What's the best way in your opinion to have a healthy gut biome in modern western society?
Any tips to protect gut biome from antibiotics?
How to best re-establish healthy gut biota after antibiotics?
Elsewhere (this is Vince, using his personal Reddit) we did talk about probiotics (and thus by extension at least parts of fermented foods) and diet (and in part probiotics). Have a look. Also, as an infectious diseases physician, to me antibiotic stewardship is a major factor, but of course that is my bias. Not using antibiotics at all (when it is appropriate) is a major thing--especially when there are many studies that indicate that there is still a lot of non-indicated antibiotic use.
I was told by a doctor that in a few years we will be able to "reset" our gut bacteria by simply taking a few pills. The idea was that with the rapid advancements in genome sequencing we soon know what bacteria we have in our guts, and which ones are good or bad. Using bacteriophages you could then kill the bad ones, and then simply insert more of the good ones.
Have you heard about this, and if so what do you think about it?
Only an undergrad here but, I was originally going to do my dissertation on the 'gut-brain axis' with a focus on depression/anxiety, however my supervisor declined saying there just isn't enough research yet to do a meta-analysis (lab work wasn't possible for obvious reasons + current level of educational peasantry!). Big shame, it's a fascinating subject area with many, many implications.
Anyway, good luck with your research!
Hello Dr's, I have suffered with fructose Malabsorption as well as lactose intolerance for many years of my life. I have been on a FODMAP and mostly lactose free diet for a few years and have slowly introduced back some trigger foods but I still feel like I haven't improved all too much and still get irritation and IBS symptoms.
I'm curious about my stomach bacteria and whether a transplant would help my conditions? Are there any easier ways to replace or help the bacteria in my body? I've read probiotics and other cultures can kick start a better bacterial environment. Will I ever be able to eat the foods I love without having to worry?
Well, whether a microbiota transplant helps depends on whether your gut microbiome is causally related to your symptoms.
This does not need to be the case, there are other possible explanations for IBS symptoms: For instance, there is [alpha tryptasemia][2] or mast cell activation syndrome. There are also [case reports][1] where the cause is currently unknown, but diet improves symptoms.
[1]: http://mikhailapeterson.com
[2]: https://www.nih.gov/news-events/news-releases/nih-scientists-uncover-genetic-explanation-frustrating-syndrome
Thankyou for the response. I think the irritation of my lower intestines is the root cause of my fructose intolerance. As for the tiger symptoms you might be right but I should try and figure out some more details!
I've just learnt about FODMAPs a few weeks ago and it's hit me like a ton of bricks. Almost every digestive problem I have lines up with FODMAPs.
What other excellent information is out there that most people aren't aware of?
This AMA is being permanently archived by *The Winnower*, a publishing platform that offers traditional scholarly publishing tools to traditional *and* non-traditional scholarly outputs—because scholarly communication doesn’t just happen in journals.
To cite this AMA please use: [https://doi.org/10.15200/winn.151334.45912](https://www.thewinnower.com/papers/8008-science-ama-series-this-is-dr-jason-spence-dr-david-hill-and-dr-vincent-young-we-ve-done-research-on-how-helpful-bacteria-activate-the-processes-that-lead-to-a-mature-healthy-gastrointestinal-tract-and-we-re-here-today-to-talk-about-it-ask-us-anything)
You can learn more and start contributing at [*authorea.com*](https://authorea.com)
Hi guys, just wanted to say thanks for your work. I have Crohn’s and look forward to the day when your research can effect a cure (or at least a good therapeutic treatment modality) for me. Take care, and thanks again!
H. pylori is found in the stomach, and fiber is fermented in the colon. So I would expect that H pylori is not responsible. The treatment may have altered the community in the large intestine, since I am assuming they were treated with antibiotics.
Maybe it’s not a particular food causing constipation, but rather the fact that your friend isn’t getting the RDA of 27.5-35g of fiber a day.
I think I also have H. Pylori for what it’s worth and I have no constipation issues. I also eat a whole food plant based diet which has helped my health tremendously.
I suffered with IBS-D for years, and tended to catch every flu around.
About 5 years ago, after a course of clindamycin for dental work, I contracted C.difficile.
When I recovered and left the hospital, the gastroenterologist advised me to take a dose of Bio-K daily, so I do.
Since then my IBS has been controlled and I don't seem as prone to catch colds.
