oral antibiotics and diarrhea

l 100+ pointsm 1+ points - Newb

Peter asks:

Why do oral antibiotics cause diarrhea? Why do doctors not prescribe anti diarreal medicines such as Imodium or Kaolin and Morphine to counteract the undesirable side effect of getyting a bad dose of the runs when taking helpful antibiotic medicine?

Dr. Adams responds:

Oral antibiotics (or IV) usually will not cause diarrhea. There are many antibiotics available for prescription. Some are oral, others are intravenous (IV). Certain classes of antibiotics will be more likely to cause diarrhea than other classes. And to make things even more confusing, certain antibiotics are indicated to treat antibiotic-induced diarrhea.

To give you some more info as to how antibiotics could cause diarrhea.....remember that antibiotics kill bacteria. Also keep in mind that we have millions of natural bacteria in our colons. If these bacteria are destroyed (as does occur by most antibiotics), other bacteria which do not belong in our colons can grow and create havoc. One bacteria which can do this is Clostridium difficile. The diarrhea caused by C. difficile is known as pseudomembranous colitis, and is sometimes called C. diff colitis. After a course of antibiotics, our natural bacterial flora will be depleted, C. diff will take hold, start to grow, and create a pseudomembrane on the lining of the colon. The result will be profuse infectious diarrhea. So this is the basic on how an antibiotic could cause diarrhea.

Why do we not prescribe anti-diarrheal medications in the setting of pseudomebranous colitis (C. diff diarrhea)? The answer is because anti-diarrheal medications would only make the problem worse. C. diff secretes a toxin, and the last things you want is the toxin to increase and worsen the infectious and inflammatory process. Anti-diarrheal medicines will allow the C diff toxin to build up and the infectious process will worsen. Thus, anti-diarrheals are not used to treat antibiotic induced diarrhea. Rather, you would want the patient to pass the infectious toxins via the diarrhea.

What do we use to treat C. diff colitis? There are two main antibiotics that are used. They are Metronidazole and Vancomycin. Both of these antibiotics work well to kill C. diff and to treat the associated colitis.


Dr. Adams is a resident in the Department of Internal Medicine at North Shore University Hopsital in Manhasset, NY. Got a question for him?

40 Comments on "oral antibiotics and diarrhea"

Heather Martin's picture

Dear Dr. Adams:
I have been suffering with C-diff after a s/p 7 weeks fundoplication. Due to the nature of the surgery, along with diarrhea, I get extreme nausea where it is impossible to function. I am now taken my third dose of Flagil( I am allergic to any suflfer or penicllin type drugs) I have now lost 30lbs( down to a size 3) What else can I do to imrprove my immune system and increase the good bacteria in my system. I am 24 years old.
any information that you could provide, would be deeply appreciated.

Heather Martin

carolyn pagonakis's picture

After knee replacement and a slight heart attack, I came home after 2 weeks and a week later, i started with the diarrhea for 3 days before they put me back in the hospital, my potassium had almost depleted and very weak, went back in 11 days later and had to stay in to be given potassium interveniously. that was in April 7th and stayed on Flagil when we though it was over after about 2 weeks, it got better today June 8, it started again i am taking Lomolil now but cAn't understand what is causing this, what do i eat to stop this awful hardship causing me to stay home alot

thanks for any thing you can tell me.

Sincerely, Carolyn Pagonakis

The Shit Volcano's picture
Comment Quality Moderatorh 3000+ points

At least you didn't react to antibiotics like my sister. She turns psychotic.

I found Jesus! He was behind the sofa the whole time!

barbara's picture

i have been diaganosed with c diff had an allergic reation to flagyl and also allergic to ceph. family type antibiotics. help how can i treat my c diff and get better without antibiotics

barbara's picture

i have lost twenty pounds going to bathroom 7 eight times a day. afraid of dying i have two young children please help me. cant take antibioics throat and eyes swell up and get rash. iam 38 contracted c diff by having a c section just a couple of months ago

carole's picture

My 84 year old dad has c diff. He is down to 120 pounds. and has been suffering from dehydration. He is on flagyll , second course and now vancomycin .He is still not better. He is being treated at the V.A. in Tucson Az. I am afraid he is going to die. where can I bring him for better treatment. He had diahrrea for 18 months before they found out what was causing it . thank you

Gordon's picture

Hi, My dad (89) has c. diff. Like yours (Carole) he was on flagyll and now on vancomycin. He is waisting away. It is now Feb 17, 2005. What happened with your dad?

joanne's picture

my question is : is there an efective cure for c-diff

Susanne's picture

Check out this website: www.cdiffsupport.com. I have had c. diff and had quite the battle. My son is suffering now. This site has all the information you will need.

mary's picture

after i had a c-section in the hospital i contracted c-diff on july 7th...now i have it for my third time since then and am on flagyl, and just found out that my daughter of 2 weeks has it. how did i contract it to her and will she have this problem for the rest of her life? how do i get it out of my family for good? and why does it keep coming back.

