
Single course of antibiotics can mess up the gut microbiome for a year - ra
http://arstechnica.com/science/2015/11/single-course-of-antibiotics-can-mess-up-the-gut-microbiome-for-a-year/
======
aschearer
Since there's so much interest in gut biomes you may be interested in learning
that what you eat greatly influences your biome. A vegan diet has been shown
to substantially change your flora [1] in as little as a day [2]. I also found
this video on the role of fiber, our gut flora, and our immune system
interesting [3].

[1]:
[http://www.nature.com/ejcn/journal/v66/n1/full/ejcn2011141a....](http://www.nature.com/ejcn/journal/v66/n1/full/ejcn2011141a.html)

[2]:
[http://www.nature.com/nature/journal/v505/n7484/full/nature1...](http://www.nature.com/nature/journal/v505/n7484/full/nature12820.html)

[3]: [http://nutritionfacts.org/video/prebiotics-tending-our-
inner...](http://nutritionfacts.org/video/prebiotics-tending-our-inner-
garden/)

~~~
justboxing
Thanks, I am a recently turned vegan. I can't say I have experienced the
change in "as little as a day". I've been a lifelong lacto-vegetarian (like
most indian people) and recently dropped diary (last 2 years).

~~~
unmole
> I've been a lifelong lacto-vegetarian (like most indian people)

Nitpick: Most Indians are NOT vegetarians, less than a third are.
[http://www.thehindu.com/todays-paper/the-food-habits-of-a-
na...](http://www.thehindu.com/todays-paper/the-food-habits-of-a-
nation/article3089973.ece)

------
refurb
I think saying that antibiotics "mess up" your gut microbiome is making a lot
of assumptions. Your biome changes if your diet changes. Saying that "any
change" is "messing things up" is something I don't think has been proven.

Of course, there are risks of using antibiotic like C. difficile infections,
but saying more than that is stretching the truth.

~~~
swsieber
I don't think that there are that many assumptions. The core assumption is
this: having a more diverse gut microbiome is healthier.

~~~
refurb
Do you have any sources to back that up?

I don't see anywhere in the article that it says the diversity in the gut was
reduced. It says it was altered.

Also, if you change your diet, your diversity is also potentially reduced. Is
that bad too?

~~~
swsieber
It would seem I was influenced by an earlier post today[1]. That post talked
about research indicating that microbiome diversity was important/healthy.

While article of this post mentions that the linked study showed a change in
composition and diversity, the abstract itself just mentioned a reduction of a
particular beneficial group of bacteria:

 _Additionally, metagenomic predictions based on 16S rRNA gene amplicon data
were performed using PICRUSt. The salivary microbiome was found to be
significantly more robust, whereas the antibiotics negatively affected the
fecal microbiome: in particular, health-associated butyrate-producing species
became strongly underrepresented._ [3]

Which I guess makes the assumption even simpler: greatly reducing a group of
healthy bacteria from your gut for a while qualifies as messing it up.

Also the earlier article I read[3] does in fact posit that a reduction of
diversity through diet change is in fact bad. Of course there is still a
debate about the truthfulness and magnitude of that statement.

[1][3]
[https://news.ycombinator.com/item?id=10552477](https://news.ycombinator.com/item?id=10552477)

[2]
[http://mbio.asm.org/content/6/6/e01693-15.full.pdf+html](http://mbio.asm.org/content/6/6/e01693-15.full.pdf+html)
[iFrame + PDF]

Edit: Italicized the quote, clarity

------
Natsu
I simply took a probiotic after being on antibiotics for a couple months and
it had a side effect of curing a lot of digestive problems I used to have. So
there's that, too. Incidentally, my doctor was the one who advised this.

EDIT: The probiotic in my case was capsules of 15B cells of Lactobasillus GG.
Marketing copy on the box suggests this is the "most clinically studied
probiotic strain" but I'm not able to verify that.

~~~
Duhck
I actually have had similar problems. In the past when I take antibiotics it
_fixes_ my GI problems.

~~~
jstelly
There is a condition called Small Intestinal Bacterial Overgrowth that fits
this description. There is even an antibiotic that is marketed toward and
prescribed for the condition called Xifaxan / rifaximin. Neomycin (another
antiobiotic) is also used to treat it.

This research lab is studying it and this doctor (Pimentel) has written a book
about it: [http://www.cedars-sinai.edu/Research/Research-
Labs/Pimentel-...](http://www.cedars-sinai.edu/Research/Research-
Labs/Pimentel-Lab/)

------
hammock
What are "probiotics"? How do we know which bacteria are the ones we need, and
do all probiotics contain the same cocktail or different strains?

Seems like saying "take probiotics" is insufficient.

~~~
Natsu
You're right. I think there was a startup on here that had done a clinical
study of some formula of theirs with many specific microbes.

In my case, I used a probiotic that contains only Lactobacillus GG (15B cells)
and saw improvement after a course of antibiotics. My doctor recommended that
when I asked, but said that it wasn't a prescription, just that he'd heard
good reports from his patients.

