Corinne is experiencing diarrhea after consuming her prescribed antibiotics for the whole week. This is because:
A. The drugs render food indigestible.
B. Gastric flora is disturbed.
C. Fluid is added into the intestine.
D. Normal intestinal bacteria are destroyed.
Correct Answer: D. Normal intestinal bacteria are destroyed.
The destruction of normal intestinal flora causes diarrhea. Bacteria in the gut, for example, help break down food. Antibiotics kill these “good” microbes along with bacteria that are causing an infection. This upsets the balance of the normal flora in the intestines. The result is often loose, watery stools known as antibiotic-associated diarrhea.
Option A: A drug that rendered food indigestible could not be given because it would cause severe malnutrition. Thousands of species of bacteria, yeast, and other microorganisms live on our skin, in our intestines, and on other body surfaces. They’re known as our “normal flora.” When it is in balance, these microbes stay put and many of them contribute to good health. Bacteria in the gut, for example, help break down food.
Option B: This is incorrect because there is no gastric flora. About one in three people who take antibiotics develop diarrhea. The symptoms usually start on the last day or two of antibiotic therapy, or a day or so after it has ended. The diarrhea is usually mild, with two to four loose stools lasting for a couple days. In most cases, it gets better quickly without treatment. That said, antibiotic-associated diarrhea makes some people very sick. The most severe form, called C. difficile colitis, can be life-threatening.
Option C: There is no way to add fluid into the intestine. Almost all antibiotics, particularly those that act on anaerobes, can cause diarrhea, but the risk is higher with aminopenicillins, a combination of aminopenicillins and clavulanate, cephalosporins, and clindamycin.1,4,5 Host factors for antibiotic-associated diarrhea include age over 65, immunosuppression, being in an intensive care unit, and prolonged hospitalization.