Q: My new dentist recommended that I take a probiotic along with the antibiotic they prescribed me. I thought I had probiotics at home, but after looking at the label more closely I realized it’s actually a prebiotic. Would that serve the same purpose?
Maintaining a healthy balance of good bacteria, fungi, and other microorganisms in the gut is essential for proper digestion and nutrient absorption. A well-balanced gut also plays a key role in supporting the immune system and promoting overall health. Emerging research continues to uncover links between gut health and a variety of medical conditions including allergies, depression, diabetes, irritable bowel disease, obesity, and even oral health concerns such as cavities and gum disease.
When antibiotics are taken to treat bacterial infections, they work by killing the harmful bacteria responsible for the infection. However, antibiotics are not selective, they often kill many of the beneficial bacteria living in the gut as well. This disrupts the natural balance of good bacteria in the gut and creates an opportunity for harmful bacteria such as Clostridium difficile or yeasts such as Candida albicans to multiply. As a result, antibiotic use can lead to a range of side effects including antibiotic-associated diarrhea, yeast infections and in more severe cases C. difficile colitis, which I once spent a week in the hospital with—it was awful!
Probiotics are live, beneficial microorganisms that can help replenish the population of good bacteria in your gut. They are found in certain fermented foods such as kimchi, kombucha, sauerkraut, and in some cheeses and yogurts. Probiotics are also widely available as dietary supplements in capsule, powder, or liquid form, and are often taken to support digestive health.
Taking probiotics during and after a course of antibiotics can help restore healthy bacteria in the gut and reduce the likelihood of side effects such as bloating, cramping, diarrhea, and yeast infections. However, timing matters. It’s important to separate probiotics from antibiotics by at least two to three hours. Taking them too close together may result in the antibiotic killing the probiotics before they have a chance to colonize in the gut.
As a general guideline, probiotics should be continued for one to two weeks after completing a course of antibiotics to give the gut time to restore balance. However, if you experienced digestive upset during your treatment, particularly diarrhea, it is advisable to continue probiotic supplementation for at least four weeks to promote full restoration of a well-balanced gut.
Prebiotics are not the same as probiotics. While probiotics introduce live microorganisms into the gut, prebiotics serve as food for the good bacteria that is already present in your gut. Prebiotics are found in high-fiber, plant-based foods such as asparagus, bananas, garlic, leeks, legumes, onions, and whole grains like barley, oats, and wheat. They are also available as standalone supplements and in combination with probiotics in supplements known as synbiotics. Although prebiotics support digestive health and may help boost immunity, they do not provide new microorganisms like probiotics do.
Therefore, the prebiotic product you currently have will not serve the same purpose as the probiotic your dentist recommended. If you decide to purchase a probiotic supplement, you’ll find there are many different options on the market. The most commonly used probiotic bacteria in supplements belong to the Lactobacillus and Bifidobacterium genera. Products aimed at supporting women’s health often focus on Lactobacillus species due to their known benefits in preventing yeast infections. Additionally, there is some research to suggest that probiotics containing Saccharomyces boulardii, a beneficial yeast, may be particularly effective in preventing antibiotic-associated diarrhea.
For most healthy people, probiotics are considered safe. However, in vulnerable populations including infants, the elderly, and people with weakened immune systems, very rare cases of probiotic-related infections have been reported. As with any new supplement, it’s always a good idea to speak with a health-care provider before starting probiotics, especially if you have chronic health conditions, are pregnant or are considering use in young children.
Erin Thompson (BSc, BScPharm) is a graduate of Dalhousie University and a community pharmacist practicing at Shoppers Drug Mart in Quispamsis N.B. Her opinions expressed in this column are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment.