Re: flagyl with probiotics and florastor?

[mgbio]

Jeff,

Any time I have taken antibiotics, and I've taken a lot of Cipro and flagyl, my nutritionist, an MD, has recommended a probiotic. I was instructed to take the probiotic either 1 hour before or 2 hours after taking the antibiotics. HTH.

:) mgbio

jeff wrote:

> hello, i am in what i suppose can be called remission, but i still don't
> feel quite normal and i am on 40 mg/day of prednisone, which my doctor
> does not want me to taper until the 6MP (which i just began a week ago)
> takes effect.
>
> last time i had a flare, a ten day course of flagyl put me into
> remission for a year and a half. we have already tried flagyl this
> flare and it did not work, but for some reason my doc thinks we should
> give it another go. i am currently taking nature's way probiotics, as
> well as florastor. my doctor does not know i am taking these. should i
> continue with the probiotics and florastor? will the flagyl negate any
> positive effects from these? should i take the florastor and probiotics
> at a different time of the day from the flagyl?
>
> i feel like since beginning the florastor only about a week ago, i have
> been getting a bit better. if the florastor has in fact been helping
> me, will taking the flagyl negate this effect? i am going to take the
> florastor for another 4 days. should i wait until then to begin the
> flagyl. how should i proceed? thanks...
>
> jeff
>

[Wayne Marsh]

jeff wrote on 8/22/04 9:25 PM:

> will the flagyl negate
> any positive effects from these?

In my experience, the answer is yes. Flagyl is a high-powered antibiotic,
and any Lactobacillus bugs swimming around in your gut will probably be dead
meat while you're taking it.

Wayne Marsh Minneapolis, Minnesota, USA
wayne...@mac.com

[Alan Kennedy]

[jeff]

> should i continue with the probiotics and florastor? will the
> flagyl negate any positive effects from these? should i take
> the florastor and probiotics at a different time of the day from
> the flagyl?

[Wayne Marsh]

> In my experience, the answer is yes. Flagyl is a high-powered antibiotic,
> and any Lactobacillus bugs swimming around in your gut will probably be dead
> meat while you're taking it.

Flagyl has minimal effect on aerobic bacteria such as Lactobacillus
spp.

This Pfizer information sheet discusses how flagyl treatment can
successfully restore lactobacillus flora in the vagina.

http://www.pfizer.com/download/uspi_flagyl_er.pdf

Flagyl is active against anaerobic bacteria, i.e. the kind that live
mostly in the human colon, e.g. bacteroides spp., eubacterium spp.,
etc. Note that 99% of the intestinal flora consist of these colonic
anaerobes: the flora of the other bowel areas added together is less
than 1%.

Taking commercial probiotics, which mostly consist of dairy-derived
aerobes, to counteract the effects of flagyl, will achieve little.
Instead, you should consider the following

1. Being treated with a fecal transfusion from a healthy genetic
relative. By re-establishing an entirely new and healthy bowel
*ecology*, you avoid the problems inherent in the "random carpet
bombing" that is ad-hoc antibiotic treatment.

2. If you must take flagyl, encourage growth of healthy bacteria in
your colon by consuming a healthy diet. Eat foods that contain fibre:
soluble fibre is particularly important, since its long chain
molecules act as "dredge ropes" which scour the surface of the
intestine, dislodging micro-organisms, giving the normal floral
inhabitants of your intestines an opportunity to recolonise.

I find organic rice is particularly effective for the latter. I eat a
mix from my local health food store which consists of

50% Organic long grain rice
35% Organic red rice
15% Organic wild rice

It is most important that the rice not be processed, i.e. had its
hulls removed: that's where the best soluble fibre is. This rice takes
a lot of cooking, and can be bulky in the guts, so I would recommend
eating smaller amounts until you get accustomed to it. And of course,
if you've got any form of structural damage to the bowel, e.g.
strictures, you may have to avoid such fibrous food.

