How to reset your gut after a round of antibiotics

It's that time of year when antibiotics start getting handed out like candy in primary care (no, they won't help your viral illness and no they aren't always needed for sinus issues). While there has been a lot of education and different toolkit and practice improvement projects around appropriate antibiotic use and prescribing practices, there are still a lot of times people need antibiotics.

Antibiotics can be life-saving and necessary, but they often come with an unfortunate side effect: a disrupted gut. Many of my clients experience symptoms like bloating, gas, or even mood changes after antibiotics, and that’s because these powerful medications don’t just target harmful bacteria; they also wipe out beneficial bacteria that keep our gut balanced and thriving.

But don’t worry! Today, I’ll share how you can reset your gut after antibiotics in a way that supports your microbiome, improves digestion, and helps you feel like yourself again.

Why It Matters to Rebuild Your Gut After Antibiotics

Antibiotics can reduce the diversity of our gut microbiome, which is a crucial marker of gut health. Studies show that a decrease in microbiome diversity can lead to various health concerns, including increased inflammation, weakened immunity, and even mental health changes, as our gut is deeply connected to our brain.

Step 1: Nourish Your Gut with Probiotics and Prebiotics

Probiotics:
Think of probiotics as the friendly bacteria that can help repopulate your gut. Incorporating a high-quality probiotic supplement can be beneficial, especially strains such as Lactobacillus and Bifidobacterium, which are shown to support gut health and immunity. Another non-bacterial (yeast based) probiotic S. Boulardii has been shown to help with gut related anti-biotic side effects. Additionally, foods like yogurt, kefir, sauerkraut, and kimchi are rich in naturally occurring probiotics and are a great way to introduce beneficial bacteria back into your gut while on and right after antibiotics.

Prebiotics:
Prebiotics, found in fiber-rich foods, feed the good bacteria in your gut, helping them grow and thrive. Foods like onions, garlic, bananas, asparagus, and oats are prebiotic-rich and promote a balanced microbiome. Adding these to your daily meals can help nurture and support those friendly bacteria after antibiotics.

Step 2: Support Digestion with Gut-Healing Foods

After antibiotics, your gut lining might be more sensitive, so it’s important to eat foods that support healing and reduce inflammation. Here are some gut-loving options:

• Bone Broth: Known for its high collagen content, bone broth provides amino acids like glutamine, which can help repair the gut lining.
• Ginger: This anti-inflammatory root has been used for centuries to ease digestion. Studies indicate that ginger can support motility and reduce discomfort, which can be beneficial as your gut resets.
• Fermented Foods: Sauerkraut, miso, and kimchi not only add probiotics but also enzymes that support digestion, making it easier for your body to absorb nutrients.

Step 3: Avoid Gut Irritants

While your gut is healing, it’s best to avoid common irritants that can increase inflammation or disrupt gut bacteria further. Here’s what to watch for:

• Processed (especially ultra processed) Foods: They often contain artificial additives and preservatives that may aggravate the gut lining.
• Refined Sugars and sugar alcohols: Research shows that sugar can fuel harmful bacteria and yeasts, potentially leading to dysbiosis, or microbial imbalance.
• Alcohol: It can disrupt the gut lining and contribute to imbalances in gut bacteria. If you’re planning to reset your gut, limiting alcohol can make a big difference.

Step 4: Take Digestive Enzymes or Bitters if Needed

After antibiotics, your digestion might feel sluggish, leading to symptoms like bloating and gas. Digestive enzymes can be helpful for breaking down food effectively and allowing your gut a bit of a break. Look for an enzyme that includes amylase, protease, and lipase, which aid in digesting carbs, proteins, and fats.

Step 5: Prioritize Sleep and Manage Stress

Our gut and brain communicate constantly, so it’s no surprise that high-stress levels and poor sleep can take a toll on gut health. Research has shown that stress affects the gut microbiome and increases gut permeability, a condition known as “leaky gut.”

• Prioritize Sleep: Aim for 7-9 hours of quality sleep to support both your gut and immune system. During sleep, the body repairs itself, including the gut lining.
• Manage Stress: Practices like deep breathing, meditation, and regular movement can reduce stress and help maintain a healthy gut-brain connection, ultimately promoting a smoother recovery.

Step 6: Drink Plenty of Water

Staying hydrated is essential for every aspect of health, including digestion. Water supports the mucosal lining of the intestines and promotes healthy motility (the movement of food through your digestive tract). Aim to drink at least eight 8-ounce glasses daily, but consider adding a pinch of salt or electrolytes to your water if you’ve been on antibiotics to help with rehydration.

Step 7: Consider a Short-Term Elimination Diet

After antibiotics, your gut may be more sensitive to certain foods, so consider removing common gut irritants like gluten, dairy, and processed foods for a few weeks. Gradually reintroduce these foods to identify any sensitivities that may have been triggered or worsened by antibiotic use. Keeping a food and symptom journal can be helpful for tracking how your body responds to different foods.

Step 8: Give It Time

Our gut microbiome can take time to recover fully. Some studies suggest that the microbiome may take up to six months to one year to regain its diversity after antibiotics, depending on the individual and the course of treatment. Be patient with yourself. 

Final Thoughts: You Deserve a Balanced, Healthy Gut

Antibiotics can disrupt your gut balance so they do need to be used judiciously. However with the right strategies, you can help your gut reset and restore balance.

By nurturing your microbiome with probiotics, avoiding gut irritants, and supporting your overall lifestyle, you’ll create an environment where beneficial bacteria can flourish. Your body is resilient—small daily steps will help restore the balance you’re aiming for.