Would-be intestinal bacteria snob seeks counsel

January 27, 2008 12:13 AM

So, thanks to the doctor, I'm on some weapons-grade antibiotics, and it looks like all the friendly symbiotic bacteria in my tract are going to be/may already have been destroyed. I guess this is sort of an opportunity, so I'm wondering, anyone have any recommendations for what to repopulate my intestines with?

I know there are yogurts that advertise what gut flora and fauna they provide, and some probiotic milks, too. I've seen something called acidophilus advertised.

I read about one yogurt that has some kind of awesome Romanian strain of bacteria a few years back, but now I can't remember what it was!

I guess it's probably futile and I'll just end up with the bacteria from my first post-antibiotic meal dominating my guts, but I'm kind of a nerd, and I feel like I should try to take charge of what I repopulate my digestive tract with, since I have the opportunity. Any and all interesting ideas are welcome!

posted by evariste to health & fitness (25 answers total)

I always use L. acidophilus concurrently with any antibiotic regimen. It works quite well to help repopulate the "friendly flora." Lots of people like to eat it in yogurt, but I just use capsules or pills, obtainable at Trader Joe's as well as many drug stores.
posted by Lynsey at 12:44 AM on January 27, 2008

Well I would definitely start the first post-antibiotic meal with yogurt. Activia advertises itself as containing "Bifidus Regularis™, a natural probiotic culture that can help regulate your digestive system by helping reduce long intestinal transit time." It might be bullshit, though. My advice is to go to your local grocery store and find the yogurt with the most cultures- but make sure they are 'live and active' cultures, otherwise they will be of no use to your barren gut. Best of luck!
posted by farishta at 12:47 AM on January 27, 2008

Well, this is actually kind of an interesting and open question. No one really has a clear picture of how the composition of our gut bacteria changes over time and in response to different environmental factors. (In fact, the NIH just funded a Human Microbiome Project that will help to answer questions like this).

The best data at the moment, though, shows that most humans have fairly similar and stable populations of microbes down there. One recent study done on the colonization of the gut in infants (who start out with a clean slate) show that initial conditions can be quite different, but that over time, the population of the gut reaches a steady state which is quite similar between humans.

This isn't all that surprising when you consider that each of us is constantly ingesting all kinds of bacteria from the environment. These come from your food, from touching your hands to your mouth, and even from things floating around in the air. There's also probably some colonization from the other end, but some people prefer not to think about that. :)

What this means for you is that your assumption of futility is probably right, at least in the long run. In the short term, though, seeding yourself with lactobacillus and acidophilus from yogurt probably isn't a bad idea. There's some evidence that these help promote healthy digestion, and during the period when your gut is in flux, it's probably better to give these "good" bacteria the advantage, rather than having some other less desirable bacteria take advantage of all that empty space.

While they do sell probiotic supplements at many health food stores, but personally, I wouldn't bother. I'd just make sure to eat a few cups of yogurt in the first few days, and then let nature take it's course.
posted by chrisamiller at 12:53 AM on January 27, 2008

Dannon is just now being sued over its probiotic marketing claims. How much merit that has, I have no idea, maybe someone else can chime in.

This article goes to some lengths to talk about probiotics.

I usually get some Yakult knock-off brand at a local Mexican grocery. They're cheap, like less than a dollar for a shrink-wrapped pack of six or eight, and they do the trick for me.
posted by gimonca at 12:59 AM on January 27, 2008

It really sucks when you have nothing to digest with, you'll be very sick for a while. The doc told me about some sort of diet that had 3 or 4 foods that I should eat after I had to snack some wicked antibiotics. I cannot remember what it was.

Something about yogurt, rice... and apple sauce??

Don't eat steak. It will come out the way it came in.
posted by idiotfactory at 1:00 AM on January 27, 2008

The doc told me about some sort of diet that had 3 or 4 foods that I should eat after I had to snack some wicked antibiotics. I cannot remember what it was.