On occasion, I've had stunning results with this rice: after a few
days of eating it, my clinical parameters improve as much as they
would as if I had active disease and had started a course of steroids,
for example. The greatest improvement comes from toilet habits: I find
myself going less frequently, having a much more "solid" experience
when I do, having far fewer problems/pain (25 years of Crohn's has
taken it's toll on my poor behind), dehydrate far less easily, sleep
sounder thus requiring less sleep, more energy, etc, etc, etc.

Alan.

[Nina]

Jeff,
As I understand it the antibiotics will reduce the effectiveness of
the probiotics significantly, just by their intent. However, spacing
the two apart will give you the benefits of both. The antibiotics will
kill everything, including the stuff that may be contributing to your
suffering. Taking the probiotics later will provide a more normal
flora until your next antibiotic dose. The probiotics will also help
with candida issues that can sometimes be a a problem with
antibiotics.
Tell you Dr, it is unlikely he/she would object. In fact it may be
recommended.
Good luck!
NinaW
jeff <> wrote in message news:<2004082219250316807%@news.comcast.giganews.com>...

> hello, i am in what i suppose can be called remission, but i still
> don't feel quite normal and i am on 40 mg/day of prednisone, which my
> doctor does not want me to taper until the 6MP (which i just began a
> week ago) takes effect.
>
> last time i had a flare, a ten day course of flagyl put me into
> remission for a year and a half. we have already tried flagyl this
> flare and it did not work, but for some reason my doc thinks we should
> give it another go. i am currently taking nature's way probiotics, as

> well as florastor. my doctor does not know i am taking these. should

> i continue with the probiotics and florastor? will the flagyl negate
> any positive effects from these? should i take the florastor and
> probiotics at a different time of the day from the flagyl?
>

[mgbio]

Thanks Jeff. One thing you should be on the lookout for is any sign of numbness and tingling in your hands and/or feet. This is a sign of peripheral neuropathy. It can happen to CD patients but is also a side effect of flagyl. I suffer from this and though it started while I was one flagyl we'll never know if it was flagyl induced or not. When caught quickly and flagyl stopped, permanent damage can be avoided.

:) mgbio

jeff wrote:
> thanks again mgbio. i have really come to count on your answers to my
> questions. i really appreciate you and others on this ng. thanks again...
>
> jeff

[Jeff2]

I take Cipro and a probiotic, Nature's Way product in fact. I highly endorse
their probiotics, but they may not work for everyone of course.

Cipro does have a number of contra-indications or things that you need to be
aware of. Cipro interacts negatively with a number of different minerals.
Most notably calcium, magnesium and I think zinc, also iron if I'm not
mistaken. The instructions say that you should take the Cipro at least 2
hours before taking anything that contains these minerals mentioned or at
least 6 hours after. This gives your body a chance to absorb the cipro and
the cipro can do it's thing without being negated by the minerals which tend
to bind up with it and render it ineffective.

So I tend to use this as a general rule of thumb. If those time periods work
for Cipro and minerals then it might also have some similar effect with
Cipro and probiotics. So I do the same with my probiotics. I take them at
least 2 hours after the cipro or 6 hours before.

I don't know for sure if cipro has any negative effect on the probiotics, or
visa-versa but just in case I'd rather try to maximize the benefits of both.
So I use the specified time periods.

Also, you said you felt that the probiotics seemed to help. I would trust
your intuition on this and continue taking them to see if you continue to
improve. Stopping after 4 days may halt the progress you've made. More and
more evidence is now pointing to the fact that having healthy gut flora can
help a lot of IBD sufferers. But regaining that healthy flora is not always
an easy thing to do.

Good luck whatever you decide to do.

Regards,
Jeff

<jeff> wrote in message
news:2004082219250316807%@news.comcast.giganews.com...

[William Kaufman]

Alan--

I assume that you eat only brown rice, not white rice?

Thanks.

"Alan Kennedy" <ala...@hotmail.com> wrote in message
news:f72dac0d.0408...@posting.google.com...

[Alan Kennedy]

[Alan Kennedy]

>> I find organic rice is particularly effective for the latter.
>> I eat a mix from my local health food store which consists of
>>
>> 50% Organic long grain rice
>> 35% Organic red rice
>> 15% Organic wild rice

[William Kaufman]

> Alan--
>
> I assume that you eat only brown rice, not white rice?