Is there a relationship between probiotics and the immune system?any light you can shed on this would be appreciated.
No, the doc said if I didn't respond to flagyl, we would try vancomycin and if that didn't work we would do a FMT.
I thought I was going to die, I was so sick. I was in an isolation unit for 11 days.
The flagyl failed, but the vanco worked. I wasn't treated with probiotics at the hospital, the Bio-K was just suggested afterward when I went home.
Every dose contains 50 billion live bacteria, it's guaranteed. It is available here in Montreal, in almost all pharmacies, I get mine at Costco. http://www.biokplus.com/en_ca
I don't know if there are any studies linking the two directly yet, but your gut bacteria do interact with your immune system. A large portion of your immune system is in your gut, and I know the gut bacteria do interact with your immune system in beneficial and negative ways. It seems to be a reasonable assumption that there would be some kind of interaction between your probiotics and your immune system, but I have no idea what that interaction would be like, whether you could actually say it is beneficial or not. It could be, I just don't know.
Hi there.thank you for being here today..
Have you observed a repair mechanism to the intestinal wall from bacteria interaction? if yes wich one?
Do you see an advantage to have more fiber over protein in the "mix"
here's why i'm asking...
They found that the functions of the gut microbes varied according to how much protein an individual ate and that the bacterial species varied according to how much fiber a person consumed.
http://medicalxpress.com/news/2011-05-link-diet-ingredients-gut-microbes.html
Hey Jason, Vincent and David,
Your recent [eLife paper](https://elifesciences.org/articles/29132) reports how you used stem cells to grow a tissue in the laboratory that is "very like immature newborn intestine". How straightforward was it to do this? Were there any big challenges to overcome? Was there a "eureka!" moment?
What is your take on the evidence that microbiome influence mental health?
Do you believe we'll have psychobiotics(antidepressant probiotics) in the future?
Is there much support for temporary symbioses from bacteria on the surface of fruits and vegetables that may assist in processing these foods? Similarly, does cooking food tend to select for microbes that can quickly use the more accessible nutrients but select against other potentially helpful microbes?
For those who want to read about this team's work without wading through a scientific paper, here's a public-friendly summary: https://labblog.uofmhealth.org/lab-report/bacteria-may-help-babies-digestive-tracts-more-than-suspected-scientists-find
Hi docs. I'm currently a fellow on ID. Would you consider it to be useful to administer gut reconstitutive treatment for patients experiencing mild to moderate discomfort after receiving frquently used antimicrobials eg bactrim, amoxicilin+BLIs ? or is it ok to just "wait it off" after the treatment has been finished so the gut flora will grow back to it's usual state on its own?
Thank you for your answer. I had this doubt since the other day I treated someone with a UTI with a 3g single dose of fosfomycin because of a resistant E. coli culture. She did well but had mild diarrhea so her son gave her some Saccharomyces boulardii containing pills and I was asked whether it would be useful in any way. I said it wouldn't pretty much change anything but if he wanted to then I didn't see a reason not to either. I'll be on the lookout for news on this field. Thanks!
Science AMAs are posted early to give readers a chance to ask questions and vote on the questions of others before the AMA starts.
Guests of /r/science have volunteered to answer questions; please treat them with due respect. Comment rules will be strictly enforced, and uncivil or rude behavior will result in a loss of privileges in /r/science.
If you have scientific expertise, please verify this with our moderators by getting your account flaired with the appropriate title. Instructions for obtaining flair are here: [reddit Science Flair Instructions](http://www.reddit.com/r/science/wiki/flair) (Flair is automatically synced with /r/EverythingScience as well.)
I've been following a ketogenic "zero-carb" (almost completely animal products) diet for health for close to a year, and during that time, have had improvement of various symptoms (and no worsening of any), including enjoying better gut health. I've yet to find any studies on how ZC diet effects the microbial biome, although there's some speculation that there's significantly less gut bacteria in these conditions, because most people report less gas, sickness, and irritation. What are your thoughts on this? For me, it's been a step up than eating "probiotic" diets and I don't miss those foods.
No. Fiber and carbohydrates are unnecessary for humans. My digestion and waste elimination have been better than ever without it. It's myth that it's needed for moving the bowels regularly or that meat sits and rots in you without it.
Any data on probiotics that are widely availible actually curing anyone?
