People with digestive problems often worry about antibiotics, and they wonder how far of a setback taking antibiotics will be. It’s a really good question, and one that you should be asking yourself every time you need antibiotics. Let’s get into all of the details about how antibiotics affect the microbiome in your gut.

I my 25-year career I’ve tested the microbiome of thousands of patients. I may even be one of the most clinically experienced doctors in the country in understanding how the microbiome in your gut affects your overall health and your digestion, because I don’t just read about it in journals, I get to see exactly how it plays out in my patients every day.

A healthy and normal gut microbiome is filled with trillions of bacteria that can be categorized into around 500 or so different species in the typical person, and around 100 or so different genera.

As a reminder, Lactobacillus is a genus, and Lactobacillus acidophilus is a species of Lactobacillus. And there are other species of Lactobacillus, not just acidophilus. So, as you can see, there are a lot of different types of bacteria that make up your microbiome.

As you probably know by now, when you take an antibiotic, you kill some of the normal good bacteria in your gut. This is significant, but maybe not nearly as wild of a killing spree as you might have been led to believe.

Antibiotics, even strong broad-spectrum antibiotics, do not kill everything. Different types of antibiotics are designed to target different types of bacteria.

If you had the idea that antibiotics clear out and sterilize our gut, even the antibiotics of last resort aren’t going to do that. It’s impossible. That simply doesn’t happen. Antibiotics do not clear out all of the bacteria in your gut.

But they do have a significant impact on your microbiome. And depending upon the makeup of the types of bacteria on your microbiome, they can have a more significant impact in some people than in others.

That’s why when you take an antibiotic, some people get symptoms, for example diarrhea, and others don’t. It all depends on the antibiotic, and the type of bacteria already present in your microbiome. Everyone’s microbiome is a bit different.

By the way, I want to clear up something that you may have been told. Not finishing your antibiotic does not cause antibiotic resistance in bacteria. That’s a myth. In reality, the longer you are on an antibiotic, the greater the chance that antibiotic resistance will develop.

The other thing about antibiotics is that their impact is much longer lasting than you may think. Once you’ve taken an antibiotic, that’s not the end of the story. Antibiotics also have a cumulative effect over years and decades.

Here’s why. All of those bacteria in your gut are competing for territory. And antibiotics impact that competition and alter the playing field.

Things that are not sensitive to the antibiotic survive and have the potential to gain more territory.  These include bacteria that don’t respond to the antibiotic because it’s not the right antibiotic for them, bacteria that have developed a resistance to that antibiotic, and things like yeast or Candida that don’t respond to the vast majority of antibiotics.

Every time you take an antibiotic, these organisms gain an advantage and flourish. And that advantage continues to grow over time.

People often tell me that they only had antibiotics a few times as a child, maybe once or twice a year for a few years. And then only a few times since.

But those all add up. And the cumulative effect can be huge.

So, for example, your Candida start to gain some territory when you have antibiotics when you are little. And then they gain a little more territory each time you have antibiotics. And then they gradually grow stronger on their own over years and decades. And then you finally have problems in your 30s. And you think, I never had problems before, so where did it come from?

By this point your microbiome is very different than it was then. Add to that years of ingesting things like sugars and alcohol, and you start to get the idea.

And often you can’t just throw in some probiotics and expect things to permanently go back to normal. It might take a lot more work than that. But you should take probiotics every time you take antibiotics.

Your microbiome is not any different than any other environment. Once the normal environment has been damaged, it can take a lot of work to get it back. But it is doable.

This video is sponsored by the IBS Treatment Center, where helping people rebuild their microbiome is what we do best.

Related Content:

How To Break Biofilms

All About Microscopic Colitis

How To Test For Candida

Garlic and the Microbiome: Good Food Reactions vs Bad Food Reactions