Which antibiotic to choose and tips...

[ECSMom]

I have IBS-D and recently have had amazing success using Xifaxan. It is the first thing that has worked to control my symptoms in 5+ years. Honestly, it's been life changing for me - I have been able to socialize with friends again and have even been able to enjoy a few foods that I never thought I'd be able to eat again. For the past month I've been struggling with an upper respiratory infection which my doctor believes is most likely a bacterial sinus infection at this point. I have been putting off taking an antibiotic as long as possible because I know from past experience it's going to destroy my stomach. I am so upset about reversing all of the good that the Xifaxan did for my gut, but I also am tired of being sick and am not getting better with the myriad of other things I have tried for the sinus infection. My gastroenterologist said I can only take 3 courses of Xifaxan in my lifetime and I was hoping to use my last 2 tries sparingly since this seems to work for me. The primary care doctor has offered me amoxicillin clavulanate or doxycycline. Has anyone found from past experiences that one impacted your stomach less than the other? (I know they both list diarrhea as a side effect.) Also any tips for supplements or other things you do while taking an antibiotic to somewhat lessen the impact to your gut?

[Lubomire99]

Hi ECS Mom having suffered and still do from acute sinusitis I find doxycycline works best for me although my new GP won’t prescribe it 🤬I have just finished a course of Clarithromycin and my stomach and body is suffering real bad . I have never had any issues with doxycycline although everyone is different . I was taking kefir and probiotics, peppermint tea etc but to no avail. Because of stomach issues now I am being tested for H pylori/gastritis . I wish you well.

[Genomics]

You might look into taking Saccharomyces Boulardii at same time and after the antibiotics, though obviously do your own research as I'm no expert (think, for one, its mentioned in a Zoe video on YouTube about antibiotic use)

[matches123]

I am on doxycycline at the moment day four and touch wood all good , hope this helps

[Superzob]

The British National Formulary (bnf.nice.org.uk/interaction... shows very few interactions of other drugs with Xifaxan, so it should be safe to take another antibiotic on top of it. Of course, any broad spectrum AB will affect the gut, but that should only be short-term unless you’re on them for a long time.

[xjrs]

Here is some research I did into this topic - more about how to protect yourself when taking antibiotics:

Antibiotics can significantly deplete both good and bad bacteria in your body. After a course of antibiotics bacteria slowly rebuild, all being well, they eventually return to balance. However, this can take time and rebalance may not be achieved, meaning that bad bacteria dominate.

Whilst taking antibiotics, if you take probiotics at the right time (at least two hours away from both previous and next antibiotic doses), they can pass through your system helping to protect the good bacteria and defend against any bad bacteria starting to dominate. The next antibiotic dose will still affect the microbiome, but some of the good bugs will survive helping the rebalancing effect when the course of antibiotics ends.

Some people may be more sensitive to histamine-producing probiotic strains such as Lactobacillus casei, Lactobacillus reuteri, and Lactobacillus bulgaricus. If this is the case, Lactobacillus plantarum, Bifdocaterium lactis, and Bifidobacterium longum would be better since they lower histamine levels, improve digestion and lower inflammation.

However, a comparison of Lactobacillus plantarum, Lactobacillus casei and Lactobacillus rhamnosus found that all helped restore the microbiome after a course of antibiotics. Lactobacillus casei was especially effective including building those strains that produce short chain fatty acids (SCFAs), particularly acetate and butyrate, which have health promoting properties. Additionally, it reduced inflammation promoting compounds, either through the SCFAs or the restoration of the microbiome. (2) In a study, Lactobacillus rhamnosus GG was also considered helpful (3) (7).

Saccharomyces Boulardii, which is a beneficial yeast that has been proven to prevent antibiotic associated diarrhoea, is the best thing to take whilst on antibiotics. The reason it is so effective is that since it is a yeast and doesn’t consist of bacteria, antibiotics won’t affect it, so it can do its job. Take 2 Saccharomyces Boulardii capsules after a couple of mouthfuls of food at breakfast and at dinner whilst taking antibiotics and for 2 weeks to a month afterwards. If you start to become constipated on Saccharomyces Boulardii, this suggests that it has or is doing its job and it might be possible to come off of them. Probiotics can be taken in addition, bearing in mind the timing mentioned above.

Another preventative measure that can be taken is to cut sugar intake whilst on antibiotics. Good bacteria not only keep bad bacteria under control, but also fungi such as candida albicans, a form of yeast, an overgrowth of which can lead to gut symptoms such as diarrhoea. Candida loves sugar and refined carbohydrates such as white bread and pasta that can be easily turned to sugar. Cutting out or reducing refined carbohydrates is generally recommended. This is especially true when on antibiotics, in particular whilst the good bacteria are being compromised, may be unable to keep candida under control and the only other way to do this is to reduce their food sources.

If you are symptom free, that is, not experienced antibiotic associated diarrhoea since the Saccharomyces Boulardii and probiotics have been doing their job, it is important to start feeding your good gut bacteria to help them repopulate. Whole grains and eating a wide colour spectrum of vegetables can assist in promoting bacterial diversity. It is this diversity that helps to keep the baddies at bay. (1)

[xjrs]

Saccharomyces Boulardii (there may be cheaper options):

revital.co.uk/products/alle...