POST-OPERATIVE INTESTINAL PROTECTION DURING ANTIBIOTIC THERAPY

For patients with a history of stomach or digestive problems from antibiotics.

If you are having surgery today, and predict that you are going to have GI symptoms from antibiotics, we recommend you find these products at a local pharmacy and start these tomorrow:

1. Saccharomyces boulardii (yeast probiotic)
• Dose: 1 capsule twice daily
• Timing: May be taken with your antibiotic
• Purpose: Reduces diarrhea, cramping, and antibiotic-related stomach upset

2. L-Glutamine Powder
• Dose: 1 scoop (3–5 g) twice daily
• Timing: Take between meals in water
• Purpose: Protects the intestinal lining and reduces irritation

3. Peppermint Oil OR Ginger Capsules
Choose one:
• Peppermint oil: 1 capsule 15 min before meals, up to twice daily if having symptoms.
• Ginger: 250–500 mg 15 min before meals, up to twice daily if having symptoms.
• Purpose: Helps reduce cramping, gas, and nausea.

4. Soluble Fiber (PHGG, Sunfiber, or Psyllium)
• Dose: ½–1 scoop once daily (about 1 teaspoon)
• Timing: Take 2 hours away from your antibiotic
• Purpose: Helps stabilize bowel movements while on antibiotics

5. Famotidine (Pepcid)
(Use this only if you have reacted strongly to antibiotics before.)
• Dose: 10–20 mg twice daily
• Purpose: Reduces nausea, stomach discomfort, and sensitivity

6. Hydration & Electrolytes
• Use an electrolyte drink once or twice daily
• Purpose: Helps prevent dehydration if stools become loose

How Long to Continue
• Take all of the above for the full 5 days of antibiotics
• Continue for 5 additional days after you finish the antibiotic

When to Call the Office
• Severe abdominal pain
• Persistent vomiting
• Fever above 101.5°F
• Watery diarrhea more than 4–5 times per day

General Tips
• Take your antibiotic with food unless instructed otherwise
• Avoid alcohol until the antibiotic course is complete
• Choose simple, well-tolerated foods for several days (rice, eggs, chicken, cooked vegetables)

IF YOU HAVE TIME, START THESE 2–4 WEEKS BEFORE SURGERY
(If you have less time, even 7 days helps.)

1. L-Glutamine Powder
• Dose: 1 scoop (3–5 g) twice daily
• Take between meals in water
• Purpose: Helps repair and strengthen the intestinal lining

2. Saccharomyces boulardii (yeast probiotic)
• Dose: 1 capsule twice daily
• Purpose: Protects your gut during antibiotic treatment

3. Mucosal Support (choose either)
• ImmunoLin (serum-derived IgG) – NutriDyn GI Defend or Fullscript SB Protect are appropriate products. One scoop daily with food.
Purpose: Helps support healthy immune function in the digestive tract

4. Butyrate or Tributyrin
• Dose: 300–600 mg twice daily
• Purpose: Supports the gut lining and reduces inflammation

5. Peppermint Oil or Ginger (for sensitive stomachs)
• Peppermint oil: 1 capsule 15 minutes before meals if having symptoms, up to twice daily
• OR Ginger: 250–500 mg 15 minutes before meals if having symptoms, up to twice daily
Purpose: Helps reduce cramping, nausea, and gas

6. Gentle Soluble Fiber (PHGG, Sunfiber, or Psyllium)
• Dose: 1 teaspoon daily
• Purpose: Helps stabilize bowel movements
• Take 2 hours away from probiotic or antibiotic doses

CONTINUE ALL OF THESE THROUGHOUT YOUR ANTIBIOTIC COURSE
Start them before surgery, and continue during the 5 days of antibiotics and for 5 days afterward.