Save my gut flora.

January 17, 2013 10:02 AM

I'm about to bomb my body with a double dose of powerful, wide spectrum antibiotics. What can I really do to help save/repopulate my gut flora?

I'm reading that yogurt doesn't actually repopulate flora (not that I can eat it for several days, anyway). Is there anything I can do to help my GI system survive the antibiotics, that is backed by research?

posted by moira to Health & Fitness (19 answers total)

Perhaps the fecal transplants covered in today's NYT? It sounds precisely up your, er, alley.
posted by Admiral Haddock at 10:06 AM on January 17, 2013 [4 favorites]

My wife drinks Kefir (specifically Tibicos) for digestive health.
posted by wongcorgi at 10:53 AM on January 17, 2013

Best answer: This sounds like a good thing to talk to your doctor about.

I know my doctor used to recommend yoghurt and now recommends probiotics. There is some research suggesting that probiotics reduce GI symptoms while taking antibiotics (one example), although it is possible that the improved GI health is for reasons other than replenishment of the natural flora.

Anecdotally, of the probiotics I've tried, the cheap ones did nothing and the higher-bacterial-count, more-species variety (still the store brand, but more expensive) has been helpful. (Of course, there's also evidence that more expensive placebos are more effective than cheap placebos. YMMV.)

Also, fun fact: Many supplements and foods marketed as probiotics/prebiotics (including some of the stomach-regulating-yoghurts) actually work primarily by added fiber, which is effective but not for the reasons advertised. I personally shop by bacterial count, not by advertising claims.
posted by pie ninja at 10:58 AM on January 17, 2013 [2 favorites]

Best answer: Fecal transplants are only used for otherwise untreatable C. difficile infections. That is not the situation here.

You might look into adding foods with inulin into your diet. (That's the added fiber pie ninja is talking about.)

Also, reading your link, I'm not sure that what that researcher was talking about was specifically applicable to your situation either. Those folks in the study had not just taken a broad-spectrum antibiotic, so they presumably had robust gut flora that the yogurt strains couldn't compete with. That's not necessarily the case for you.

Previously (includes Science!)
Previously
posted by purpleclover at 11:04 AM on January 17, 2013

Response by poster: Thanks. I'll start with standard probiotics and move on to the heavier-duty stuff if I have problems.
posted by moira at 11:38 AM on January 17, 2013

Fecal transplants are only used for otherwise untreatable C. difficile infections.

This is incorrect; that just happens to be what that one study reported today was looking at. Fecal transplants have been investigated--and seem very promising--in the treatment of a range of intestinal problems. You might find it difficult to find a doctor willing to go down this route for restoring your intestinal biota unless you do suffer from some kind of intestinal problem but it might be worth talking to your doctor about the possibility of saving a stool sample in case of future problems.
posted by yoink at 11:56 AM on January 17, 2013 [1 favorite]

Response by poster: (Foods as well, thanks for the links.)
posted by moira at 12:00 PM on January 17, 2013

Back in the old timey times(1960's) a wise old Dr. in our town told my folks to give me either buttermilk or warm beer after I had a major run of antibiotics. My folks were cool and let me sip on warm beer. Must have worked cause I don't remember having any trouble otherwise.
posted by PJMoore at 12:15 PM on January 17, 2013

look closely at the labels on the probiotic yougurt...often the different brands have different cultures...try them all.

also...pick up a bunch of breath mints/gum, particularly fruity flavors...most antibiotics will leave you with a mouth that tastes like a copper mine took a dump. it'll help with the inevitable nausea...
posted by sexyrobot at 12:58 PM on January 17, 2013

Yoink: Yes, I am aware that there is a long history of using fecal transplants to resolve persistent diarrhea and there is hope that it could help those with ulcerative colitis and Crohn's and such. At the same time, I think it's irrelevant to the OP, as I find it highly unlikely that a random doctor would consider such a thing prospectively. Furthermore, bringing it up might make her sound like a crackpot. So there's that.

Really, ask your doctor for advice, OP.
posted by purpleclover at 3:08 PM on January 17, 2013 [1 favorite]

Furthermore, bringing it up might make her sound like a crackpot.

There is an explosion in recent research on the deleterious (and remarkably long-lasting) effects of antibiotics, especially in terms of their effects on the flora of the gut. If your doctor thought you were a crackpot for simply inquiring about this then you need a better (and better informed) doctor.
posted by yoink at 3:45 PM on January 17, 2013

Best answer: Along with kefir and yogurt, other fermented foods such as: kombucha, kimchee, apple cider vinegar (get the raw, unpasteurized kind that includes the Mother), sauerkraut, miso (the real stuff that is alive and requires refrigeration), etc. can help repopulate the gut.
posted by fancyoats at 4:14 PM on January 17, 2013

Best answer: Ha, yes, I am in the throes of post-antibiotic colon I'll just not go into it, and am going to the doc tomorrow for that very reason. Of course you should ask your own doc, but if your curious and I forget to stop back in the thread, memail me.

I have been taking acidophillus like mad and it hasn't helped; hence, to the doc.

Thanks, but fuck you, antibiotics.
posted by angrycat at 5:12 PM on January 17, 2013

If you're looking for a way to measure this, you might want to check out uBiome, a project that lets you sequence your gut bacteria over time.
posted by carolinaherrera at 5:22 PM on January 17, 2013 [1 favorite]

Take probiotics with a prebiotic colustrum powder. Avoid sugars and alcohol.

You could also consider following an anti candida diet for a few weeks during & post antibiotics course.

drink plenty of water to flush your system.
posted by Under the Sea at 1:11 AM on January 18, 2013

Talk to your doctor about this. Some foods (probably not probiotics) can interfere with antibiotics. If a doctor prescribing powerful antibiotics doesn't have advice about re-populating gut flora, you may want a 2nd opinion.
posted by theora55 at 7:15 AM on January 18, 2013

Best answer: So, doc was all, try Align and we will test your poop. I feel that I should send my poop tester a vanilla candle. Man.
posted by angrycat at 9:55 AM on January 18, 2013

Oh, also my doc didn't know about the poop transplants and when I mentioned it she gave me a looooong side look.
posted by angrycat at 9:57 AM on January 18, 2013

Fecal transplants are very unusual and not considered part of the standard of care right now. I see a lot of people with recurrent C diff coming through the ER and I had never heard of the transplants until I read this article a few months back (note that the doc who wrote it hadn't heard of it either until he was doing some research for a sick family member with C diff).... anyway don't be hard on your docs if they don't know about this, is my point - it may be a great story for a news article but it is not all over the medical literature as yet (and certainly not for patients who are just taking antibiotics for some routine reason and are just worried about the potential for side effects!!).
posted by treehorn+bunny at 11:25 AM on January 18, 2013 [1 favorite]