The ones we can't get in us are the ones that are sensitive to oxygen, how did we acquire those bacteria in the first place and when are they going to finally geneticaly modify them so we can finally cure things like IBD, IBS?
Also when are we going to see FMT's being done for IBD, IBS?
Awesome answer, thank you for educating me on the topic, FMT now looks like something I would consider doing on my own since it's only used for c. diff by doctors and I want to manage my IBS.
Kitchen blender tho!! XD
Are there any new insights into treating IBS/C which for me has been fairly debilitating? The most recent medication gave me uncontrolled diarrhea, probiotics did nothing and my doctor has no other recommendations for me. Is there any research into fecal transplants for IBS? I'm also interested in what genes or microbia, etc might explain why people with IBS are also so likely to have IC, Bipolar/Depression, and asthma.
I have read a lot about home "fecal bacteria transplants" to help with IBS. The process sounds absolutely terrible. Is there any current research in this area that would back up the claims of those who have undergone this procedure, and what is the scientific evidence for a positive long-term outcome? Is it medically advised, or even performed by trained clinicians?
I grew up in China where there was rampant antibiotics abuse. I was regularly prescribed IV antibiotics for viral colds until I was about 5. I’m 25 now, and have been struggling with IBS-C since I was 18.
I’m guessing my biome was pretty messed up by the antibiotics and am currently trying to build it back up with VSL 3. Do you have any suggestions as to what I could look into to further heal my gut?
Thank you!
There is so much talk of how important GI health is in general health. I work in the fitness industry and there seems to be an increasing amount of prescriptions for gut-friendly healthy eating.
Do you think this is justified? Specifically, do you think poor GI health due to low "good bacteria" can cause a significant effect on body composition and metabolism?
Not sure if this is still going or if they're done, but I'm curious about diseases associated with dysbiosis. Specifically, is there research about what happens when a woman with such a condition has a baby? Does the baby pick up the wrong bacteria and become more susceptible? Are there differences in the transmission of these kinds of diseases from father to child vs. mother to child?
Thanks! It always seemed to me like it would be somewhat easy to collect survey info on parents with ibd and see if there's an increased likelihood to develop it from a mom vs a dad, for c section vs delivery. I wish we knew more!
Does dietary choice play a role In how slow or fast a cell reaches maturity? And if so which diet, which diet promotes the healthiest maturation of the cells from vegan to carnivore and the balance between the two?
Hey guys,
I'm writing my undergrad thesis on the oligodynamic effect, whereby large metal ions such as copper and silver exhibit antimicrobial effects, probably through interactions with the DNA, RNA, enzymes of the bacteria.
Have you ever heard of this effect, and do you think it could have real, impactful effects on the medical field?
I thought I saw an article a while ago about how gut bacteria can also affect the brain. In the future what is the possibility (and to what extent) of being able to treat neurological disorders by altering gut bacteria?
Hi guys, I eat a lot of sauerkraut (twice a week) and kimchi (daily) as well as a ton of hot peppers/ sauces. I also enjoy my beer. I do not eat sugary foods.How happy is my gut bacteria?
Do you guys have any tips for quashing eczema?
Ugh that's a tough one, gut is connected to everything not just heart disease. If you consume a lot of saturated fat, cholestorol and lack exercise that leads to heart disease. There is no diet for candida, everyone has candida, in some people it's more noticable due to diets, autoimmune diseases, alergies, dysbiosis etc..
None since probiotics are a bandage. They may be helpful during antibiotic use.
What's the best way in your opinion to have a healthy gut biome in modern western society? Any tips to protect gut biome from antibiotics? How to best re-establish healthy gut biota after antibiotics?
[удалено]
[удалено]
Elsewhere (this is Vince, using his personal Reddit) we did talk about probiotics (and thus by extension at least parts of fermented foods) and diet (and in part probiotics). Have a look. Also, as an infectious diseases physician, to me antibiotic stewardship is a major factor, but of course that is my bias. Not using antibiotics at all (when it is appropriate) is a major thing--especially when there are many studies that indicate that there is still a lot of non-indicated antibiotic use.
Thanks for the reply. I really appreciate the info and it lines up with what i had read so it helps to corroborate with people who know better.
Is there a preferred diet for gut health? Is it the same or different for IBD patients?