My understanding of the term "brown rice" is that it is actually white
rice. But "brown rice" is the term used to differentiate unprocessed
white rice from processed white rice (known as "white rice").

So, yes, although the "long grain rice" I eat is white in colour
(actually more of a cream colour) it is "brown rice", not "white
rice".

Here are some pictures of the rice I mean

Descriptions and Photos: Rice, Brown
http://www.all-creatures.org/recipes/i-rice-brown.html

While looking for a picture of "brown rice", I also chanced upon this
most interesting page which claims that the nutritional benefits of
brown rice can be increased by soaking.

Soaked brown rice is better for you
http://www.abc.net.au/science/news/stories/s225249.htm

In the past, I have tried mixing 15% wild rice with ordinary "white
rice" and found that it doesn't provide nearly the same benefit: the
"brown rice" is also required.

Regards,

Alan.

[William Kaufman]

Alan--
Do you lend any credence to the theory or practice behind the starch-free
and sugar-free "specific carbohydrate diet" as a means of remediating IBD? I
assume that you don't since you're eating rice, but I'm curious to hear your
views about it.

Thanks,
Bill

"Alan Kennedy" <ala...@hotmail.com> wrote in message

news:f72dac0d.04082...@posting.google.com...

[Alan Kennedy]

[William Kaufman]

> Alan--
> Do you lend any credence to the theory or practice behind the
> starch-free and sugar-free "specific carbohydrate diet" as a
> means of remediating IBD?

Indeed, I do believe that SCD can be effective in the management of
IBD. I refer you to the archives

http://groups.google.com/groups?q=%22alan+kennedy%22+%22specific+carbohydrate+diet%22

> I assume that you don't since you're
> eating rice, but I'm curious to hear your views about it.

There are a number of things to say in reply.

1. Just because I don't follow a regime personally doesn't imply that
I believe it to be ineffective.

2. As you may have inferred from reading the threads in the archives,
I believe that the SCD works primarily for unknown microbiological
reasons, not the biochemical reasoning which forms the basis of the
diet.

3. I wonder how brown rice would be classified by the SCD? I don't
know the SCD intimately enough to say. Perhaps the complex
carbohydrates in the rice are permitted by SCD? Is not the SCD
primarily concerned with the elimination of simple carbohydrates, i.e.
certain di-saccharides: other simple carbohydrates, e.g.
mono-saccharides such as fructose, are permitted, as are
poly-saccharides.

4. I believe that a diet containing complex carbohydrates is a
fundamental requirement for maintaining a healthy bowel flora. Such
complex carbohydrates are "prebiotics", i.e. food for "probiotics".

I suppose I would summarise by saying that *any* treatment for IBD
that does not take the microbial ecology of the intestine into account
is, at best, based on incomplete data, and at worst, has a high risk
of unpredictable outcomes.

And, it appears more and more, treatments that focus primarily on
intestinal ecology are delivering very promising results: fecal
transfusion, worm therapy, etc. More and more evidence is confirming
that a healthy gut microbial ecology is a fundamental requirement for
a healthy human bowel, which is itself a prerequisite for a human body
to be healthy.

The 10 trillion microbes that occupy the human intestine are really an
unclassified organ of the human body. They are of comparable weight to
the heart, brain, liver, etc, and at least as complex at a molecular
level. We are truly symbiotic with a range of bacterial species upon
which we depend for good health: they depend on us, we depend on them.
And they are very good at defending their turf, i.e. our intestines,
from pathogenic invasion, using a range of "biochemical warfare"
techniques: the role and complexity of bacteriocins (bacterial
antibiotics) in the ecology is only beginning to be understood, for
example.

Pity nobody makes enough money out of this area to spend some of it on
clinical trials: I believe that fecal therapy should among the first
line treatments for a range of bowel conditions: it's effective, fast
and cheap, with a low risk profile if properly administered under
medical supervision.

Alan.

