# Why are antibiotics so damn hard on the digestive system? **URL:** \ **Category:** Factual Questions\ **Created:** [February 6, 2013, 6:16pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507 "2013-02-06T18:16:26Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [February 7, 2013, 1:56am UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/21 "2013-02-07T01:56:09Z")
> [@Quercus](#): > > I saw an article in the last month or two (though my Google-fu is too weak to quickly find it) that some people are experimenting with artificial feces This is one subject I’m _definitely_ not going to google for myself. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [February 7, 2013, 4:00am UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/22 "2013-02-07T04:00:29Z")
According to this [May 2012 JAMA meta-analysis](http://jama.jamanetwork.com/article.aspx?articleid=1151505) probiotics work for antibiotic-associated diarrhea (AAD). > [@](#): > > The pooled relative risk in a DerSimonian-Laird random-effects meta-analysis of 63 RCTs, which included 11 811 participants, indicated a statistically significant association of probiotic administration with reduction in AAD (relative risk, 0.58; 95% CI, 0.50 to 0.68; P \< .001; I2, 54%; [risk difference, −0.07; 95% CI, −0.10 to −0.05], [number needed to treat, 13; 95% CI, 10.3 to 19.1]) in trials reporting on the number of patients with AAD. This result was relatively insensitive to numerous subgroup analyses … > > … The existing evidence base for the prevention or treatment of AAD consists primarily of Lactobacillus interventions, either alone or in combination with other genera. Although RCTs of interventions of Streptococcus, Enterococcus, or Bacillus were eligible for inclusion in the review, few trials were identified. The included trials predominantly used lactic acid–producing bacteria such as Lactobacillus rhamnosus, or L casei with few exceptions, the Saccharomyces trials used the yeast S boulardii [cerevisiae]. The relative efficacy of probiotic interventions may be strain specific81; however, this analysis found no evidence that the effectiveness varies systematically even by probiotic genus. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [February 7, 2013, 4:11am UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/23 "2013-02-07T04:11:26Z")
> [@Qadgop\_the\_Mercotan](#): > > Again, these are mostly only one strain of bacteria, not really sufficient to change much. Recent research suggests it takes a dozen different strains to make a big difference quickly. Though some experts are saying they might be able to get a decent clinical effect with 6 strains. > > Much new investigation is going on in this field. Doc, you can now get probiotics with a dozen strains in them. They do cost more, but they are out there. The days where all they have is _Lactobacillus acidophilus_ are over, if you look for them. > **[Amazon.com: DrFormulas' Best Probiotics for Women & Men | Nexabiotic Multi...](https://www.amazon.com/DrFormulas-Probiotics-Saccharomyces-Lactobacillus-Acidophilus/dp/B0050FKPU0)** > > Buy DrFormulas' Best Probiotics for Women & Men | Nexabiotic Multi Probiotic with Saccharomyces Boulardii, Lactobacillus Acidophilus, B. infantis, Prebiotic 60 Count Capsules (Not Pearls) on Amazon.com ✓ FREE SHIPPING on qualified orders ---
**Author:** ![moriah](https://avatars.discourse-cdn.com/v4/letter/m/b2d939/32.png) [@moriah](https://boards.straightdope.com/u/moriah)\ **Post date:** [February 7, 2013, 4:39am UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/24 "2013-02-07T04:39:18Z")
[Fecal transplant.](http://www.nytimes.com/2013/01/17/health/disgusting-maybe-but-treatment-works-study-finds.html) ---
**Author:** ![cmyk](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cmyk/32/3353_2.png) [@cmyk](https://boards.straightdope.com/u/cmyk)\ **Post date:** [February 7, 2013, 5:14am UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/25 "2013-02-07T05:14:31Z")
Yeesh… > [@](#): > > Books on traditional Chinese medicine mention giving it to people by mouth to cure diarrhea in the fourth century; one book called it yellow soup. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [February 7, 2013, 5:57am UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/26 "2013-02-07T05:57:26Z")
> [@cmyk](#): > > Yeesh… And likely, 99% of the time, the very worst thing you could possibly do. ---
**Author:** ![cmyk](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cmyk/32/3353_2.png) [@cmyk](https://boards.straightdope.com/u/cmyk)\ **Post date:** [February 7, 2013, 6:06am UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/27 "2013-02-07T06:06:04Z")
Poop Soup™. It’s the worst thing to do, and the worst way to do it. /Wilford Brimley ---