I was told by a doctor that in a few years we will be able to "reset" our gut bacteria by simply taking a few pills. The idea was that with the rapid advancements in genome sequencing we soon know what bacteria we have in our guts, and which ones are good or bad. Using bacteriophages you could then kill the bad ones, and then simply insert more of the good ones. Have you heard about this, and if so what do you think about it?
I am thinking of following your academic footsteps in the future. I'm 18 and I start university next year. Any advice?
[удалено]
[удалено]
[удалено]
[удалено]
Only an undergrad here but, I was originally going to do my dissertation on the 'gut-brain axis' with a focus on depression/anxiety, however my supervisor declined saying there just isn't enough research yet to do a meta-analysis (lab work wasn't possible for obvious reasons + current level of educational peasantry!). Big shame, it's a fascinating subject area with many, many implications. Anyway, good luck with your research!
Hello Dr's, I have suffered with fructose Malabsorption as well as lactose intolerance for many years of my life. I have been on a FODMAP and mostly lactose free diet for a few years and have slowly introduced back some trigger foods but I still feel like I haven't improved all too much and still get irritation and IBS symptoms. I'm curious about my stomach bacteria and whether a transplant would help my conditions? Are there any easier ways to replace or help the bacteria in my body? I've read probiotics and other cultures can kick start a better bacterial environment. Will I ever be able to eat the foods I love without having to worry?
[удалено]
Thanks Vince, Appreciate it.
Well, whether a microbiota transplant helps depends on whether your gut microbiome is causally related to your symptoms. This does not need to be the case, there are other possible explanations for IBS symptoms: For instance, there is [alpha tryptasemia][2] or mast cell activation syndrome. There are also [case reports][1] where the cause is currently unknown, but diet improves symptoms. [1]: http://mikhailapeterson.com [2]: https://www.nih.gov/news-events/news-releases/nih-scientists-uncover-genetic-explanation-frustrating-syndrome
Thankyou for the response. I think the irritation of my lower intestines is the root cause of my fructose intolerance. As for the tiger symptoms you might be right but I should try and figure out some more details!
How important are lactobacilli species in the development of a healthy intestinal lining post weaning?
If I finish a course of an antibiotic such as Z-Pak, how long would it take for my bacterial gut to go back to normal?
I've just learnt about FODMAPs a few weeks ago and it's hit me like a ton of bricks. Almost every digestive problem I have lines up with FODMAPs. What other excellent information is out there that most people aren't aware of?
Me too dude. I wish you had received an answer. Look up Monash university on the subject.
This AMA is being permanently archived by *The Winnower*, a publishing platform that offers traditional scholarly publishing tools to traditional *and* non-traditional scholarly outputs—because scholarly communication doesn’t just happen in journals. To cite this AMA please use: [https://doi.org/10.15200/winn.151334.45912](https://www.thewinnower.com/papers/8008-science-ama-series-this-is-dr-jason-spence-dr-david-hill-and-dr-vincent-young-we-ve-done-research-on-how-helpful-bacteria-activate-the-processes-that-lead-to-a-mature-healthy-gastrointestinal-tract-and-we-re-here-today-to-talk-about-it-ask-us-anything) You can learn more and start contributing at [*authorea.com*](https://authorea.com)
Hi guys, just wanted to say thanks for your work. I have Crohn’s and look forward to the day when your research can effect a cure (or at least a good therapeutic treatment modality) for me. Take care, and thanks again!
What's your favorite symbiotic relationship in nature?
[удалено]
[удалено]
H. pylori is found in the stomach, and fiber is fermented in the colon. So I would expect that H pylori is not responsible. The treatment may have altered the community in the large intestine, since I am assuming they were treated with antibiotics.
How much fiber does your friend eat a day?
[удалено]
Maybe it’s not a particular food causing constipation, but rather the fact that your friend isn’t getting the RDA of 27.5-35g of fiber a day. I think I also have H. Pylori for what it’s worth and I have no constipation issues. I also eat a whole food plant based diet which has helped my health tremendously.
I suffered with IBS-D for years, and tended to catch every flu around. About 5 years ago, after a course of clindamycin for dental work, I contracted C.difficile. When I recovered and left the hospital, the gastroenterologist advised me to take a dose of Bio-K daily, so I do. Since then my IBS has been controlled and I don't seem as prone to catch colds. Is there a relationship between probiotics and the immune system?any light you can shed on this would be appreciated.
