Antibiotics are important for treating bacterial infections, but they can also temporarily alter the gut microbiome. Nutritionist Rashi Chowdhary has shared simple ways to support digestive health while completing an antibiotic course.
Antibiotics can be essential when prescribed for bacterial infections, but their effects are not always limited to the harmful bacteria causing illness. These medicines can also reduce some beneficial bacteria in the gut, potentially leading to temporary changes in the digestive system.
Some people may experience loose stools, bloating, abdominal discomfort or other digestive changes while taking antibiotics or shortly afterwards. This is why paying attention to gut health during treatment, rather than only after completing the course, may be useful.
Nutritionist Rashi Chowdhary recently addressed the issue in an Instagram video, offering suggestions on how people can support their gut microbiome while taking antibiotics. She also emphasised that antibiotics should not be viewed negatively when they are genuinely needed.
“Sometimes you really need them, so stop feeling guilty about it,” Chowdhary said, highlighting the importance of using antibiotics appropriately rather than avoiding them out of concern about their effect on gut bacteria.
Why antibiotics can affect gut health
The digestive tract contains a complex community of microorganisms collectively known as the gut microbiome. These bacteria and other microorganisms have roles in digestion, metabolism and interactions with the immune system.
Antibiotics work by targeting bacteria responsible for infections. However, depending on the antibiotic and the individual, they can also affect parts of the normal bacterial community in the gut.
This temporary disruption can contribute to digestive symptoms in some people. The extent and duration of these changes vary depending on factors such as the type of antibiotic, treatment duration, individual health and existing gut microbiome.
For this reason, gut-supportive measures can be considered alongside prescribed treatment.
1. Consider probiotics during the course
One of Chowdhary’s suggestions is to discuss probiotics while an antibiotic course is still underway instead of automatically waiting until the medication has been completed.
Probiotics contain live microorganisms that are intended to provide health benefits when consumed in adequate amounts. However, different probiotic strains have different properties, and evidence for preventing or managing antibiotic-associated digestive problems varies between products and strains.
Chowdhary mentions Saccharomyces boulardii, a probiotic yeast, as one option. Because it is a yeast rather than a bacterium, it is not affected by antibacterial medicines in the same way that bacterial probiotics can be.
She also mentions combinations involving Lactobacillus rhamnosus and Bifidobacterium, which have been studied in connection with antibiotic-associated gastrointestinal problems.
Another category she highlights is spore-based probiotics, which are designed to withstand conditions in the digestive tract.
However, probiotic supplements are not suitable for everyone. People with certain medical conditions or weakened immunity, for example, may need specific medical advice before using them.
2. Keep a gap between antibiotics and probiotics
Chowdhary suggests separating probiotic supplements from antibiotic doses, mentioning a gap of around two to three hours.
The reasoning is that some antibiotics may affect bacterial probiotic strains if they are taken simultaneously. However, the appropriate timing depends on the specific antibiotic and probiotic being used.
Therefore, anyone considering a probiotic should check the product instructions and speak to a doctor or pharmacist about the most appropriate timing.
Most importantly, probiotics should not be considered a replacement for prescribed antibiotics.
3. Add fermented foods gradually
Fermented foods can also be included as part of a varied diet.
Foods such as kimchi, sauerkraut and kombucha are examples of fermented products that may contain live microorganisms or fermentation-derived compounds.
However, Chowdhary advises against suddenly consuming large quantities of several fermented foods at once, particularly when the digestive system is already sensitive during an antibiotic course.
A gradual approach may be more comfortable for people who experience bloating or other digestive symptoms.
Fermented foods should also complement, rather than replace, a balanced diet containing adequate protein, fibre, fruits, vegetables and whole grains.
4. Do not overlook everyday habits
Gut health is not determined by supplements and fermented foods alone. Chowdhary also stresses the importance of basic lifestyle habits during recovery.
Adequate sleep can support overall recovery, while managing stress may help maintain general wellbeing. Regular physical activity, when a person’s health permits it, is another important part of maintaining a healthy lifestyle.
Getting adequate daylight or spending some time outdoors can also support general wellbeing and healthy routines.
These measures may appear simple, but maintaining regular sleep, activity, nutrition and stress-management habits can be particularly helpful when the body is recovering from an infection.
Should everyone take probiotics with antibiotics?
Not necessarily. Probiotics are not universally required whenever someone takes antibiotics.
The type of antibiotic, the person’s health, previous digestive problems and the reason for treatment all matter when deciding whether a probiotic is appropriate.
Some probiotic strains have been studied for reducing the likelihood of antibiotic-associated diarrhoea, but benefits are strain-specific and are not guaranteed with every commercial product.
Therefore, people should not assume that every probiotic supplement will provide the same benefit.
A doctor or pharmacist can help determine whether a probiotic is appropriate and, if so, which type and timing may be suitable.
Never stop antibiotics without medical advice
Perhaps the most important point is that concerns about gut health should never lead someone to discontinue prescribed antibiotics.
Antibiotics are intended to treat bacterial infections, and stopping treatment or changing the dosage without medical advice can interfere with treatment and may contribute to antibiotic resistance.
They should also not be used for viral infections such as most common colds and uncomplicated viral illnesses unless a healthcare professional has identified a bacterial infection requiring antibiotic treatment.
Patients should take prescribed antibiotics according to their doctor’s instructions and ask their healthcare provider if they experience significant side effects.
A balanced approach to gut care
Supporting the gut during antibiotic treatment does not require an elaborate diet or a large number of supplements.
A balanced diet, adequate hydration, sufficient sleep and appropriate physical activity can form the foundation of recovery. Fermented foods can be introduced gradually if they are well tolerated, while probiotic supplements can be discussed with a healthcare professional when appropriate.
The key is to treat the infection effectively while recognising that antibiotics can temporarily influence the gut microbiome.
If diarrhoea is severe or persistent, or if there is blood in the stool, significant abdominal pain, fever, dehydration or other concerning symptoms during or after antibiotic treatment, medical attention should be sought promptly.
Ultimately, antibiotics should be used when medically indicated, without unnecessary guilt or fear. At the same time, taking simple steps to maintain overall digestive and general health can help make the treatment period more comfortable.