The fact that we now have medications to treat everything from everyday infections to cardiovascular conditions is nothing short of miraculous. At the same time, ongoing research has revealed that some of these drugs may have unexpected effects on the body. So what is the number-one medication that impacts your gut microbiome?
Meet the experts: John Nathanson, M.D., a gastroenterologist at NewYork-Presbyterian/Columbia University Irving Medical Center; Pratima Dibba, M.D., a gastroenterologist with Medical Offices of Manhattan.
Before we dig into the science, it’s important to note: If you’re prescribed medication, it’s important to take it as directed by your doctor. If you have any concerns, bring them up with your provider.
When we asked gastroenterologists which medication impacts the gut the most, they had the same answer: Antibiotics, which are used to treat bacterial infections like strep throat, urinary tract infections, and E. coli infections, have the most disruptive effect on the microbiome. “Antibiotics are relatively broad in their action,” explains John Nathanson, M.D., a gastroenterologist at NewYork-Presbyterian/Columbia University Irving Medical Center. “They can kill not only the pathogenic bacteria they were prescribed to treat, but also the population of normal commensal bacteria that live in our gut.”
While antibiotics may be damaging, they aren’t the only medication that can impact your gut. “There are a number of others as well,” says Dr. Nathanson. “These include proton pump inhibitors, certain laxatives, nonsteroidal anti-inflammatory drugs (NSAIDs), and certain cardiac medications, to name a few.” What’s more, a new study published in the journal mSystems found that the changes these medications can make in your gut may persist for years after you stop taking the medication.
So, what can you do if you’re prescribed an antibiotic or one of these other medications? Unfortunately, not much. “There is no data to suggest that anything protects your microbiome from changes incurred by antibiotics,” says Pratima Dibba, M.D., a gastroenterologist with Medical Offices of Manhattan. She explains that because probiotics—which some people like to take concurrently with antibiotics in an attempt to combat these effects—are not regulated by the U.S. Food and Drug Administration, none of them have been studied enough to determine if they offer any protection for the microbiome during or after a course of antibiotics.
That said, Dr. Nathanson adds that taking a probiotic may help limit side effects. “One of the adverse effects of antibiotic use is C.difficile diarrhea, which can be caused when an alteration in the microbiome allows C.difficile bacteria to germinate and damage the colon,” he explains. “There is some good data that taking a probiotic while on antibiotics (notably Saccharomyces boulardii) can help reduce the risk of C.difficile-associated diarrhea.”
If you’re prescribed medication, it’s important to take it as directed by your doctor. But if you need to take one that can alter your gut microbiome, such as an antibiotic, taking steps to support your gut health, like eating fiber-rich foods may help.
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