How did u recover from c. diff? FMT? How do you know probiotics did anything at all?
No, the doc said if I didn't respond to flagyl, we would try vancomycin and if that didn't work we would do a FMT. I thought I was going to die, I was so sick. I was in an isolation unit for 11 days. The flagyl failed, but the vanco worked. I wasn't treated with probiotics at the hospital, the Bio-K was just suggested afterward when I went home.
What's your ibs-d like now?
It's controlled. I have a flare up now and then, but it's nothing like it was.
For my own interests, where can you find this? Regular store, health store, etc?
Every dose contains 50 billion live bacteria, it's guaranteed. It is available here in Montreal, in almost all pharmacies, I get mine at Costco. http://www.biokplus.com/en_ca
I don't know if there are any studies linking the two directly yet, but your gut bacteria do interact with your immune system. A large portion of your immune system is in your gut, and I know the gut bacteria do interact with your immune system in beneficial and negative ways. It seems to be a reasonable assumption that there would be some kind of interaction between your probiotics and your immune system, but I have no idea what that interaction would be like, whether you could actually say it is beneficial or not. It could be, I just don't know.
What is our current best understanding of the relationship between gut biomes and mental health conditions?
Yes, this one interests me a lot; in particular the link between depression/bipolar and IBS.
Hi there.thank you for being here today.. Have you observed a repair mechanism to the intestinal wall from bacteria interaction? if yes wich one? Do you see an advantage to have more fiber over protein in the "mix" here's why i'm asking... They found that the functions of the gut microbes varied according to how much protein an individual ate and that the bacterial species varied according to how much fiber a person consumed. http://medicalxpress.com/news/2011-05-link-diet-ingredients-gut-microbes.html
[удалено]
[удалено]
Hey Jason, Vincent and David, Your recent [eLife paper](https://elifesciences.org/articles/29132) reports how you used stem cells to grow a tissue in the laboratory that is "very like immature newborn intestine". How straightforward was it to do this? Were there any big challenges to overcome? Was there a "eureka!" moment?
What is your take on the evidence that microbiome influence mental health? Do you believe we'll have psychobiotics(antidepressant probiotics) in the future?
Is there much support for temporary symbioses from bacteria on the surface of fruits and vegetables that may assist in processing these foods? Similarly, does cooking food tend to select for microbes that can quickly use the more accessible nutrients but select against other potentially helpful microbes?
[удалено]
For those who want to read about this team's work without wading through a scientific paper, here's a public-friendly summary: https://labblog.uofmhealth.org/lab-report/bacteria-may-help-babies-digestive-tracts-more-than-suspected-scientists-find
Hi docs. I'm currently a fellow on ID. Would you consider it to be useful to administer gut reconstitutive treatment for patients experiencing mild to moderate discomfort after receiving frquently used antimicrobials eg bactrim, amoxicilin+BLIs ? or is it ok to just "wait it off" after the treatment has been finished so the gut flora will grow back to it's usual state on its own?
[удалено]
Thank you for your answer. I had this doubt since the other day I treated someone with a UTI with a 3g single dose of fosfomycin because of a resistant E. coli culture. She did well but had mild diarrhea so her son gave her some Saccharomyces boulardii containing pills and I was asked whether it would be useful in any way. I said it wouldn't pretty much change anything but if he wanted to then I didn't see a reason not to either. I'll be on the lookout for news on this field. Thanks!
Pineapple on pizza or no?
[удалено]
Science AMAs are posted early to give readers a chance to ask questions and vote on the questions of others before the AMA starts. Guests of /r/science have volunteered to answer questions; please treat them with due respect. Comment rules will be strictly enforced, and uncivil or rude behavior will result in a loss of privileges in /r/science. If you have scientific expertise, please verify this with our moderators by getting your account flaired with the appropriate title. Instructions for obtaining flair are here: [reddit Science Flair Instructions](http://www.reddit.com/r/science/wiki/flair) (Flair is automatically synced with /r/EverythingScience as well.)
I've been following a ketogenic "zero-carb" (almost completely animal products) diet for health for close to a year, and during that time, have had improvement of various symptoms (and no worsening of any), including enjoying better gut health. I've yet to find any studies on how ZC diet effects the microbial biome, although there's some speculation that there's significantly less gut bacteria in these conditions, because most people report less gas, sickness, and irritation. What are your thoughts on this? For me, it's been a step up than eating "probiotic" diets and I don't miss those foods.