**Author:** ![Koxinga](https://avatars.discourse-cdn.com/v4/letter/k/4af34b/32.png) [@Koxinga](https://boards.straightdope.com/u/Koxinga)\ **Post date:** [February 7, 2013, 6:20am UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/28 "2013-02-07T06:20:32Z")
> [@cmyk](#): > > Yeesh… > > > [@](#): > > > > Books on traditional Chinese medicine mention giving it to people by mouth to cure diarrhea in the fourth century; one book called it yellow soup. So _that’s_ how [stinky tofu](http://en.wikipedia.org/wiki/Stinky_tofu) originated. I knew it! Seriously, the stuff smells literally like shit. Steaming, pan-fried, shit. ---
**Author:** ![CandidGamera](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/candidgamera/32/2878_2.png) [@CandidGamera](https://boards.straightdope.com/u/CandidGamera)\ **Post date:** [February 7, 2013, 2:10pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/29 "2013-02-07T14:10:53Z")
I usually tolerate antibiotics rather well, but for some reason in the last couple of years, they haven’t been giving me my beloved Amoxicillin, instead trying out others. (I had a non-itchy rash with it once - they may be being over-cautious about an allergic reaction.) Well, late last year, I got Bactrim for the first time. Six hours after my first dose (with food!) I got so nauseous that I thought I was going to die. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [February 7, 2013, 2:11pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/30 "2013-02-07T14:11:28Z")
> [@DrDeth](#): > > Doc, you can now get probiotics with a dozen strains in them. They do cost more, but they are out there. The days where all they have is _Lactobacillus acidophilus_ are over, if you look for them. > > [Amazon.com: DrFormulas' Best Probiotics for Women & Men | Nexabiotic Multi Probiotic with Saccharomyces Boulardii, Lactobacillus Acidophilus, B. infantis, Prebiotic 60 Count Capsules (Not Pearls) : Health & Household](http://www.amazon.com/Benebiotics-Multi-probiotic-Lactobacillus-Bifidobacterium-Saccaharomyces/dp/B0050FKPU0/ref=sr_1_1?ie=UTF8&qid=1360210164&sr=8-1&keywords=probiotics+supplement+strains) Good! Hopefully they’re the _right_ strains. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [February 7, 2013, 2:26pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/31 "2013-02-07T14:26:03Z")
Nm. ETA: I was about to mention the memorable phrase “Yellow soup,” but others have done so. Hair of the dog that bit you. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [February 7, 2013, 2:27pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/32 "2013-02-07T14:27:53Z")
> [@DSeid](#): > > According to this [May 2012 JAMA meta-analysis](http://jama.jamanetwork.com/article.aspx?articleid=1151505) probiotics work for antibiotic-associated diarrhea (AAD). Yeah, but you wade thru all the data, and it does point out that the effectiveness may be derived via use of preparations that contain blends of multiple species, though it bemoans lack of documentation as to just how many species of which type were used in most of the trials studied. And with an NNT of 13 (need to treat 13 patients with this regimen to have one bad outcome avoided), it won’t benefit the typical patient. Not that it should be avoided for that reason, but patients should not expect to see a difference in their particular case. ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [February 8, 2013, 2:22pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/33 "2013-02-08T14:22:53Z")
> [@Qadgop\_the\_Mercotan](#): > > Meh. Yoghurt doesn’t have enough variety of strains in it to make much of a difference. Won’t hurt, usually doesn’t help much. > > Fecal transplant is the answer. Heh - I just heard a podcast on this very subject and yeah, that’s what I thought too! Seriously. No, they don’t operate and implant poop in your gut… they actually take a somewhat purified donation, mix it with milk, and administer by a nasogastic tube or something. Supposedly it has a pretty dramatic effect. Of course, I’m guessing that if it’s done during the antbiotic treatment, the medication would just kill those critters too. ---
**Author:** ![Happy\_Fun\_Ball](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/happy_fun_ball/32/17664_2.png) [@Happy\_Fun\_Ball](https://boards.straightdope.com/u/Happy_Fun_Ball)\ **Post date:** [February 8, 2013, 2:52pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/34 "2013-02-08T14:52:09Z")
> [@Mama\_Zappa](#): > > Heh - I just heard a podcast on this very subject and yeah, that’s what I thought too! Seriously. No, they don’t operate and implant poop in your gut… they actually take a somewhat purified donation, mix it with milk, and administer by a nasogastic tube or something. Supposedly it has a pretty dramatic effect. > > Of course, I’m guessing that if it’s done during the antbiotic treatment, the medication would just kill those critters too. Link to podcast please? I have been following these advancements for years and find it fascinating. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [February 8, 2013, 3:32pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/35 "2013-02-08T15:32:27Z")
