Written by Christine Giordano, MD | Reviewed by Patricia Pinto-Garcia, MD, MPH
Key takeaways:
Antibiotics are lifesaving, but they can cause side effects — especially nausea, upset stomach, and diarrhea.
Foods that are a natural source of probiotics can help protect your gut and improve your nausea while you’re taking antibiotics.
Fiber-rich foods can also lessen nausea and upset stomach.
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Antibiotics are one of the wonders of modern medicine — they cure infections that just a few decades ago would’ve been deadly. But, like all medications, they can cause unpleasant side effects, like upset stomach and antibiotic-induced nausea. The good news is that you can take steps to prevent nausea associated with antibiotics. Let’s take a look at foods that can relieve your sour stomach while your antibiotics fight off infection.
Why do antibiotics cause nausea?
There are several reasons antibiotics cause nausea:
Stomach-lining irritation: Some antibiotics irritate the gut, which causes cramping or a burning feeling in your stomach after you take the medication. Gut irritation can also lead to nausea and vomiting.
Disrupted gut microbiome: Antibiotics don’t just kill bad bacteria — they take out a lot of good gut bacteria, too. Good gut bacteria help you digest food, create essential vitamins, and detox harmful substances. When your microbiome gets out of balance, you can develop an upset stomach, indigestion, and diarrhea.
Acid reflux: Antibiotics can irritate the esophagus by causing acid from inside the stomach to move into the esophagus. This leads to heartburn and nausea.
While many antibiotics can cause nausea, doxycycline and erythromycin are the most common culprits. In fact, about 1 in 10 people taking doxycycline will experience significant upset stomach and nausea.
What can you eat with antibiotics to avoid nausea?
If you need to take antibiotics that are hard on the gut, there are steps you can take to minimize (or totally avoid) antibiotic-associated nausea. First, you can adjust your diet to protect your gut microbiome. A healthy microbiome can help you avoid the stomach problems that develop when “bad” bacteria take over.
Here are five foods that can help maintain the normal balance of bacteria in your gut.
Fiber-rich foods
High-fiber foods can reduce inflammation in your gastrointestinal system and protect your microbiome. Try adding these high-fiber foods to your diet while you’re taking antibiotics:
Leafy greens like kale and spinach
Beans
Oatmeal
Fruits
Chia or flax seeds
Cultured or fermented foods
Cultured and fermented foods are a great source of probiotics, which help rebuild the gut microbiome. Foods you can add to your daily diet include:
Yogurt
Cheese
Kimchi
Sauerkraut
Miso
Natto (fermented soybeans)
Buttermilk
Kombucha
Fermented vegetables
Check food labels to make sure items were made with live cultures or “active cultures,” including Lactobacillus or Bifidobacteria.
Garlic
Garlic doesn’t just ward off vampires. It also prevents bad microbes. Garlic is a prebiotic. Prebiotics are basically food for good gut bacteria. Lab studies show that garlic boosts the growth of good bacteria.
You’ll want to eat raw garlic for best effects. If eating whole, raw garlic cloves doesn’t sound appealing, try adding chopped, raw garlic to salad dressing or guacamole. You can also rub cut garlic cloves on toast.
If pungent foods are your thing, raw onions and leeks are also great prebiotics to add to your diet.
Dark chocolate
It turns out chocolate can be good for you. Good gut bacteria ferments cocoa in chocolate to create anti-inflammatory compounds that can help protect your gut. Cocoa also contains dietary fiber and antioxidant compounds (catechin and epicatechin). Dark chocolate contains more cocoa than other types of chocolate. Try adding a square to your diet when taking antibiotics.
Probiotic supplements
Like cultured and fermented foods, probiotic supplements contain probiotics like Lactobacillus, which can rebuild your gut microbiome. Probiotic supplements come in many forms, including capsules and powders. They might also get added to beverages and other foods.
There’s good data to support using probiotics while taking antibiotics. But the quality of supplements can vary widely because the FDA doesn’t regulate supplements. Your healthcare provider can help you choose a reputable probiotic. But many health experts recommend sticking with foods that are naturally high in probiotics instead of turning to supplements.
What other steps can you take to avoid antibiotic associated nausea?
Aside from adding some gut-friendly foods to your diet, you can follow these steps to keep antibiotics from irritating your stomach:
Take your antibiotics with a meal or snack.
Drink a glass of water with your antibiotics and stay hydrated throughout the day.
Don’t lie down for 30 minutes after taking your antibiotic.
Ask your healthcare provider if you should take a heartburn medication while you’re taking antibiotics.
What should you do if your nausea persists when taking antibiotics?
Side effects like nausea can make it tough to finish a course of antibiotics. But it’s important to finish all your antibiotics so that your infection doesn’t get worse or come back.
So, if you’re having symptoms that make it hard for you to take your medicine, you should contact your healthcare provider. There are prescription medications that can relieve nausea and vomiting from antibiotics. Your provider might also recommend a different antibiotic that may not make you feel as nauseated.
The bottom line
Antibiotics can disrupt the normal balance of healthy bacteria in the gut and irritate the stomach and esophagus. This can lead to antibiotic-associated nausea, diarrhea, and upset stomach. Foods high in fiber, probiotics, and prebiotics can help you fight off nausea and upset stomach from antibiotics.
References
American Chemical Society. (2014). The precise reason for the health benefits of dark chocolate: Mystery solved.
Hempel, S., et al. (2012). Probiotics for the prevention and treatment of antibiotic-associated diarrhea a systematic review and meta-analysis. JAMA.
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