You Docs: Taking an antibiotic? Don't forget the probiotics

Drs. Oz & Roizen:

July 21, 2013 

Here's a gut check. Up to 39 percent of people who take an infection-fighting antibiotic wind up with diarrhea, a side effect that can be annoying or even downright life-threatening. Why? Because along with killing off infection-producing culprits, antibiotics slay good gut-dwelling bacteria that protect you from gastrointestinal distress. And those good guys do many other beneficial things for you, too, including building and maintaining your immune strength.

Side effects like diarrhea are probably why 20 percent of folks stop taking their antibiotics before they should - and that can be even more dangerous than the initial infection. If some of the disease-causing bacteria have not yet been slain (chances are they were the strongest of the lot), you can get doubly ill as they rebound and begin to multiply again.

Now, a new report shows that pairing antibiotics with "good" bacteria (probiotics) slashes the risk of antibiotic side effects. Raising your intake of probiotics (the beneficial bacteria found in your guts and available in supplements and foods like yogurt, tempeh and kefir) can lower your odds of getting diarrhea by a whopping 64 percent. It also can slash your risk by 66 percent for illness associated with a dangerous type of tough-to-kill bacteria, clostridium difficile (or C. diff) that shows up in hospitals and afflicts the young and elderly.

So let your doctor know that you plan on taking probiotics with the antibiotic and for five days longer than your prescription. If he gives you the go-ahead (generally, taking probiotics isn't recommended for people with a compromised immune system), here's how to make the most of this opportunity to keep things balanced:

- Taking a supplement? Look for "spore form" probiotics. They are tough guys that can withstand a bath in your stomach's super-strong digestive acids. We prefer the spore probiotics that contain bacillus coagulans GBI-30, 6086 and lactobacillus GG, a strain activated by stomach acid.

- Choose food with the right good bacteria. More and more probiotic products crowd the dairy aisle in the supermarket, each teeming with a different group of beneficial bacteria. What's best? For preventing or helping to calm antibiotic-associated diarrhea, try Saccharomyces boulardii and a combination of Lactobacillus acidophilus and Lactobacillus casei. Other types proven to run "the runs" out of town include Lactobacillus rhamnosus GG, Lactobacillus reuteri and Lactobacillus acidophilus.

- Don't overlook yogurt. You don't have to take a probiotic supplement to get benefits. There's evidence that a daily serving of yogurt can cut risk for diarrhea by two-thirds. Just make sure your carton says "live active cultures." Choose plain, nonfat yogurt to avoid loading up on saturated fat and sugar. Mix in chopped fruit and a couple of walnuts for flavor.

- Nurture your gut's beneficial bacteria. Specific types of fiber act as prebiotics. They're the favorite food of all those helpful gut bacteria, so when you eat bananas, asparagus, onions, garlic, dandelion greens, Jerusalem artichokes, jicama, barley, berries, tomatoes, honey, flaxseed, beans or pectin-containing apples, you're feeding the good guys. Then everyone's happy!

Mehmet Oz, M.D., is host of "The Dr. Oz Show," and Mike Roizen, M.D., is chief medical officer at the Cleveland Clinic Wellness Institute. Distributed by King Features Syndicate.

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