It was probably the BRAT diet. (Bananas, Rice, Applesauce, and Toast) It's often recommended for people (esp. children) with GI problems.
posted by chrisamiller at 1:17 AM on January 27, 2008

I am currently taking antibiotics (minocin) full time, all of the time. My doctor has me on this concurrently.

At the very least, I know they work because they keep the yeast infections away. If I ever miss taking these tablets at night, odds are I've got one. Sorry if you're male and that doesn't help you at all, or if yeast infections are not a side affect of your particular antibiotic.

I take it regularly, and everything's been great. If you start taking a similar supplement to replenish the good bacteria in your system, just a reminder to make sure you don't take it with tap water or too soon after/before the antibiotics.
posted by Squee at 1:23 AM on January 27, 2008

Eat your yogurt (filled with live and active cultures) and avoid your veggies. No, really. When I'm on antibiotics, a salad is quite positively the worst, most painful thing there is to digest.
posted by wallaby at 3:22 AM on January 27, 2008

Was wandering, shouldn't your intestines should get the bacteria it needs back naturally?

But i guess you need to get the good bacteria back into you while on anti-biotics. probably go for the yogurt, and simple carbohydrates. Unfortunately, you probably need to go for more processed foods, to help your digestion and reduce the chance of getting 'bad' bacteria.

Probably something you should talk to you doctor about.
posted by cofie at 3:43 AM on January 27, 2008

I read recently that this might be the precise reason your appendix exists. When the digestive tract has been knocked back to a clean slate, the appendix helps repopulate it from it's stores.

Read: Appendix -- Maintaining Gut Flora, Wikipedia for more.
posted by Static Vagabond at 6:41 AM on January 27, 2008

yogurt, soft cheese, acidophilus milk, refined carbs. not a cure-all, but it'll help.
posted by thinkingwoman at 6:43 AM on January 27, 2008

If you do go the rout of probiotic supplements make sure you get some with several strains of bacteria in it. There are worlds living in your guts and they aren't populated by just L. acidophilous.
posted by munchingzombie at 7:29 AM on January 27, 2008

My docs have suggested to me I take acidophilus supplements to control my yeast infections. The ones I get in the drugstore all see to have several strains of bacteria in them. For the most part - they work.

Here's the important part- read the container, and if it says to keep them refrigerated after opening (even if it's really tiny print!) - do it! I googled around and read somewhere that unrefrigerated, up to 5-6% of the bacteria die per day. Assuming they're not all alive when you actually take them home (all the ones I've read say 'X billion cells at time of manufacture', so I'm guessing that means some die off between they time they're manufactured and the time they get to you.) I realized that by the end of first month, I was essentially take a bunch of (unrefrigerated) dead bacteria that, obviously, weren't doing a lot of anything.
posted by cgg at 7:59 AM on January 27, 2008

One recent study done on the colonization of the gut in infants (who start out with a clean slate) show that initial conditions can be quite different...

The ideal solution to this problem may require a society which does not exist and maybe ought not to, but you would probably be well served if you could find a nursing mother with a little milk to spare. Drinking it from a glass would be good because of the growth factors, but taking it directly from the breast would be best because you would then also be inoculated with bacteria from the mother's skin. You would probably need to take a stomach acid supressant such as Prilosec at the same time to give the bacteria a chance of getting through alive to your intestines.
posted by jamjam at 8:18 AM on January 27, 2008 [1 favorite]

I had chronic salmonella and had to nuke my system with Cipro. Fun. Anyway, I used both pro and prebiotics. The research with probiotics is mixed. From what I've read, it does help, but it doesn't usually colonize your system permanently. Think of your digestive tract as having some extremely xenophobic denizens. They aren't selling land for newcomers, even if they are weakened. Prebiotics encourage a good environment for the residents. Some I used included miso, oats, and kefir with inulin. Two of those, miso and kefir, are also probiotics, so that kills two birds with one stone.
posted by melissam at 8:45 AM on January 27, 2008