Gwen's picture

I had oral surgery last May. The dentist put me on clyndamycin. Like 2 weeks later, I got dirrhea. I didnt know why i had it and took immodium--big mistake. I didnt know what was wrong with me for like another week when i realized it was from my antibiotic (i read the package insert) and by then i was so weak I could barely move. I went to Patient First and got flagyl, which didnt help. I saw a specialist; she gave me vancomycin. I've been on that twice now, gone through 2 full doses of Flora-Q (to rebuild my good bacteria), and even used the third new antibiotic for c diff (which wasnt even approved by the FDA in June and gave me a yeast infection). I'm still not completely better. This is a mess. What can I do? And why do some antibiotics give you c diff and others yeast infections?

Marcia's picture

If anybody has been diagnosed with c diff and is battling this monster please i invite and encourage you to come to this site. www.cdiffsupport.com it has given me all the info there is about this illment and you will find all kinds of support and advise. You will see you are not alone in this battle.

Anonymous Victoms's picture

I am a mother of 2 children. One has this..I have this as well. Going on 7years. I look like
I'm 9 months preg. I go to the restroom at least 36 times in a 12 hour day. My son has to wear his pull up. He's 6. I just found out this C-Diff. Their talking about putting me on anti-. Now I don't know if I want to.

The Shit Volcano's picture
Comment Quality Moderatorh 3000+ points

What a horrible disease! I feel for you people, even if this has never happened to me.

I found Jesus! He was behind the sofa the whole time!

patsy's picture

I gave birth to my baby girl 13 weeks ago, I had a third degree tear which I had repaired a week later I was discharged from hospital. Seven days after being out of the hospital I got terrible cramping pain and diarrhea approx once an hour I went to the hospital and after an agonising four days of diarrhea, sickness, fever and high blood pressure they diagnosed c diff although this was only after an x ray, a cat scan, an ultrasound and several internals. The hospital then told me I couldnt see my baby and isolated me into a single room. twelve weeks on and I have the same symptoms but the abdominal cramps arent anywhere near as severe however the diarrhea is there is this likely to be c diff. I am very worried it is as I couldnt handle the separation from my baby again.

Anonymous Coward's picture

help..my bf has c diff! going to the va clinic tomorrow( again) can't stop the diah and fever. i feel so bad for him.......what is this?

turd turdgutson's picture
l 100+ points

It's an unnecessary bump of a two-year -old post. Tell your boyfriend to take some Immodium A-D and drink lots of liquids and quit whining. He'll thank you for it later.

"You will spray oil when you fart. You will have diarrhea. You will be shitting constantly and you will lose control of your bowels." - Mr. Angry on alli

Anonymous Poop Info's picture

My friend's son was having major problems & the doctors wanted him to have surgery. Said he had parasites/microorganisms inside. He was getting thinner and weaker everyday. He would throw-up and poop and the docs put him on a bunch of things and said surgery was the only way. Well is mom found some parasite killing and immune boosting herbal remedies called Paraguay (tea) and River Essentials (pills) from a company at www.makelifebetter.com and after a month or so of taking the tea and pills my friend was better and when he went to see the same doc that said surgery was the only option that doc did testing and said my friend didn't have any more parasites/microorganisms and any more problems. Yeah, doc was floored as was my friend & his mom. Well, since she saw how excellent the products worked with her own eyes and with medical backup by the docs before and after results, his mom became an affiliate with the company. I got the product item numbers for anyone interested: Paraguay (item 17128) and River Essentials (item 15880).

Another site that has awesome all natural products for parasitic problems is www.drnatura.com
Check out all of the testimonials (they are real) and be prepared to see people's photos (gross but is proof) of what came out in the toilet when they started using the system. Dr. Natura has a parasite tea too. Read everything to make sure your symptoms match with what their products are used for...chances are that you and your loved ones will be much better w/ these all natural remedies.

By the way, docs tend to tell you all natural remedies don't work b/c they need to peddle the prescription drugs or for some other reason, like making you have surgery (which they make more money off of then office visits) before all options are exhausted. If you really want to check the results, get the basic tests done needed to verify that a problem exists. Then take the natural products. After you feel better in 1-3 months (or more depending on how severe your case is), then go back to the same doc for follow-up tests to prove it to yourself and to the doc. That way b/c of you he/she may help another patient that also may benefit.

