics should always be taken under medical supervision. “As with any other circumstance, seek medical attention if you’re experiencing concerning or severe symptoms like fever, allergic reaction, blood in the stool, and severe or prolonged pain, vomiting, or diarrhea.”“You can also be proactive by seeking professional support to help maintain a healthy gut while taking antibiotics, even if you’re not experiencing any symptoms.”
So while my numerous bathroom trips weren’t unusual, someone else on the same drugs may not experience them, or I might not have if I had taken a different type.
My main worry was that the stomach upset would continue long after the antibiotics were over, or that my gut microbiome would be irreversibly damaged.
“Long-term gut disruptions after taking antibiotics don’t happen to everyone. Everyone has a unique gut microbiome, just like our fingerprints,” says Zenker.
“Individuals starting with a healthier gut microbiome are generally more likely to have a smoother outcome from antibiotic use,” she says.
I wondered whether I should take a probiotic supplement or change my diet in some way to improve my gut health.
“Taking probiotics doesn’t guarantee that the bacteria actually stay alive and thrive in the gut,” says Zenker.
“If you're young, healthy and taking a short course of narrow-spectrum antibiotics, probiotics may not provide significant benefits.”
“While probiotics can be helpful while on antibiotics, they’re not necessary. In some cases, it’s advised against.”
She had some other advice, however.
“The way you support your gut while taking antibiotics doesn’t have to be much different than how you would on any other day,” she says.
She adds that what you eat and how you care for your gut during and after antibiotics can meaningfully influence how well it recovers.
“All the food choices that we make impact our gut microbiome in some way. When you’re making food choices, you’re choosing which gut microbes will thrive and which ones won’t,” she says.
“During and after an antibiotic treatment can be a good time to focus on supporting a healthy microbiome since your gut may be particularly vulnerable to changes.”
Here’s how she recommends gently supporting your gut health while on antibiotics and beyond.
What to eat to support gut health
“Prioritize staying hydrated, eating a variety of whole fiber-rich foods, and including prebiotic foods,” she says.
“Limit foods that aren’t as great for your gut, like deep-fried foods, soda, sweets and alcohol. Excessive added sugar can impair healthy bacteria and promote unhelpful bacteria, especially when your gut is more vulnerable from antibiotic use.”
“Prebiotics (not to be confused with probiotics) are one of the many different categories of fiber,” says Zenker.
She explains that prebiotics are like food for the beneficial bacteria in the gut and feeding them well helps them thrive. When these beneficial bacteria are doing well, they create compounds that improve whole-body health.
Zenker says some good sources of prebiotics include:
- Oats
- Chia seeds
- Flaxseeds
- Raw garlic
- Bananas (especially unripe)
- Apples
- Legumes, like beans and lentils
- Cooked and cooled starches like potatoes
“If you normally don’t eat very much fiber, don’t suddenly skyrocket your fiber intake, since this can cause digestive discomfort. Start small and increase your fiber intake slowly.”
What to eat to soothe your symptoms
Zenker tells Fit&Well that while the advice above is good for gut health in general, if you are experiencing adverse digestive symptoms on antibiotics, there are steps you can take to help.
“You might feel better by avoiding spicy foods, greasy or oily foods, highly acidic foods, carbonated beverages and caffeine,” she says. “Alcohol in particular can worsen symptoms like nausea and vomiting.”
“If you’re feeling unwell, you may choose to focus on bland foods like rice, potatoes, broth-based soup, oatmeal, steamed vegetables and bananas. Soluble fiber can be particularly helpful at preventing diarrhea, and can be found in foods like oats, chia seeds, legumes and apples.”
She suggests that you can try consuming foods reported to soothe digestive symptoms, like ginger or peppermint, often taken as a herbal tea.
“Taking your antibiotics along with food, as well as having small, frequent meals, can also help,” she adds.
Some foods may interact with your medication, so check with your doctor before you start the antibiotics whether there is anything you need to avoid.
