The term “gut” is synonymous with the digestive tract−primarily the stomach, small and large intestines, but also includes our mouth, esophagus, liver, gallbladder and pancreas. Our gut serves as host to approximately 1,000 unique species of bacteria, both good and bad, that regulate the immune system, aid in food digestion, produce certain key nutrients and protect us from toxins and pathogens. To ensure proper gut health, we need to maintain the proper balance of bacteria. But many of the common medications we use can upset that balance.
Some medications you should be mindful of and that can affect gut health include:
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Antibiotics – We all know that antibiotics can be highly effective in treating serious bacterial infections, but there is increased concern about misuse and overuse. Never take an antibiotic if it has not been prescribed to you by your physician, and steer away from antibiotic usage when an illness can be resolved on its own.
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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) – NSAIDs (i.e Motrin, Advil and Aleve) are North America’s number one painkiller of choice. Unfortunately, they don’t just kill pain. They also disrupt the normal balance of the beneficial bacteria living in your gut. In addition, taking these too often and on an empty stomach can cause ulcers in the gut lining and potentially lead to a bleeding ulcer.
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Proton Pump Inhibitors (PPIs) – These acid blockers—used to treat indigestion, peptic ulcers and acid reflux—are also known to both reduce nutrient absorption and the diversity of gut bacteria. This can lead to an increased chance of infections like Clostridium difficile (also known as C. difficile or C. diff) and pneumonia, as well as vitamin deficiencies and bone fractures. Generic PPI names include omeprazole, pantoprazole, esomeprazole, lansoprazole, rabeprazole and dexlansoprazole.
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Antacids – Beyond PPIs specifically, all antacids (TUMS) neutralize the acid in our stomach, which is the body's first line of defense from harmful pathogens that we ingest every day. We increase our risk for stomach bugs and infections if we are taking antacids on an ongoing basis.
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Antidepressants – One of the most popular classes of antidepressants are selective serotonin reuptake inhibitors (SSRIs). Scientists estimate that 90 percent of serotonin is made in the gut. Imbalances in serotonin have been linked to diseases including irritable bowel syndrome, cardiovascular disease and osteoporosis. This gives us a lot to consider when taking a SSRI and anyone taking these medications (Prozac, Zoloft, Citalopram, Sertraline etc) should also be taking a probiotic to improve the efficacy of the medications.
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Sleeping pills – Like antidepressants, sleeping pills are fat-soluble drugs. They not only induce dependance and can impact short and long term memory, but they can penetrate the gut wall and injure the natural balance of the digestive system. (Zopiclone, Ativan)
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Laxatives – Laxatives have their place, for example after surgery, but they do not fix the root cause if diet or lifestyle is causing constipation. Not only are these often habit forming, then can also affect the balance of gut bacteria. They should be used in moderation and only for short periods of time. (Senokot, PEG, Dulcolax)
- Statins – Statins, or cholesterol lowering medications, are the most widely prescribed medications worldwide. Recent research indicates that statins may negatively influence the balance of gut bacteria, in addition to other side effects. (Lipitor, Crestor, any medication that ends with -statin)