....in the meantime, if you swallow one fresh clove of garlic (not the entire thing bundle which is made up of like 4-6 cloves) once every week for a month it sometimes helps too if your case is not too severe. I was having problems last month and my uncle told me about that & after I took the garlic only twice, I passed some little shrimp like creatures (they were weird) for 3-4 days & then I stopped having the runs. I wouldn't have even thought knew what they were if I hadn't looked closer (not that close) and saw that they (each time I passed like 6-8, last day I passed 2-3) had little black eyes on top & very tiny legs. Anyway, I even stopped taking the little blue pills that my doc had prescribed and had been taking for like 6 months w/o any results and only his "IBS" conclusion, which I have concluded roughly means "I don't know so "I'll Bull $h!+"" Anyway, I tried to share with him the all natural things that actually helped me and he tried to get me to take more meds & said surgery might be necessary. I was laughed and hung up b/c his meds hadn't done crap for 6 months. Anyway, try natural steps, if you aren't in a hospital. By the way, the products at Dr. Natura were invented and examined by Drs. who opened their minds up to alternatives b/c they either had a problem themselves or wanted to better help their patients and others.

Good luck to everyone and prayers be with you.

Anonymous Coward's picture

Nature's Sunshine has a product called Algin, which stops diahhrea. Also, a really good probiotic will help to restore the friendly bacteria that was ruined by antibiotics. Be sure the probiotic is HIGH in the friendly bacteria. Sometimes also, an allergy elimination diet has to be started; no sugar in anything, no fake sugars in anything, so read ingredients in anything you buy, no wheat or anything w/ gluten, NO dairy products...try it for 2 wks (not easy, but nothing is) and see what results you get; you may be surprised. Then add one thing back at a time & see if you can then tolerate it then; if not, maybe cleansing products may be in order. Really, try this, it sure won't hurt ONE thing and has helped many. Lots of green veggies, fruits..you may have to see a Naturopath to see which veggies & fruits and meats that you can tolerate. NO red meats unless grass fed, no dark chicken or turkey meat and deer or buffalo for the red meat helps a bunch. A nettie pot also helps sinus problems, you may want to check that out also, just google it and use sea salt in it. Sometimes sinuses play havoc big time w/ the digestive system. Just my opinion, not advice, just helped me a lot. Oil of oregeno also helps sinuses...google that, but also use a probiotic at night before going to bed, on an empty stomach and not at same time as the oil of oregeno.

donnams73's picture

I got sick with an ear ache in March of 2007. I was put on Augmentin. My last dose of Augmentin My diarrehea started. Went back to Dr she said I still had ear ache put me on another antibiotic was told diarrhea was a virus gave me lomotil. Went to hospital they started me on flaggyl did two rounds of it it came back Took vancomyocine for 2 weeks I was doing week. I just had a procedure done for a kiney stone and put on cipro. Guess what happened? its baaack!!!! I CAN"T take it!!!! HELP!!!!!

;)'s picture

I had a mild case of c-diff after taking tetracycline and Cipro. I got it from a nursing home. My gastroenterologist prescribed flagyl 500 mg three times a day for ten days. As soon as I took Flagyl, I vomitted everything I ate and has gotten weak. Im not telling you to follow what I did because i stopped the Flagyl because it's making me vomit and Im only 90 lbs and I went to a herbal store in Danbury and bought Grapefruit seed extract it's an herbal antibiotic killing the bad bacteria but letting the good bacteria remain in our system per the nutritionist info >my coworker recommended it becauase she had friend who had C diff for a very long time but didnt get well with flagyl and Vancomycin and was referred to this herbal store and was given Grapefruti seed extract and C- diff went away. Ive been trying it for a few days now and I dont have anymore diarrhea and I am eating now. Hopefully it wont relapse but so far i am ok. ive been also taking boularddi found in health food stores and acidophilus.

C Diff Sucks's picture

Hi all. Currently being treated for recurring C Dif. Started as a sinus infection given back to back rounds of offending antibiocts. cdiffsupport.com has this list and much more info that will save your sanity. Flagyl then Vancocin, still praying. Be very careful,there are many false 'negative" labs than come back, thus allowing doc to treat it as Non CDiff and prescribe yet another offending antibiotic. I was hospitalized and sent home with Cipro due to fist false Neg. Never leave your Doc's office without asking for an explaination of C Diff. They wont look you in the eye, but in my opinion its because they simply cant cure this, it is one complicated illness. Im a healthy 44 year old woman and have been battling this beast for months. Again, cdiffupport.com has more information than any Doc Ive seen so far.

