Antibiotics are a powerful tool in fighting bacterial infections like strep throat, whooping cough or a urinary tract infection. But they can leave the patient with nausea, diarrhea or an upset stomach.
That’s because antibiotics kill bacteria indiscriminately. They eradicate the malicious bugs causing illness and the beneficial bacteria in the digestive tract that help the body digest and absorb nutrients — disrupting the balance of microbes in the gut, experts say.
“As they’re fighting the bugs that are making you sick, they’re also killing the good bugs that are in our intestines,” Lauri Wright, Ph.D., a registered dietitian, associate professor and director of nutrition programs at the University of South Florida, tells TODAY.com.
“They can wipe out a lot of the good bacteria that are in the gut.”
Antibiotics can also cause villi, the little finger-like projections in the intestines that move things along, to lie flat, which can lead to problems with nutrient absorption, Wright adds.
People can experience antibiotic-associated diarrhea, nausea, bloating and cramping, says Theresa Gentile, a registered dietitian in New York and a spokesperson for the Academy of Nutrition and Dietetics.
But eating right can help diminish the gut flora disruption and restore a healthy balance of the beneficial bacteria.
“They can regrow and repopulate the gut with either foods or supplemental probiotics,” Gentile tells TODAY.com.
Antibiotics foods to eat
While taking antibiotics, the dietitians recommend adding the following to the menu:
Probiotic foods
These probiotic foods contain the healthy bacteria that help create a well-functioning gut.
They include:
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Yogurt with live cultures. But be careful because dairy can decrease the absorption of some antibiotics, like tetracycline, so always check the label on your medication for any food-drug interactions, Wright cautions.
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Kefir, a fermented milk beverage thinner than yogurt but creamier than milk.
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Fermented foods like kimchi, sauerkraut, tempeh and kombucha.
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Cheese. Certain varieties like Swiss, provolone, Gouda, cheddar, Edam, Gruyère and cottage cheese contain probiotics, according to Harvard Health. The same precaution about dairy potentially making some antibiotics less effective applies here, so check the label.
Prebiotic foods
Prebiotics feed the good bacteria in the gut. They’re fibers the body can’t digest, so they’re able to reach the large intestine, where most of those beneficial microbes live, and nourish them.
The strategy is that after eating foods with the healthy bacteria, you then eat other foods that help them thrive, Wright says.
All prebiotics are fiber, but not all fiber is prebiotic, researchers note.
Foods that contain prebiotic fibers include:
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Bananas
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Apples
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Garlic
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Onions
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Leeks
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Asparagus
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Beans
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Whole grains like quinoa, brown rice and oats
Foods with vitamin K
Antibiotics can kill bacteria in the intestines that produce vitamin K, a nutrient that supports normal blood clotting and makes proteins for healthy bones.
“Increasing the intake of the green leafy vegetables like spinach and kale and collards are ways to get vitamin K back in through food,” Wright says.
The only exception is if someone is taking the blood thinner warfarin because this medication and vitamin K work against each other, she adds.
Best foods to eat with antibiotics to avoid nausea
If you have nausea, eating bland foods like saltine crackers or white toast can help, both experts note.
Dry starchy foods are more easily digested, Gentile adds.
“Carbohydrate digestion starts in the mouth, and it’s the only macronutrient that does. So it already starts digesting early and it gets through pretty quickly through digestive (system),” she says.
Broths can help patients stay hydrated, especially if they have diarrhea, Gentile notes.
Ginger or lemon can also help with nausea.
Should you take a probiotic supplement when taking antibiotics?
Wright always prefers using food first, but a probiotic supplement can give people an extra boost.
“The supplement is a good idea because you probably can’t consume enough probiotics in foods,” Gentile says.
The highest quality supplements usually contain Lactobacillus or Bifidobacterium, Wright says, the most commonly used human probiotics, according to studies.
Wait about two to three hours after your antibiotic dose to take the probiotic so the medication doesn’t destroy the healthy bacteria delivered by the supplement, she advises.
Antibiotics foods to avoid
Be careful with these options, the dietitians say:
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Grapefruit. It can interact with some antibiotics such as erythromycin, according to the National Capital Poison Center. Check the label of your antibiotic.
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Fried foods and other foods with a lot of fat. They delay gastric emptying, which “might just make you feel fuller longer and just not feel well,” Gentile says.
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Spicy foods. They can worsen nausea for some people.
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Sugary foods. Candies, sodas and pastries can fuel the harmful bacteria in the gut, throwing off the balance in your body even more, Wright says.
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Alcohol. It can worsen side effects like nausea and diarrhea, she notes.
What should I eat for breakfast while taking antibiotics?
As long as your antibiotic isn’t contraindicated with dairy, pair Greek yogurt with sliced bananas or berries, and sprinkle some chia seeds on top for another source of prebiotic fiber, both dietitians suggest.
Another option is a bowl of oatmeal with bananas and chia seeds, Gentile adds.
What to eat after antibiotics treatment
Continue the probiotic-rich foods and the prebiotic foods so that you can build the gut flora up quicker and with the right balance of healthy bacteria, Wright recommends.
Most healthy adult microbiomes return to normal after two months, studies have found.
This article was originally published on TODAY.com