[William Kaufman]

>
> 3. I wonder how brown rice would be classified by the SCD? I don't
> know the SCD intimately enough to say. Perhaps the complex
> carbohydrates in the rice are permitted by SCD? Is not the SCD
> primarily concerned with the elimination of simple carbohydrates, i.e.
> certain di-saccharides: other simple carbohydrates, e.g.
> mono-saccharides such as fructose, are permitted, as are
> poly-saccharides.

No--in the SCD, both disaccharides and polysaccharides are forbidden, which
means that all starches--including all grains--are on the SCD "illegal"
list. As Elaine Gottschall writes in "Breaking the Vicious Cycle," "Any
cereal grain is strictly and absolutely forbidden, including corn, oats,
wheat, rye, rice, millet, buckwheat, or trticale in any form, whether as
bread, cake, toast, zweiback, crackers, cookies, cereals, flour, or pasta."

Yet you seem to do well with brown rice, and I and others seem to have
experienced a soothing effect from oatmeal (I have Crohn's disease). So
maybe wheat is the culprit for some reason?

I'd be interested in hearing more about your overall diet plan--what foods
you find beneficial and which you find harmful. (By the way--do you have
Crohn's or some other form of IBD?)

4. I believe that a diet containing complex carbohydrates is a
> fundamental requirement for maintaining a healthy bowel flora. Such
> complex carbohydrates are "prebiotics", i.e. food for "probiotics".

Interesting--this is what my gastroenterologist told me. But Gottschall's
theory is that starches, because they are such a digestive challenge and
spend so much time fermenting in the intestines, encourage the growth of
harmful bacteria, not the beneficial ones. But my GI doctor seems to agree
with you--that the carbohydrates encourage the growth of beneficial
bacteria. I suppose that no one has pinned this down definitively.

I do take oral probiotics. I hope that they do some good, although there is
some doubt that the beneficial bugs survive their encounter with stomach
acids and ever reach the intestines. To enhance their chances of getting
past the stomach, I take an enteric-coated brand.

Bill Kaufman

[Jeff2]

Alan - where were you a year or two ago when I was getting lambasted for
promoting good bowel health through treatments that aid in building a good
intestinal ecology. Damn! lol.

But seriously, although I took some heat you have a much more polished and
learned approach. It's good to see someone who can get the information out
in such scholarly fashion. :-)

My hat is off to you (well if I wore one it would be)
Jeff

"Alan Kennedy" <ala...@hotmail.com> wrote in message

news:f72dac0d.04082...@posting.google.com...

[heathernaf]

the way i understand it is that florastor is a yeast based probiotic.
because it is a yeast and not a bacteria, it can be taken right away with
the antibiotics and still live, unlike lactobacillus, which would be
killed off. from my experience, i've only seen good results with the
florastor.

[Bevi]

I keep reading this and am on a second bout with c-dif... I thought it had gone, it appears to have been a product of multi antibiotics. (PAs and NAs and Doctors should be educated to also prescribe/recommend probiotics when ordering these hi functioning anti biotics. In my case, I went to urgent care on the 13th of the month and was told I had a 'little pneumonia' and was prescribed a shot and two antibiotics, on the 18th I was worse, went to ER and the NP there said I had acute bronchitis and they should have treated that first and was put on two more hi functioning 'paks' :( I had never heard of the probiotic thing, and they never informed me of the dangers of these antibiotics. Consequently, 2 days after Thanksgiving the nightmare started.. Uncontrollable diarrhea day and night. Doctor was no help, down here you are told to go to ER ...(even the your doctor is the one with all of your records:( ) I kept calling, a friend mentioned probiotics and that was the first I had heard. Finally after some horrific phone calls to the Doc's office I was prescribed Flagyl.. which was somewhat effective. My mother was in another state and became very ill and had Hospice. I was so bad that I could not fly home, I needed to be by my facilities every moment. I went on a tear and that was when the flagyl was ordered... after testing for c dif.... it did not respond as quickly, so finally she put me on a protocol.. I was the one who mentioned probiotics and started taking them via a health food store.. but doc put me on Floranex 4 tablets 4Xdly finally. She also added vancomycin and finally with the aid of lomotil which they do not recommend taking much of.. I was able to fly home. Mom passed away:( The combination of the two seemed to have helped tho it took a couple of months ... well now it is back and I am frustrated. Don't know what to do.. back on Flagyl waiting more test results. I just found out that perhaps I should not take the probiotics near the same time as the flagyl.. I am not hopeful either way, I must admit. I just found this place..I know it is not c dif, but symptomology is so similar

