Antibiotic Associated Diarrhea

Antibiotic associated diarrhea is becoming more common, and can occur as late as a year after the use of antibiotics.

Your intestines normally have lots of bacteria in your intestines, in fact, 10x as many as you have cells in your body! We call this mass of bacteria the “gut microflora” or “intestinal microbiome”. These bacteria serve an important function in your intestines. They interact with the lining of the intestines, and keep unhealthy, or disease causing bacteria, from multiplying and being absorbed into the body. They also produce folic acid and vitamin K, both necessary vitamins. These healthy bacteria can also ferment sugars and turn them into fatty acids which are then absorbed by the intestines and used by your body for energy.

If you have to take an antibiotic, or eat meat from animals that were treated with antibiotics, as animals are that are raised in commercial farming organizations, or CFO’s, your gut microflora may be reduced, and other bacteria may predominate and cause problems.

Clostridium difficile is a bacteria that lives in the environment as spores, and can be ingested by contamination from your hands to food you eat.

If you normal gut bacteria are reduced, they are not able to prevent these spores from germinating, and these bad bacteria multiply. The clostridium difficile bacteria produces a toxin that damages the colon lining, and causes diarrhea. It can also cause severe damage to the lining of the colon, called pseudomembranous colitis. This infection can cause prolonged diarrhea and profound weight loss. The colon can rupture due to this inflammation, and people have even died because of complications of this infection.

Treatment of clostridium difficile can be difficult, and prevention is key

Physicians try to avoid prescribing antibiotics unless needed. Antibiotics only work for bacterial infections, not for viral infections, and though symptoms can be similar, your doctor will talk to you and examine you to determine if your illness is caused by bacteria, and warrants antibiotics, or is viral, and needs different treatment.

You can also reduce your exposure to antibiotics by eating meats that come from farms that don’t use antibiotics while raising their animals.

If you have to take an antibiotic, you can help keep good bacteria in your intestines by eating foods that are prebiotic, and provide nutrition for beneficial bacteria, and take a probiotic or eat foods that contain probiotics.

Prebiotics foods are those that contain oligosaccharides, which are carbohydrates with a few sugar chains linked together. Their size is between monosaccharides (single chain sugars) and polysaccharides (many sugar chains). They act as food for certain kinds of bacteria, so allow these good intestinal bacterial to grow. Prebiotic foods include onions and their relatives, garlic, leeks, asparagus, legumes (beans and peas) chicory root, and Jerusalem artichokes. Inulin is found in the chicory root, and is an additive in the “Fiber One” line of foods. These foods are not digested as well in the small intestine, so arrive at the colon, where they, along with fiber, are a source of nutrition for beneficial bacteria, which then make some B vitamins and a substance called butyrate, which may help prevent certain cancers. Honey, red wine and maple syrup also contain prebiotics.

So it’s a good idea to include prebiotic foods in your diet regularly! If you have diarrhea, these foods can be hard to eat, so it’s a good idea to keep your colon bacteria in good health in advance!

Probiotics are beneficial bacteria and yeast that help keep the balance of bacteria toward “good bacteria”. When you are on an antibiotic, it is killing off good bacteria along with the bad bacteria it is treating. These good bacteria are from the group of bacteria called lactobacillus and Bifidobacterium, and can be taken as a supplement or by eating foods that contain these bacteria.

Probiotic foods are those that are fermented, as these bacteria are causing the fermentation. These include yogurt and kefir, which are both forms of fermented milk. Buttermilk and acidophilus milk (which has acidophilus bacteria added to ferment the lactose) also have lots of probiotic bacteria. You probably have heard that these can help digestion, and that you should take them when you are on antibiotics, to prevent diarrhea. These are pretty easy to digest if you don’t feel well, as generally they sit easily on your stomach. You can take these if you are lactose intolerant as the bacteria ferment the lactose (a sugar) so you don’t have to.

Other probiotic fermented foods are sauerkraut, kim chee (Korean fermented vegetables) sourdough bread, tempeh, and some soft cheese, including gouda cheese.

These are healthy foods (though watch the salt in sauerkraut and kim chee) and can be included in your regular diet to maintain good intestinal health.

You can also purchase probiotic pills, that have these healthy bacteria. They are available over the counter, at your pharmacy.

If you do have to take an antibiotic, it’s a good idea to either take probiotic pills or eat probiotic foods while you are on the antibiotic and for a couple weeks after as well.

If you eat meats that are from animals raised in concentrated farming operations, (any meats not indicated as organic or grass fed) you are likely being exposed to antibiotics, as these animals are treated with antibiotics as they otherwise get sick from being fed a heavy corn diet, and from being kept in close quarters with other animals. Thus, it’s a good idea to include prebiotic and probiotic foods in your diet regularly, as we are seeing clostridium difficile infections in persons who have not knowingly taken antibiotics.

If you are diagnosed with clostridium difficile diarrhea, or “c-diff”, your doctor will prescribe specific antibioitics to treat this. Be sure to take a probiotic, either as a pill or a probiotic food, while you are being treated. Continue it for a couple weeks afterward you complete the treatment to help your good gut microflora repopulate.

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