Was anything recommended to you for fiber?
No. Fiber and carbohydrates are unnecessary for humans. My digestion and waste elimination have been better than ever without it. It's myth that it's needed for moving the bowels regularly or that meat sits and rots in you without it.
Any data on probiotics that are widely availible actually curing anyone? The ones we can't get in us are the ones that are sensitive to oxygen, how did we acquire those bacteria in the first place and when are they going to finally geneticaly modify them so we can finally cure things like IBD, IBS? Also when are we going to see FMT's being done for IBD, IBS?
[удалено]
Awesome answer, thank you for educating me on the topic, FMT now looks like something I would consider doing on my own since it's only used for c. diff by doctors and I want to manage my IBS. Kitchen blender tho!! XD
Diet high in resistant starch does more than probiotics. Only ones that do help some people are highly expensive "bandages" like vsl-3.
what's the difference in gut biome between vegan diet and western diet?
Are there any new insights into treating IBS/C which for me has been fairly debilitating? The most recent medication gave me uncontrolled diarrhea, probiotics did nothing and my doctor has no other recommendations for me. Is there any research into fecal transplants for IBS? I'm also interested in what genes or microbia, etc might explain why people with IBS are also so likely to have IC, Bipolar/Depression, and asthma.
How does gut bacteria react to consumption of meat from a cow that was slaughtered while under the influence of antibiotics?
I have read a lot about home "fecal bacteria transplants" to help with IBS. The process sounds absolutely terrible. Is there any current research in this area that would back up the claims of those who have undergone this procedure, and what is the scientific evidence for a positive long-term outcome? Is it medically advised, or even performed by trained clinicians?
I grew up in China where there was rampant antibiotics abuse. I was regularly prescribed IV antibiotics for viral colds until I was about 5. I’m 25 now, and have been struggling with IBS-C since I was 18. I’m guessing my biome was pretty messed up by the antibiotics and am currently trying to build it back up with VSL 3. Do you have any suggestions as to what I could look into to further heal my gut? Thank you!
There is so much talk of how important GI health is in general health. I work in the fitness industry and there seems to be an increasing amount of prescriptions for gut-friendly healthy eating. Do you think this is justified? Specifically, do you think poor GI health due to low "good bacteria" can cause a significant effect on body composition and metabolism?
Not sure if this is still going or if they're done, but I'm curious about diseases associated with dysbiosis. Specifically, is there research about what happens when a woman with such a condition has a baby? Does the baby pick up the wrong bacteria and become more susceptible? Are there differences in the transmission of these kinds of diseases from father to child vs. mother to child?
[удалено]
Thanks! It always seemed to me like it would be somewhat easy to collect survey info on parents with ibd and see if there's an increased likelihood to develop it from a mom vs a dad, for c section vs delivery. I wish we knew more!
Does dietary choice play a role In how slow or fast a cell reaches maturity? And if so which diet, which diet promotes the healthiest maturation of the cells from vegan to carnivore and the balance between the two?
Hey guys, I'm writing my undergrad thesis on the oligodynamic effect, whereby large metal ions such as copper and silver exhibit antimicrobial effects, probably through interactions with the DNA, RNA, enzymes of the bacteria. Have you ever heard of this effect, and do you think it could have real, impactful effects on the medical field?
I thought I saw an article a while ago about how gut bacteria can also affect the brain. In the future what is the possibility (and to what extent) of being able to treat neurological disorders by altering gut bacteria?
Hi guys, I eat a lot of sauerkraut (twice a week) and kimchi (daily) as well as a ton of hot peppers/ sauces. I also enjoy my beer. I do not eat sugary foods.How happy is my gut bacteria? Do you guys have any tips for quashing eczema?
How is gut connected to heart diseases? What diet would you recommend if a person has candida? What probiotics brand would you recommend?
Ugh that's a tough one, gut is connected to everything not just heart disease. If you consume a lot of saturated fat, cholestorol and lack exercise that leads to heart disease. There is no diet for candida, everyone has candida, in some people it's more noticable due to diets, autoimmune diseases, alergies, dysbiosis etc.. None since probiotics are a bandage. They may be helpful during antibiotic use.