For myself, I took them regularly for a couple weeks afterwards, then
sporadically after that as constant usage doesn't appear to be required, at
least for me.

~~~
mangeletti
If anyone knows the name of that startup, please do tell.

~~~
Natsu
Searching suggests it might be this story:

[https://news.ycombinator.com/item?id=8456128](https://news.ycombinator.com/item?id=8456128)

------
sunsu
If anyone is interested in a good probiotic with a lot of solid science behind
it, you should definitely check out
[http://www.generalbiotics.com](http://www.generalbiotics.com)

It was created by the guys behind the NSF funded Human Biome project. It's
excellent and contains over 100 strains (not just a few like most probiotic).

------
justboxing
Ask HN: Any proven natural (without meds) ways to "reset" and restore gut
flora?

Context: I grew up in India and to this day, there is a tendancy by Doctors to
prescribe Antibiotics for anything, even cold viruses and non-bacterial
illnesses.

Erythromycin is 1 such antibiotic that Indian doctors prescribe for things
such as the common cold, cough and similar seasonal illnesses.

Due to this, I've developed a lot of food allergies and my gut is hosed.

So I was wondering if anyone has been able to successfully "reset" their gut
and regrow the good bacterial and improve their immune system.

Thank you!!

~~~
aaronbrethorst
Fecal transplants seem to have a high success rate of fixing some gut health
issues[1]. I've never tried one, though.

I take probiotics on a daily basis, but research is much more scant for
them[2]. That said, I notice a marked difference when I stop taking them for a
few days.

[1]
[https://en.wikipedia.org/wiki/Fecal_bacteriotherapy](https://en.wikipedia.org/wiki/Fecal_bacteriotherapy)

[2]
[https://en.wikipedia.org/wiki/Probiotic#Research](https://en.wikipedia.org/wiki/Probiotic#Research)

~~~
Cheyana
Fecal transplants for the win, with my friend's mother-in-law. She had one a
few weeks ago after suffering with digestive issues for a while and she's been
great ever since.

------
haswell
I went through my entire childhood without ever getting sick enough to need
antibiotics. Then, I managed to catch strep in my early 20s, and went on a
course of antibiotics to take care of it.

This is of course purely anecdotal, but the following year was pure hell from
a digestive system standpoint, and looking back, I'm pretty sure it was tied
to that course of antibiotics. Thankfully, things cleared up on their own, but
I'd definitely be looking at probiotics if forced to go on antibiotics again
for some reason.

Glad to see research on this topic.

~~~
sparkie
Had similar experience. Had allergic reaction to penicillin first
prescription, which triggered my full body to come out in itchy hives. Went
through 3 courses of different antibiotics until I was fit enough to get out
of bed. Had bad guts for a couple of years following, which was usually an
alternation between diarrhea and constipation. Sometimes I'd sit on the throne
several times a day and no movement, except mucus or eventually, blood, as I'd
developed piles.

I went on a super high fibre diet, ate as much low calorie food as I could a
day to keep things moving. Ate lots of fermented foods, mainly dairy,
sauerkraut, cured meats. Eliminated sugar, took up cycling to work to get fit.
I've not been ill since, my bowels are moving, and piles are gone. Not the
most pleasant story, but thought I'd share it.

~~~
justboxing
Thanks for sharing your story @sparkie. Doesn't sound like a whole of fun,
what you went through.

Do you know of any high-fiber low-calorie non-meat, non-diary foods? Also,
does the %age of soluble vs insoluble fiber matter, or no?

~~~
sparkie
Various beans, sweet potatoes, yams, most root vegetables. Sweet potatoes
became my favourite food when I realised you could use them as a sugar
replacement for many kinds of baking, which made giving up the sugar so much
easier.

As for % of soluble and insolubale, I've never really paid attention to it. I
probably eat far more soluble fiber than insoluble though, if it helps.

------
hippich
I was taking probiotic [1] to fix stomach issues after a course of
antibiotics. Certainly felt better this time.

[1] [http://www.amazon.com/dp/B00L7YD9UG](http://www.amazon.com/dp/B00L7YD9UG)

------
ryangittins
"Mess up" sounds like a pretty loaded term to me. It sounds like "change"
would be a more appropriate word, but the headline wouldn't be able to be
skimmed over and then passed along to friends quite so easily.

------
sshillo
I wonder what effects a night of drinking does. Yagerbombs and beer pong,
probably not great for the gut.

------
fiatjaf
How do you know when it is "necessary" to take antibiotics?

~~~
DanBC
There's a health campaign in England you might be interested in:
[https://antibioticguardian.com/](https://antibioticguardian.com/)

But when a doctor prescribes a medication a useful question (no matter what
the medication) is "What happens if I don't take it? What happens if we just
watch and wait?"

~~~
fiatjaf
Thank you for the helpful answer.

