Gut Check

Pill Box: What about microbiomes?

click to enlarge John R. White chairs WSU-Spokane’s Department of Pharmacotherapy.
John R. White chairs WSU-Spokane’s Department of Pharmacotherapy.

I have been reading a lot lately about the gastrointestinal microbiome and its link to health. Are there medications that have damaging effects on the microbiome?

The billions of microorganisms that live in our gastrointestinal tract have been getting a great deal of attention lately in the scientific and medical community. While there's been the suggestion from researchers that our individual gastrointestinal microbiomes (the types and numbers of organisms that live in our gut) and alterations in the microbiome may be linked to dementia, depression, obesity, autism, diabetes and other issues, the exact nature of these potential associations is still being worked out.

At this point we can say that our gastrointestinal microbiomes are very important for good health, but the particulars are still up for debate. The primary types of medication that can have damaging or altering effects on the microbiome are broad-spectrum antibiotics. It goes without saying that antibiotics should only be taken in certain situations where they are absolutely indicated. Maintenance of a healthy microbiome is simply another factor that we should add to our list of reasons for not overusing antibiotics. In cases where they are needed, changes to the microbiome that result will likely resolve in the weeks to months after antibiotic exposure. Other medications, such as ones that alter the acidity of the gastrointestinal tract, may also alter the microbiome.

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