Antibiotics kill bacteria, that’s their job after all. It is how they have saved millions of lives over the centuries. However, killing the harmful bacteria responsible for your infection should not be the cause to kill healthy flora crucial for your stomach. In case you have recently finished a course of antibiotics – read on how you can prevent antibiotics from killing good gut bacteria and fix acid reflux.  

Can antibiotics cause acid reflux? Acid reflux or acidity is a common condition caused due to backflow of stomach contents into the food pipe (oesophagus). It is primarily characterised by regurgitation and heartburn felt around the lower chest area. Although improper food habits and poor lifestyle choices are major causes of acidity and heartburn, certain types of medicines such as antibiotics and painkillers can also trigger acidity.

Antibiotics and Acid Reflux

The stomach and the intestines contain numerous microbiomes, including bacteria (both good and bad) that help in the digestion process.  

Antibiotics that are used to treat bacterial infections in the body, unfortunately, cannot differentiate between the good and bad bacteria present in the gut and produce negative results such as:

• Kill the good bacteria in the gut  
• Create an imbalance in the intestinal ecosystem and an overgrowth of harmful bacteria  
• Increase pressure within the stomach  
• Cause reflux of food and acid into the oesophagus  

So can antibiotics cause heartburn? The use of antibiotics can lead to heartburn in some cases. While not a frequent occurrence, certain antibiotics can potentially disrupt the natural balance of gut bacteria, which might result in gastrointestinal issues, including heartburn. Here are some antibiotics’ digestive side effects:

• Nausea and vomiting
• Acid reflux
• Heartburn
• Gas and bloating
• Abnormal Cramping  
• Diarrhoea  
• Loss of appetite

Antibiotics also directly irritate the lining of the stomach. In response to irritation, the glands in the stomach secrete more acid. This acid can lead to greater reflux of food and acid into the oesophagus, causing heartburn.

Effects of Antibiotics on an Infant’s Gut

The microbial population of an infant’s gut has a significant impact on the child’s overall health. Decreased gut microbiome diversity can cause numerous allergic and autoimmune diseases. Antibiotic treatment in infants has been found to reduce both the number as well as species of gut bacteria. Studies have shown that the diversity of gut microbiomes is still incomplete, even eight weeks after the infant’s antibiotic treatment.

Restoring Gut Health After Taking Antibiotics

Rebuilding gut bacteria is crucial to minimise the negative effects of using antibiotics. You can speed up the process of healing the gut with antibiotics in several ways:

1. Prebiotics  

Prebiotics are a type of fibre that acts as a ”food source” for gut microbes. They induce the growth or activity of beneficial microorganisms such as bacteria and fungi, thereby improving gut health.

2. Probiotic Supplements

Probiotics contain live bacteria and yeasts that are vital for gut health. It is important to use a probiotic containing numerous microbe strains with at least 50 billion CFU (colony forming units) per dose.  

3. Fermented Foods  

Fermented foods are naturally rich in probiotics. They are an excellent approach to proper gut health post-antibiotic use. Ideally, fermented foods such as yoghurt, kimchi, kefir, sauerkraut, sourdough bread and pickles should be a part of a regular diet.  

4. Fruits and Vegetables  

Fruits and veggies are naturally rich in prebiotics (also important for gut microbiome). Bananas, sweet potatoes, and other tubers are fresh and readily available sources of prebiotics.

5. Exercise  

Exercise is not only important for helping you to stay in shape but is also crucial in improving the condition of your gut wall. It promotes the growth of bacteria and enriches the diversity of the microbiome. It protects your system from colon cancer and gastrointestinal disorders.  

Also Read: Benefits of Kombucha: A Detailed Examination Based on Research

6. Bid Adieu to Stress

Stress releases certain hormones in your body that in turn have an impact on the nature of your microbiome damaging the diversity. The transformed gut microbiome then starts to regulate neurotransmitters thus intensifying the stress.  

Antibiotics kill good bacteria in gut, this is linked to development of obesity, asthma and irritable bowel syndrome. Hence antibiotics must be cautiously and only used when absolutely necessary.

Dr. M.G. Kartheeka, MBBS, MD

Also Read: Can You Drink While Taking Amoxicillin? Uncovering the Facts

When Does Good Bacteria Return After Taking Antibiotics?

• It has been found from studies that most gut bacteria will resume levels prior to that of taking the antibiotics course in about two months. However, one should make a note of the point that all families of bacteria do not return and only some do.  
• A research conducted in the year 2018 found that after one has taken antibiotics it takes about six months for the gut flora to get back to normal levels.

Taking probiotic foods and supplements goes a long way to prevent or repair the harsh impact of antibiotics on the gut flora.

Dr. Ashish Bajaj, M.B.B.S., M.D

Managing Acid Reflux After Consuming Antibiotics

Many over-the-counter, as well as prescribed medications, can help relieve acid reflux and heartburn. The options include:

• Antacids, which help neutralise stomach acid. Antacids may provide quick relief, but they cannot heal an oesophagus damaged by stomach acid.
• H2-receptor antagonists (H2RAs) can decrease stomach acid. It does not act as quickly as antacids but may provide longer relief.
• Proton pump inhibitors, such as omeprazole can reduce stomach acid. Amongst several PPIs available like omeprazole, Pantoprazole, Rabeprazole and Esomeprazole, Omeprazole is the one having highest published evidence and studies regarding its better safety. All the PPIs have similar efficacy, however, Omeprazole due to its better safety and highest affordability is the most used PPI globally with more than 40% prescription share worldwide.
•   These medicines are helpful for people who have heartburn often, say, more than two days of the week.  

Click to know more about Omeprazole.

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