[zumon...@yahoo.com]

Hi Bevi,

> I keep reading this and am on a second bout with c-dif... I thought it had gone, it appears to have been a product of multi antibiotics. (PAs and NAs and Doctors should be educated to also prescribe/recommend probiotics when ordering these hi functioning anti biotics. In my case, I went to urgent care on the 13th of the month and was told I had a 'little pneumonia' and was prescribed a shot and two antibiotics, on the 18th I was worse, went to ER and the NP there said I had acute bronchitis and they should have treated that first and was put on two more hi functioning 'paks' :( I had never heard of the probiotic thing, and they never informed me of the dangers of these antibiotics. Consequently, 2 days after Thanksgiving the nightmare started.. Uncontrollable diarrhea day and night. Doctor was no help, down here you are told to go to ER ...(even the your doctor is the one with all of your records:( ) I kept calling, a friend mentioned probiotics and that was the first I had heard. Finally after some horrific phone calls to the Doc's office I was prescribed Flagyl.. which was somewhat effective. My mother was in another state and became very ill and had Hospice. I was so bad that I could not fly home, I needed to be by my facilities every moment. I went on a tear and that was when the flagyl was ordered... after testing for c dif.... it did not respond as quickly, so finally she put me on a protocol.. I was the one who mentioned probiotics and started taking them via a health food store.. but doc put me on Floranex 4 tablets 4Xdly finally. She also added vancomycin and finally with the aid of lomotil which they do not recommend taking much of.. I was able to fly home. Mom passed away:( The combination of the two seemed to have helped tho it took a couple of months ... well now it is back and I am frustrated. Don't know what to do.. back on Flagyl waiting more test results. I just found out that perhaps I should not take the probiotics near the same time as the flagyl.. I am not hopeful either way, I must admit. I just found this place..I know it is not c dif, but symptomology is so similar

The post you're replying to is nearly 10 years old. This group is a lot less active these days.

It would help me if you broke your post up, I see one long run on paragraph. Its make sit harder for me to read / understand.

That said, there are many Probiotics out there. If you can afford it, VSL#3 has the most clinical studies behind it. I'm in the USA and don't know of any insurance that covers it either, so its all out of pocket.

I've tried it and never noticed any benefit but my metabolism is ... odd.

I use "Nature's Way Primadophilus Bifidus" and it has helped. I was diagnosed with small bowel bacteria overgrowth in 2012 and that is treated with antibiotics or probiotics. Due to my GI problem antibiotics almost always cause diarrhea, so I upped my dose from 1 capsule to 4 per day and improved within a wekk (not well just better). It took months to finally take care of.

Consumer Reports has an article on them: http://www.consumerreports.org/cro/2013/10/probiotics-can-help-prevent-dangerous-infections/index.htm

There are many different probiotics, I'm not aware of any optimal dosing time when used with antibiotics. Part of the process is using the probiotics to keep adding "good" bacteria so they are the ones that are around after the antibiotics are done.

There are still a few of us around so you might get a few more responses. If you have any specific questions, please ask.

HTH,

-
Luke

[zumon...@yahoo.com]

Hi Bevi,

Me again.

I didn't think of it last time but there is a treatment for cdiff (in the USA, not sure where else) called something like "fecal microbiota transplantation".

Basically take a stool sample from a healthy donor, thin it with saline and give it (via colonoscopy) to someone suffering from cdiff. It is like taking probiotics but coming in the other end.

Search and you'll find many articles. Here are 2.

http://www.mayoclinic.org/medical-professionals/clinical-updates/digestive-diseases/quick-inexpensive-90-percent-cure-rate

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365524/

HTH,

-->Luke