Intestine: What to take after antibiotic treatment?

Probiotics, traditionally prescribed after taking antibiotics, would not be the best option.

Researchers have evaluated three types of care designed to restore our biological balance following antibiotic treatment: probiotics, fecal transplantation and fiber consumption. It seems that the third option is preferable to the other two.

Antibiotics kill the harmful bacteria that cause disease, but also cause collateral damage to the microbiome, the community of bacteria that lives in our intestines. This results in a deep, though usually temporary, depletion of beneficial bacteria.

Bacterial strains

The classic strategy for reducing this disturbance is to take a probiotic supplement containing live bacteria during or after antibiotic treatment. The logic is simple: the beneficial bacteria in the gut are damaged by antibiotics, so why not replace them with the "beneficial" bacterial strains of probiotics to help the intestinal bacteria regain their balance?

This hypothesis has been questioned by a recent study. Participants took antibiotics and were divided into two groups: the first group received a probiotic preparation with 11 strains for four weeks; the second received a placebo.

A complex system

The researchers found that the damage caused by antibiotics to the intestinal bacteria of people in the first group allowed the probiotic strains to colonize the intestine effectively. But this colonization delayed the normal recovery of the microbiota, which remained disturbed throughout the six-month study period. In contrast, the microbiota in the second group returned to normal within three weeks of antibiotic administration. This research reveals a surprising truth: we still do not know what types of bacteria are really beneficial, or even what constitutes a healthy microbiome.

In addition, it is unlikely that individual bacterial strains are particularly useful. It is rather the thousands of microbes working together that could be beneficial for health. This means that the addition of one or even 11 strains of bacteria in a probiotic has no impact on the balance of this complex system.

Fuel for bacterial fermentation

The study also explored an alternative approach to microbiome restoration. A group of participants had their own stool removed and frozen before antibiotic therapy. They were then reintroduced into their gut at the end of antibiotic therapy. This treatment, known as fecal transplantation, restored the microbiome to its original level after just eight days. The other group took 21 days to recover. This approach therefore effectively restores the gut microbiome following antibiotic treatment, but these patients nevertheless remain at risk of serious complications, such as an infection of the bloodstream.

Fibers are a third alternative. Fibrous compounds pass undigested by the small intestine and enter the colon, where they act as fuel for bacterial fermentation. So, if you are taking antibiotics or have recently completed treatment, be sure to eat plenty of vegetables, fruits, and whole grains. Your intestinal bacteria will be grateful to you.

Video: 5 tips to keep your gut microbiome healthy. UCLA Health Newsroom (December 2019).