MSG's picture
Comment Quality Moderatori 2000+ points

I started on antibiotics two days ago for a cellulitis infection. First I got a shot (left buttock), then the pills. Yesterday morning all was well (decent normal b.m.), but by afternoon I was having suspicious farts, then a very urgent soft bowel movement that wasn't diarrhea, but close. An hour and a half later, another one--small, but powdery diarrhea,the real thing. Not having read this article, I took two immodium. The diarrhea stopped, but I have farted like a wind band through most of the night (as quietly as I could, of course). We were visiting out-of-state friends, so I couldn't see myself going splatty poop every hour, which is why I took the stuff. I'll try to tough it out from here on with no immodium. Maybe my system will get used to this pill.

shitake boy's picture
l 100+ points

I know that whenever I am placed on an anti-biotic, I get diarrhea in the worst way. Sometimes within an hour, I am on the toilet 2-3 times, because of the havoc the antibiotic wreaks on my stomach. Couple that with the IBS I already have, and you see where I am going with this. Fortunately for me, I have not been on any sort of antibiotic over a year now.

In search of the ever evasive BM

In search of the ever evasive BM

Bilgepump's picture
Comment Quality Moderatorh 3000+ points

Shitake boy, I understand "diarrhea in the worst way", my question is, what is the best way?

"One of the founding members of the Front Page Hyena Pack, and runs as its alpha male when the urge strikes him, which is often." Daphne (one perceptive chick)

annoymous's picture

So Ive had the shitz since takin medication for my tooth infection let alone I got a god damn yeast infection I cant do my hubby I feel like shit and my life is horrible!!! So note to self I took Amox-clav and then lindamycin AKA THE SHITZ for 2 weeks now finally Im going to the doc to get med's without shitting my pants or having horrible gas that my hubby says hes going to divorce me for! I have fissures to make the issue worse! MY ass is my worst Enemy! I wish I could do anal but cant!Why I have fissure's and my asshole has diarehha whenever it wants to come!

Anonymous Coward's picture

A pretty safe cure for c. diff. colitis is yogurt. It restores the natural bacterial balance of your body. Anytime you take anitbiotics, take probiotics in the form of active cultures yogurt. It works.

Poopcleanerupper's picture

OMGosh.... I have laughed so hard reading this page! Although I understand the seriousness of this issue, my 2 year old is a pooper himself, due to throat surgery and severe i.v. anti-biotic intake, I have honestly been able to see the lighter side of the issue! I trust his doctor (she literally saved his life) and will meet with her this afternoon. I am hopeful that we can treat it with yogurts and natural remedies. He's only 2, and I've always been against anti-biotic treatment for all the obvious reasons;however, when there are 3 abscess in a baby's throat that could go to his brain causing brain damage or rupture and cause him to asperate and die there really is NO choice. THANK YOU ALL for giving me a great giggly morning!!!

turd turdgutson's picture
l 100+ points

I'd like to revise the free medical advice I dispensed previously. Do NOT tell your boyfriend to drink half a bottle of Immodium AD - instead, have him drink two full bottles of ol' reliable, Fleet's Phospho Soda, equip him with a twelve-pack of toilet paper, and lock him in the bthroom for 12 to 24 hours. It'll probably result in an obliterated commode, but he'll come out of it purged clean and hopefully still alive. You may wish to stock up on air fresheners during this procedure.

"...you guys are missing the genius of Turdgutson's idea. We should certainly not be shitting in the sink, but why not invent a Toilet Disposal? Your tampon, giant turd, or some hooker's hand won't flush? Just flip a switch!" - SamDamnit

"You will spray oil when you fart. You will have diarrhea. You will be shitting constantly and you will lose control of your bowels." - Mr. Angry on alli

nyufly's picture

All I have to say is probiotics. I'm recently battling a bout of antibiotic diarrhea. The antibodies kill all good and bad bacteria in the body, except for c.diff of course. With all the good bacteria gone c.diff have more room to multiply and wreak havoc onm the intestines. So introducing the good bacteria will help the get the rampant C.diff under control. Bloods V.S. Crips. Ya we taking back all the intestines you mark a** busters.