> [@Qadgop\_the\_Mercotan](#): > > … And with an NNT of 13 (need to treat 13 patients with this regimen to have one bad outcome avoided), it won’t benefit the typical patient. Not that it should be avoided for that reason, but patients should not expect to see a difference in their particular case. A fair point but one can also look at it like this: antibiotic-associated diarrhea was only 58% as likely when using probiotics, i.e. the risk was cut almost in half. The reason for the need to treat (NNT) being 13 was mainly, as stated, “AAD does not occur in the majority of patients.” Most people won’t have AAD if they use probiotics … and most won’t if they do _not_ use probiotics. If you are someone however who IS prone, and wants to avoid it, then using probiotics may cut your risk nearly in half. ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [February 8, 2013, 4:37pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/36 "2013-02-08T16:37:41Z")
> [@L. G. Butts](#): > > Link to podcast please? I have been following these advancements for years and find it fascinating. How Stuff Works, which is related to the Discovery Channel etc. (I think). They have lots of cool info. Related podcasts include Stuff You Missed In History Class and Stuff Your Mom Never Told You. The one in question (which I quite literally listened to just 2-3 days ago) was called “Fecal Transplants” and it came out on January 24th. ---
**Author:** ![bordelond](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bordelond/32/150_2.png) [@bordelond](https://boards.straightdope.com/u/bordelond)\ **Post date:** [February 8, 2013, 7:24pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/37 "2013-02-08T19:24:57Z")
So … what’s going on physiogically with people who take antibiotics and DON’T have any digestive effects? ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [February 8, 2013, 9:13pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/38 "2013-02-08T21:13:29Z")
> [@bordelond](#): > > So … what’s going on physiogically with people who take antibiotics and DON’T have any digestive effects? The antibiotics didn’t kill \*all \*your gut probiotics. They usually don’t, in fact. ---
**Author:** ![johnpost](https://avatars.discourse-cdn.com/v4/letter/j/f17d59/32.png) [@johnpost](https://boards.straightdope.com/u/johnpost)\ **Post date:** [February 10, 2013, 2:38pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/39 "2013-02-10T14:38:19Z")
some recent shit from downunder. Poo transplants - the Australian story > **['Poo transplants' - the Australian story - ABC Radio National](https://www.abc.net.au/radionational/programs/ockhamsrazor/27poo-transplants27---the-australian-story/4501528)** > > Dyani Lewis from the Melbourne School of Population Health at the University of Melbourne, provides an insight into the Australian scene of 'poo transplants' and how the 100 trillion microbes living in and on our bodies are not all bad for our... ---
**Author:** ![johnpost](https://avatars.discourse-cdn.com/v4/letter/j/f17d59/32.png) [@johnpost](https://boards.straightdope.com/u/johnpost)\ **Post date:** [February 10, 2013, 3:15pm UTC](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507/40 "2013-02-10T15:15:43Z")
> [@johnpost](#): > > some recent shit from downunder. > > Poo transplants - the Australian story > > ['Poo transplants' - the Australian story - ABC listen](http://www.abc.net.au/radionational/programs/ockhamsrazor/27poo-transplants27---the-australian-story/4501528) there was also Clostridium difficile and the probiotic bomb > **[Clostridium difficile and the probiotic bomb - ABC listen](https://www.abc.net.au/listen/programs/healthreport/clostridium-difficile-and-the-probiotic-bomb/4488506)** > > A study recently published in the New England Journal of Medicine tested the effects of infusing donor faeces into patients experiencing recurrent Clostridium difficile infections. along with some older shit Human Probiotic Infusion > **[Catalyst](https://iview.abc.net.au/show/catalyst)** > > Exploring the forefront of science and technology, Catalyst brings you compelling stories looking at the latest in science from health and medical breakthroughs to astronomy, environment, and agriculture. [Previous page](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507.md?page=1) [Next page](https://boards.straightdope.com/t/why-are-antibiotics-so-damn-hard-on-the-digestive-system/649507.md?page=3)