Antibiotics vs probiotics: how to protect your gut flora

Posted on 5 July 2018

The specific bacterial species found in your gut, skin, and mouth (collectively termed your microbiome) are as unique as your fingerprint, says Ilsabé Spoelstra, a dietician at Mediclinic Bloemfontein. Every human is teeming with billions of microorganisms, and most are very good for your health.

When we say that every person is unique, few of us are referring to each individual’s particular combination of gut flora.

All about balance

The balance of good to bad bacteria (those that make you unwell) in your microbiome plays a crucial role in your health. A healthy microbiome helps your body absorb nutrients, regulate your immune system, balance blood sugar and, according to research, even affects your emotions.

Prescribed to treat bacterial infections by killing bacteria, antibiotics save thousands of lives every year. However, these medications cannot differentiate between harmful and beneficial bacteria. As a result, they indiscriminately damage all your bacteria.

“Depending on the initial health of your gut microbiota, the frequency of antibiotic use, your diet and your environment, it can take anything from a week to several years for intestinal microbiota to fully recover,” Spoelstra explains.

A damaged gut microbiome can reduce immune function, inhibit digestion and absorption, and lead to serious conditions such as colon cancer, diabetes, obesity, depression and inflammatory bowel diseases (including Crohn’s disease and ulcerative colitis),” she adds.

The full impact of antibiotics on the microbiome is not yet fully understood, but it is clear is that a damaged gut microbiome is detrimental. What should we be doing to protect our beneficial bacteria?

1. Minimise use of antibiotics

“We often start a course of antibiotics for the slightest sniffle. This does more harm than good for your body,” Spoelstra warns. “Antibiotics are only effective for bacterial infections and won’t cure viral or other infections. Using antibiotics too often is a common mistake.”

The detrimental effects may not be immediately apparent, she adds, meaning people often don’t associate the impact on their health with the initial cause (antibiotics).

2. Take probiotic supplements

Most of us will find that at some point in our lives a course of antibiotics is warranted and unavoidable. Available over the counter, probiotic supplements offer your body strains of good bacteria, helping to re-establish and support your microbiome.

Not all microbiota can be cultivated, and therefore probiotics can’t undo all of the damage caused, but they are a valuable aid in rebalancing your microbiome.

Probiotics should be taken for one to two months once a full course of antibiotics is completed, advises Spoelstra.

“In time, as the gut microbiome is better understood, we may be able to develop and prescribe specific strains and strengths of probiotics in response to symptoms or specific conditions,” adds Gayle Landau, a dietician at Wits Donald Gordon Medical Centre.

3. The right diet: your gut is a farm in need of fertiliser

A diet rich in prebiotics – non-digestible fibre in food or supplements – provides the food healthy bacteria need to grow.

Examples of probiotics include raw:

  • Chicory root
  • Jerusalem artichoke
  • Dandelion greens
  • Garlic
  • Leeks
  • Onions (raw or cooked)

“We need at least 35g to 45g of fibre per day to fully support our gut microbiome. The average intake in the modern diet is 10g per day — far too little for optimal gut health,” says Spoelstra.

“Think of it as farming. If you buy a bull and a cow and you feed them adequately they will reproduce. If you don’t give them enough food, they won’t have the energy for reproduction and will eventually starve to death. The same is true for your gut microorganisms,” says Spoelstra. “A few will survive on 10g of fibre per day, but not enough to support the health of your gut and all of the functions it is responsible for.”


Published in Gastroenterology

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

Post a comment

One Response to “Antibiotics vs probiotics: how to protect your gut flora”

  1. Monique Coetzee says:

    Good article, thank you, although there is a lot of controversy around taking probiotics, you can rather take a lot of yoghurt, and other probiotic-rich foods / beverages. And try your best to only take antibiotics when they are absolutely indicated by a medical practitioner, your microbiome plays a major role in your entire well-being 🙂

Leave a reply