Do antibiotics cause IBS?

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The discovery of antibiotics in the 1920s was a great milestone in medicine saving the lives of billions of people suffering from a variety of bacterial diseases. Unfortunately, it’s become a common practice nowadays to overuse antibiotics even in instances when they are not effective in the fight against specific pathogens, e.g. viruses. One example is the increased consumption of antibiotics to treat COVID-19. It is estimated that almost 78% of patients were prescribed antibiotics for COVID-19 which is a viral infection. (1.)

What are the risks associated with the overuse of antibiotics?

Antimicrobial resistance

Continuous exposure to antibiotics enables certain bacterial strains to become completely resistant to them. These bacterial strains then reproduce and lead to the development of life-threatening bacterial infections. Antimicrobial resistance is considered by the World Health Organisation to be one of the top 10 global public health threats. It could cause an epidemic of certain diseases such as tuberculosis or gonorrhea since the treatment with antibiotics would eventually become ineffective against these. Despite that people are still unaware of the risks the misuse or overuse of these medications poses on public health.

Alteration of the gut microbiota

Antibiotics kill both ‘good’ and ‘bad’ bacteria and this way alter the composition of gut microbiota. It was found that the composition may remain altered for up to 4 years after antibiotic treatment. Alteration of gut microbiota causes dysbiosis in the gut – an unhealthy imbalance in the gut microbial diversity.

Development of IBS

Researchers found that there are similarities in gut microbiota between IBS patients and those after antibiotic treatment. In both cases, there is a reduction in microbial diversity, especially Bifidobacteria, which protect the body against pathogens, help regulate immune response, and the digestion of certain dietary components. Instead, they found an overgrowth of Enterobacteria which are known to cause low-grade inflammation in the gut wall. The evidence suggests that increased consumption of antibiotics (especially in children) is related to the development of gastrointestinal symptoms and could potentially be the cause of IBS or the worsening of IBS symptoms. (2.)

    Doctor handing pills to a patient.

    What can I do to prevent this?

    Avoid the misuse of antibiotics

    Antibiotics are often prescribed for common viral infections such as a cold, flu, ear infections, COVID-19, etc. They are not an effective treatment against viral infections and can kill the ‘good bacteria’ that are there to help you fight the infection. It is not a good idea to take antibiotics as a form of prevention or those prescribed to another person.

    Try taking probiotics and prebiotics to improve gut microbiota

    Probiotics are known to help restore balance in the disrupted gut microbiota and could potentially ease the IBS symptoms. They could also improve digestion and overall intestinal function. Learn more about which type of probiotics to take and how it works.

    Prebiotics are a type of nondigestible fibers that act as ‘food’ for beneficial gut bacteria. They promote its growth and help its metabolic activity. They can be found in certain foods (garlic, bananas, oats, apples, etc.) or dietary supplements.

    Summary

    Antibiotics are an effective treatment for bacterial infections. Throughout the past five decades, treatment with antibiotics significantly reduced the spread of diseases caused by pathogenic bacteria. There is however a need for greater awareness of the consequences caused by the overuse of this ‘miracle drug’. These consequences include a fast spread of bacteria that are resistant to antibiotics and disruption to the diversity of the gut microbiota that is linked to the development and the worsening of IBS symptoms.

    You should consult with a professional whether taking antibiotics is truly necessary to treat your infection and if yes, consider taking probiotics (and prebiotics) to balance out the loss of beneficial gut bacteria.

    References

    1. Malik, S. S., & Mundra, S. (2022). Increasing Consumption of Antibiotics during the COVID-19 Pandemic: Implications for Patient Health and Emerging Anti-Microbial Resistance. Antibiotics12(1), 45. https://doi.org/10.3390/antibiotics12010045
    2. Mamieva, Z., Poluektova, E., Svistushkin, V., Sobolev, V., Shifrin, O., Guarner, F., & Ivashkin, V. (2022). Antibiotics, gut microbiota, and irritable bowel syndrome: What are the relations? World Journal of Gastroenterology28(12), 1204–1219. https://doi.org/10.3748/wjg.v28.i12.1204