Dysbacteriosis specialist in Bay Area

[MikeOr]

I have been Dxed with IBS long ago, but I think I have a more specific issue: poor tolerance of oral antibiotics due to dysbacteriosis. Eg, a recent prophylactic dose of Azithromycin before a tooth surgery turned into at least a 4 day long watery diarrhea with cramps. I am not sure if dysbacteriosis falls under IBS Dx or not. Do you know of any specialist (preferably in Bay Area, California) who is known to deal with this problem ? General GI specialists do not seem to know much about dysbacteriosis.

[xjrs]

Do you mean dysbiosis which means gut bacterial imbalance with bad bugs dominating in the gut? If that's the case, this is implicated for many people with IBS with or without antibiotics. However, antibiotics can make the imbalance worse and can cause an imbalance even for those without IBS. A 'specialist' is unlikely to be necessary for this common problem. Ideally when on antibiotics it is best to take saccharomyces boulardii which is a beneficial yeast to help guard against this. This won't be affected by the antibiotics since it isn't bacteria. It is also a good idea to take probiotics following the course of antibiotics and additionally at the same time as the antibiotics, at least 2 hours either way from each dose. I've tried many probiotics over the years and Alflorex worked best for me. I think the equivalent outside of the UK is Align. It contains a strong Bifdobactrium strain that is good at kicking dominating bad bugs into touch.

[MikeOr in reply to xjrs]

Thanks xjrs. Yes, it is what you call dysbiosis.

I used to take Florastor, which contains saccharomyces boulardii yeast, with antibiotics. It seemed to work for a while, but once I got a bad diarrhea, and a stool test revealed a lot of yeast with no other pathogens detected. So I stopped Florastor for good. But this yeast diarrhea still returned a couple of times same year.

Do you take both the yeast and Alflorex with antibiotics ?

[xjrs in reply to MikeOr]

Yes. I used to take both the saccharomyces boulardii and probiotic whilst on antibiotics - with the timing mentioned. However, I am not sure if the saccharomyces boulardii would be an issue with a yeast problem. Though we all have yeasts and bad bugs in our guts - it is whether the microbiome is strong enough to keep these under control. Diet is very important too to ensure that good bugs are thriving. The Mediterranean diet is one of the best diets for the microbiome.

[MikeOr in reply to xjrs]

Hi xjrs,

I always take a probiotic (something like Lactobacillus Rhaminosis) when taking antibiotics. But it does not always help. I am wondering if I should ask for injectable antibiotics.

[xjrs in reply to MikeOr]

Hi MikeOr, probiotics need to be taken 2 hours away from each antibiotic dose. The probiotics will still suffer a bit from the antibiotics, which is why it is a good idea to take the saccharomyces boulardii in addition, but you said you may have a problem with the yeast.

I've never heard of injectable antibiotics.