Kefir is what I drink when my tummy gets toasted by antibiotics. It has all the probiotic stuff and keeps the toilet time after an antibiotic course to a minimum. I like the Lifeway stuff, they have tons of flavors and I still remember seeing their original plant on Wild Chicago so it has a special place in my heart. :)
posted by @homer at 9:45 AM on January 27, 2008

Go down to the health food store and buy some raw kombucha. It's fermented tea (non-alcoholic) with live cultures still inside it. It's said to have a slew of health benefits, which I am not entirely sure of, but it is loaded with live, probiotic bacteria. Some people hate the taste, others love it. I think it's a bit like apple cider vinegar crossed with non-alcoholic beer. It's pretty sweet, so it's a bit like a sour candy as well. I suggest you avoid ginger flavored ones, as the ginger will make the taste too intense, as you have the sour flavor plus the burn from the ginger.
posted by mccarty.tim at 9:53 AM on January 27, 2008

I went through the same thing with anti-biotics.

At the local vitamin/supplement store (GNC, Vitamin Shoppe), they should have 'biotic' supplements with several of the common stomach and intestine bacteria. The one I used had 8 different 'live organisms' is the mix, more than just the acidophilus.

I took those and ate a yogurt once a day for about 2 weeks. Seems to all be back in order now.

Good luck.
posted by Argyle at 9:56 AM on January 27, 2008

You will actually be re-colonized by bacteria from people near you, disgusting as that sounds. I suppose you could try to spend time near people who you know have good digestion.

There have been experiments with treating some bowel illnesses by knocking out the patient's gut flora with antibiotics and then feeding them pureed feces from healthy people. It works. Bleah.
posted by hattifattener at 10:45 AM on January 27, 2008

Recent studies suggest that the type of intestinal flora you have may contribute to/mitigate against obesity. So, if what hattifattener says is true about being re-colonized by the bacteria of people around you, you might wanna hang out with the ectomorphs for the next little while.
posted by mumkin at 11:24 AM on January 27, 2008 [1 favorite]

You would probably be well served if you could find a nursing mother with a little milk to spare

I think you're interpreting the infant colonization study the wrong way. Breast milk doesn't appear to be a strong factor in encouraging any particular type of bacteria. This can clearly be seen in the paper, where they state that the children's microbial population fluctuates wildly during the first few months.

If you understand population ecology, you'll understand that this is because one or more strains of bacteria find their way into the gut (by chance) and then take advantage of the lack of competition to undergo exponential growth. As more types of bacteria get introduced, the competition and interplay between them gets more complex, until eventually, a more or less steady state is reached. It's only several months into life that the children really settle down and develop stable populations.
posted by chrisamiller at 11:37 AM on January 27, 2008

Some feel that probiotics should be used during not just after antibiotics. Take your choice of probiotic ,(good and better suggestions above), in between your doses of antibiotics. The theroy is that you can avoid getting complety out of wack by continually reintroducing good bacteria.
posted by flummox at 6:27 PM on January 27, 2008

Kimchi (like the other fermented foods kombucha and kefir) is another probiotic food.

That said, due to a recent non-antibiotic related "situation" in that "area" (euphemisms are really for the best here) besides yogurt and a little raw milk cheese, I'm also taking this, of which my doc (board certified in family practice and holistic medicine) said "That's a good one."

IANAD, this is not medical advice.
posted by jocelmeow at 12:43 PM on January 28, 2008

Thanks, everyone!
posted by evariste at 9:21 PM on January 30, 2008

I am a bit wary of both kombucha and Primal Defense, as they both seem bit too exotic.
I've been undergoing a doctor-supervised dietary modification routine to help determine what foods I'm sensitive to so I can avoid them. Several things are usually going on at once, but I am pretty sure that store-bought kombucha (two different brands) causes a negative reaction for me. My doctor (an osteopath, aka D.O.) agrees and recommends sticking to proven probiotics like L.Acidophilus and friends.

http://ask.metafilter.com/tags/kombucha

http://www.metafilter.com/tags/kombucha

posted by markhu at 6:00 PM on June 25, 2008