Opinion & Editorial

TO YOUR GOOD HEALTH – Antibiotics vs. probiotics

DEAR DR. ROACH: I understand that the overuse of antibiotics can harm the good bacteria in the intestinal tract, as well as the bad. While I don’t feel that I am abusing antibiotics, I have been prescribed two courses in the past five years. I wonder what action can be taken to try to ensure that balance in my gut is restored. — M.L.
ANSWER: We are just beginning to understand the beneficial effect of bacteria living in our intestine, and there is preliminary evidence that antibiotics might have adverse long-term effects due to loss of healthy bacteria. I think the most important message from this is to use antibiotics as little as possible, but two courses in five years is certainly modest.
The use of probiotics (healthy bacteria) might help prevent growth of harmful bacteria, improve the immune system, reduce pain and improve the function of the gut lining.
I don’t think probiotics are necessary after the occasional course of antibiotics. However, it is reasonable to consider probiotics in some situations, including in people with inflammatory bowel disease (Crohn’s disease and ulcerative colitis), in cases of infectious diarrhea and perhaps in people with irritable bowel syndrome. Commercial probiotics are expensive, not FDA-approved and aren’t proven to treat or cure any disease as of yet.
Yogurt often is recommended, but not all yogurt contains live healthy bacteria. Even in the ones that do, many of the bacteria are killed by our stomach acid. Other fermented dairy products, such as kefir, have higher concentrations of bacteria. Both of these might be problematic in people with lactose intolerance (which can happen to anyone temporarily after a bout of infectious diarrhea)
DEAR DR. ROACH: My domestic partner’s body heat is always very warm. We keep our home at 75 degrees F, and she complains that the house is too hot. Even at night when I touch her, I can feel the heat on her body. What do you think might be causing this to happen? Is this normal? She is in her mid-60s. — C.B.
ANSWER: It is not at all abnormal for people to have different temperatures at which they feel comfortable, and 75 degrees F is on the warm side of comfort for many.
One way that our bodies regulate temperature is through blood flow to the extremities. When the blood vessels are open, the person will feel quite warm to the touch, and when trying to conserve heat, the skin feels cold and clammy.
If she is really bothered by it, it might be worth thinking about two common medical issues: hyperthyroidism and vasomotor instability of menopause. In hyperthyroidism, the entire metabolism is enhanced, so the person is warm all the time. A simple blood test can confirm this diagnosis.
In a woman in her 60s, it is common to have periods of vasomotor instability, usually called hot flashes. In these, the blood vessels open up and the woman becomes uncomfortably hot for a few minutes. It is possible that one of these could be happening for your partner. However, sometimes variations in normal physiology can fool the physician into thinking there is a problem.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]. To view and order health pamphlets, visit www.rbmamall.com.
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