What is an antibiotic?
Antibiotics eradicate pathogenic infections and save lives; they also disrupt the integrity of the intestinal microbiome. Many physicians recognise the need for restoring a patient's microbial balance following a course of antibiotic therapy, far fewer understand how to do this effectively.
What is the dose and timing that determine the impact, after antibiotics?
As antibiotics kill off infection-causing micro-organisms, they also non-selectively destroy communities of beneficial gut bacteria, weakening the stability of the intestinal microbiome.
The degree to which these drugs damage intestinal microbiota depends on drug type, treatment duration, and frequency of use. Certain antibiotics trigger a greater release of endotoxins and cytokines than others. Higher daily doses prove to be more impactful. Prolonged use of high-dose antibiotics can cause extreme damage to the microbiome that can take years of restorative therapy to reverse. Intravenous antibiotics can have the same negative impact on gut flora as oral drugs.
How can you restore the Flora?
Probiotics are a comprehensive strategy to restore gut flora following antibiotics. Looking at the microbial diversity of a healthy gut ecosystem, and when using products that contain many different species of beneficial microbes rather than "mono-cropping" with one or two single strains.
It’s recommended to use one month of probiotic treatment for every week that a patient was on antibiotics. Those who have been on prolonged continuous antibiotic regimens will need long-term restoration. Patients receiving IV antibiotics should also take commensal probiotics.
How do you rebuild the Glycocalyx?
People who have been on long-term or multiple courses of antibiotics typically show a severe erosion of the glycocalyx (glycoprotein covering that surrounds the cell membranes of some bacteria, epithelia and other cells) that normally coats the intestinal microvilli.
Without a healthy glycocalyx, organisms like Lactobacilli and Bifidobacilli have great difficulty establishing themselves. Supplementation with ordinary probiotics will usually fail.
To restore a healthier microenvironment, you need to leverage the unique characteristics of Saccharomyces boulardii, an antibiotic-resistant, probiotic yeast originally isolated from lychee fruit in Indochina. It stimulates brush border enzymes and promotes polyamine production, which feeds the intestinal microvilli and can be helpful for healing ulcerative colitis, Crohn’s disease and irritable bowel syndrome.
What are the side effects?
It is important to be aware that in the first few days of taking S. boulardii, some patients may experience a noticeable "bowel flush" as the probiotic yeast displaces the Candida species. Candida die-off can also make people feel ill.
In 9 out of 10 patients, four weeks of intensive S. boulardii supplementation is sufficient to restore a healthy glycocalyx layer and induce adequate IgA secretion. This then sets the stage for a much more effective round of restoration with a multi-strain probiotic.
What is a Comprehensive Approach?
Probiotics are just one part of the picture. If a patient cannot tolerate any probiotic, it’s a red flag that a patient's immune system is not functioning properly.
Fish oil, zinc, vitamin A, and colostrum are to be of value in many cases. This is really good for restoring SIgA. Glutamine supplements can also be helpful in some cases.
Plant-based medicines like oregano oil, tea tree oil, or pau d'arco extract may be helpful in ridding the GI tract of pathogenic yeast. These natural yeast-busters should never be used at the same time as S. boulardii; this "friendly" yeast is just as vulnerable to things like oregano and tea tree as the pathogenic yeasts.
Many probiotic and prebiotic foods can aid the process of gut restoration.
When your gut has been compromised, you don’t want to tax your gut. "Taxing" foods include wheat, dairy, sugar, unhealthy fats and fried items. These foods, throw gasoline on the fire of a recovering intestinal system.
One should eat plenty of foods that promote the growth of healthy commensal organisms . Organic stewed apples, cooked until soft and shimmery, as one good option. Cooking apples release pectin - a soluble fibre that provides fuel for beneficial bacteria.
What foods will help restore the bacteria in the gut?
Prebiotic fruits and vegetables, including foods bananas, sweet potatoes help to rebuild the gut microbiome, providing insoluble fibre that feeds good, but not harmful, bacteria.
Fermented, unpasteurised vegetables like sauerkraut, kimchi, and fermented beets, are another excellent source of natural probiotics. Every vegetable produces different families of beneficial bacteria during fermentation, encouraging patients to eat one forkful of fermented vegetables twice a day. The key to health in your gut is the diversity of your microbiome, pointing out that thousands of different families of bacteria live and interplay in the gut with a wide-ranging impact on our health.