Tired's picture

So about a year ago I started suffering from bouts of diarrhea after practically every meal. I had to rush to the bathroom from an overwhelming urge to go after meals. I was always gassy but not really in pain. I couldn't eat many things, this even included drinking water at times, because everything seemed to set me off. Ironically coca-cola and pizza were the only things I could stomach with minimal side effects. So anyway, after about six months I went to the doctor and she took a stool sample and said that I had inflamed cells in there but not much else. So she prescribed metronidazole for me for two weeks. However I took this after two weeks of taking antibiotics for a surgery on my ankle. During the time I took all the antibiotics my symptoms decreased, but about 3 or 4 days after I stopped the antibiotics my symptoms came back, but differently. I would want to go to the bathroom but nothing would come out save some mucus. My doc prescribed some anti-spasmotics for my intestine and that helped, and after a while that stopped but I'd still get an urge to go to the bathroom after big meals. Now I've been taking digestive enzymes and herbal teas and whatnot and that seems to help me deal with it more or less. But I still can't get a straight answer from any of my doctors as to what I have, cause as soon as I stop the enzymes, my symptoms return. Does anyone know if this is IBS for sure? Or is it possible that I had some infection and then the antibiotics killed it off and then they just completely effed up my natural balance in my stomach? Sometimes I think I'm getting better, because I can eat a lot more foods now, but I'm still terrified, because I can't live with IBS, I travel a lot, and dealing with food is far too difficult. Can anyone suggest any tests/questions I can ask my doctors about? Because I can't get a straight answer out of them and I can't just guess as to what I have! Anyway, anyone else with shit like this, I completely sympathize.

Anonymous Coward's picture

I had cdiff and it was awful. I couldn't tolerate cdiffsupport.com enough to get any support. The mods are catty, they didn't want to hear about poop, and one of them always puts " " around words. Almost as bad as having cdiff.

ChiliKahKah's picture
j 1000+ points

better to take the antibiotics when you feel like crap even if it makes you crap your brains out.

Poop People's picture

Many comments focus on probiotics - which is fantastic.

Taking a specific probiotic for those on antibiotics will prevent thrush / diarrhoea occuring for most people.

But as the doc mentions, C.Diff is an altogether nastier beast... however there is once again a probiotic solution. Look for Saccharomyces boulardii... this is a probiotic yeast shown in clinical trials to tackle toxins A and B created by C.Diff and can help treat and prevent C.Diff from recurring.

It is available in the UK as OptiBac Probiotics For bowel calm; in the US as Florastor; in mainlaind Europe as Reflor / Bioflor / Ultraleveure - all the same thing - high doses of just S.boulardii probiotic in a capsule.

Windbag's picture

My God, I laughed until I farted some more. I've been on Amox-Clav for 3 days and even the dog won't come near me anymore. My wife moved into the guestroom last night,and the plants are all dying. I'm heading out to the kitchen to look for some yogurt.

sittingpretty's picture
Comment Quality Moderatori 2000+ points

Windbag, you are funny. Care to register?
...And their flesh like dung. Zeph. 1:17

...And their flesh like dung. Zeph. 1:17

kimberlyg's picture

Try taking 1 tablespoon on betonite clay in water once a day. It worked for me. Apparantly C.diff bacteria is attracted to it and the clay pulls it out of your system. Hope you guys find this helpful.

Anonymous Coward's picture

Please try Pau d'arco tea. It is a known treatment for: candida and other fungus, viruses such as polio and influenza, arthritis, diabetes, parasites, bacteria, cancer, liver disease, fever, venereal and rheumatic disorders, skin disorders such as eczema, herpes and the mange, and more.
ease, also try Pau d'arco tea. It is a known

Anonymous Coward's picture

Try wild oil of oregano capsules.
Hippocrates used Oregano for curing various diseases such as stomach pain and respiratory diseases. In the 15th century, Paracelsus used Wild Oregano to treat diarrhea, psoriasis, vomiting, jaundice, and fungal diseases.
Carvacrol from Oil of Oregano is a natural phenol that contains powerful anti-microbial activity. Flavonoids provide natural antiseptic properties, and Terpenes (long chain hydrocarbons) are natural anti-inflammatory agents.
It's worth trying.

Exodus 2pt0's picture

I feel for you guys, 2 days ago I was prescribed Cefdinir for a sinus infection, and last night the runs began. Woke up at 3:00am to let my puppy out and havnt gone back to sleep since. Every 15 minutes or so I'm punishing the toilet, wife went to sleep in the guest bedroom it's been so bad.

I'm about to go raid the fridge for her yogurt, teach her to leave me alone likethis lol.

Post new comment

  • Allowed HTML tags: s:62:"<em> <strong> <cite> <code> <ul> <ol> <li> <dl> <dt> <dd> <br>";
  • Lines and paragraphs break automatically.

More information about formatting options

This question is for testing whether you are a human visitor and to prevent automated spam submissions.
Enter the characters shown in the image.
To prevent automated spam submissions leave this field empty.