Navigating post-antibiotic IBS: A gut dietitian’s take

As a gastro dietitian, over the years I’ve seen so many clients who are struggling with the challenges of post-antibiotic irritable bowel syndrome (IBS). 


So, what exactly is post-antibiotic IBS? In short, it’s a condition that can arise after a course of antibiotics and often brings about really uncomfortable and distressing symptoms. In today’s article, we'll shed light on post-antibiotic IBS and hopefully, give you some insights into how nutrition changes can make a big difference in managing your symptoms.

Understanding post-antibiotic IBS

Post-antibiotic IBS occurs when the delicate balance of bacteria in the gut is disrupted by antibiotic treatment, leading to symptoms like bloating, abdominal pain, diarrhoea, and constipation. This imbalance can persist long after the antibiotic course has ended, causing no end of ongoing digestive troubles.

My clients often tell me in clinic that they suddenly have symptoms when eating foods that they never had issues with before. Which can be frustrating, to say the least! 

Post-infectious vs post-antibiotic IBS

The difference between post-antibiotic and post-infectious gut symptoms can be a little confusing. 

Post-antibiotic means that you have taken an antibiotic for any part of your body, not just within your gut. One example could be for a urine infection. The antibiotic itself has messed things up. 

On the other hand, post-infectious means you’ve specifically had a stomach bug. You may or may not have taken any medications for it but it has caused a gut biome imbalance. That’s right - it’s about as clear as mud! But don’t lose hope, there is so much that can be done to get you back on track. 

Working with a gastro dietitian

A gastro dietitian can help you on a journey to, not only improve your symptoms but also tackle their root cause through food. That might look like a special diet process, to identify triggers, like the low FODMAPs diet, or through adding foods which help rebalance, heal and repair your gut health.

Not everyone needs the same thing so, my focus is always on creating a personalised approach. Some healthy foods, believe it or not, can actually be a big trigger for symptoms like bloating, diarrhoea and pain. 

Personalised nutrition tips

Some dietary approaches can be restrictive in the short term, so it’s key you balance your macronutrients, by having sources of protein, carbohydrates, and fats. Keep lots of diversity of different foods to keep up your vitamin and mineral levels. Calcium is an important example. Some foods that can help you get all you need are dairy, like cheese and yoghurt (top tip - lactose-free is often better tolerated in the early stage), or fortified plant alternatives, like coconut milk. 

What about the low FODMAPs diet?

One approach that has shown promise in managing IBS symptoms is the low FODMAPs diet. FODMAPs are fermentable carbohydrates that can exacerbate digestive issues in susceptible individuals. A big part of what I do when working with the FODMAPs approach is helping my clients navigate the complexities to pinpoint their triggers (that can be the tricky bit!).

It’s also so important to make sure it’s achievable with your routine and, quite frankly, not a miserable experience! Normally that will mean lots of recipes and food swaps, rather than cutting everything out. 

Other nutrition strategies

Low FODMAPs is by no means right for everyone, and not something we want you on strictly long term. Other approaches may involve incorporating gut-friendly foods, such as probiotics, prebiotics, and fibre-rich options, into your meal plans and recipes to build up your beneficial microbes. 

Education is the key

At the heart of my approach as a dietitian is education. It’s so important for you to gain the knowledge and skills you need to take control and make informed dietary choices. Understanding the underlying cause and mechanisms behind post-antibiotic or post-infectious IBS and how nutrition can play a pivotal role in the best treatment approach.

Take the first step

If you're struggling with symptoms and looking for help from a qualified professional remember, you’re not alone! To get started, you can reach out by emailing me via my profile, or by booking a free discovery call to find out more.

The views expressed in this article are those of the author. All articles published on Nutritionist Resource are reviewed by our editorial team.

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London WC2H & W1H
Written by Emily Reilly, RD, MNutr
London WC2H & W1H

Hi, I’m Emily! As an experienced Registered Dietitian, I’m passionate about the life-changing power of nutrition. I work with my clients to translate cutting-edge nutritional research into inspiring nutrition coaching.

Our lives are so busy! So my approach is to make advice and recipes which are actually do-able, and tailored to you.

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