Drug induced digestive dilemma

Posted on Fri, 4 Sep 09

The 2-3 kilograms of bacteria that typically reside inside our digestive tract have formed a harmonious relationship with our digestive system and are as much dependant on us for survival as we are on them. When our gut bacteria are out of balance life can be made a living hell with digestive symptoms such as pain, bloating, constipation and or diarrhoea (1). Alarmingly, a very common drug prescription is toxic to gut bacteria and may be the reason many people suffer from chronic digestive complaints.

Antibiotic agony

The most significant and frequent cause of disruption to gut flora are antibiotics with a single course negatively affecting gut bacteria for at least 16 months afterwards (2).  There is a strong association between antibiotic use and digestive complaints. In a survey of people who had received an antibiotic prescription it was found that transient digestive complaints were more than three times more common in those who had received antibiotics in the last 4 months (3). The more severe symptoms of irritable bowel syndrome (IBS) have also been strongly correlated with previous antibiotic use (4).

Restoring bacterial balance

The association between antibiotic use and the development of chronic digestive complaints is often overlooked. Fortunately it is possible to restore healthy gut bacteria with probiotic supplements.  A number of specific probiotic bacteria have shown promise in improving or completely relieving symptoms such as constipation, diarrhoea, bloating and pain and the collective symptoms of IBS. Commercially available probiotic strains with some evidence to support their use for gastrointestinal complaints include Lactobacillus plantarum 299v (5), Lactobacillus acidophilus NCFM (6,7) and a product containing a combination of strains called VSL#3 (8,9) while many other strains have shown little or no effect.

References

1. Lin HC. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA. 2004 Aug 18;292(7):852-8.

2. Hawrelak JA, Myers SP. The causes of intestinal dysbiosis: a review. Altern Med Rev. 2004 Jun;9(2):180-97.

3. Maxwell PR, Rink E, Kumar D, Mendall MA. Antibiotics increase functional abdominal symptoms. Am J Gastroenterol. 2002 Jan;97(1):104-8.

4. Mendall MA, Kumar D. Antibiotic use, childhood affluence and irritable bowel syndrome (IBS). Eur J Gastroenterol Hepatol. 1998 Jan;10(1):59-62.

5. Niedzielin K, Kordecki H, Birkenfeld B. A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2001 Oct;13(10):1143-7.

6. Rosseaux C et al. Lactobacillus modulates intestinal pain and induces opiod cannabinoid receptors. Nature. Online; 10 December 2006.

7. Faber S et al. The use of probiotics in the treatment of irritable bowel syndrome: the results of two case reports. Altern Ther Health and Med. Jul/Aug, 2005. 11; 4: 60-62.

8. Kim HJ,et al. . A randomized controlled trial of a probiotic combination VSL# 3 and placebo in irritable bowel syndrome with bloating. Neurogastroenterol Motil. 2005 Oct;17(5):687-96.

9. Kim HJ, et al. A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther. 2003 Apr 1;17(7):895-904.