Dear Doctors: I had to take antibiotics recently, and I want to help my gut microbiome recover. My doctor said instead of taking probiotics, I should eat a lot of high-fiber foods. I was surprised when she said using herbs and spices can also help gut diversity. I would like to know more about this.

Dear Reader: Antibiotics are often an effective treatment for clearing up a bacterial infection. Unfortunately, because they are broad-spectrum medications, they can kill or inhibit the trillions of beneficial bacteria that make their homes in our gut. Research shows that, depending on the specific drugs used and the length of treatment, the gut flora can be disrupted for a few weeks to several months after treatment.

Not surprisingly, as awareness of the importance of the gut microbiome has grown, patients taking antibiotics are actively seeking approaches to speed the healing process. Taking probiotics can seem like a good idea, but research has shown that they can actually delay recovery.

The gut microbiome is a complex ecosystem. When antibiotics significantly reduce the diversity there, introducing a small number of probiotic strains can disrupt the natural balance within the gut, particularly when those organisms are not native to an individual’s own microbiome. The end result is a disruption of the natural recovery process.

Your doctor is recommending that you repair your gut the old-fashioned way. That is, by providing it with the nutrients microbes need to recover their numbers. High-fiber foods that sail through the stomach and small intestine largely unscathed reach the large intestine intact. There, through the act of fermentation, the mighty microbes of the gut turn them into food for themselves, as well as a variety of short-chain fatty acids and other biologically active compounds that support gut and overall health.

That brings us to the foods themselves. In addition to leafy greens, vegetables, fruit, grains, beans and legumes, which fall into the high-fiber category, it’s a good idea to include fermented foods in a gut-recovery diet. These foods -- such as yogurt, kefir, tofu, pickles, tempeh and kimchi -- contain a range of beneficial live cultures. Research also shows that herbs and spices can give a meaningful boost to the gut. These flavor enhancers, such as garlic, cinnamon, turmeric and oregano, turn out to be rich in polyphenols, a category of organic compounds that act as antioxidants. Polyphenols in a post-antibiotic diet have been shown to selectively feed beneficial microbes, discourage the growth of harmful ones and support the overall conditions the microbiome needs as it rebuilds and repairs.

We hope you will consider the food-based recovery route your doctor has prescribed. Probiotic supplements, while easy to use, contain high numbers of a limited range of microbes. Plant-based and fermented foods, by contrast, introduce microbes and microbial fuel at a gradual and measured pace. This gives existing gut bacteria the time and room to recover and helps avoid disrupting the natural process of recolonization.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: If it's true that, according to a 2024 study, there are some 200,000 deaths (amazingly!) each year from medical errors in the United States, might AI be used to reduce them? I've read it can help with ventilator mishandling, patient instruction omissions and detecting diagnostic oversights.

Dear Reader: Your question about artificial intelligence broaches a topic that is generating both cautious enthusiasm and widespread concern. It may seem like an emerging debate, but the idea of AI as a medical tool dates back to the mid-20th century. What started as a largely theoretical idea in 1950 had, by the turn of the century, evolved into a range of algorithms and pattern-recognition models. These were designed to assist with imaging analysis, diagnosis and even some aspects of clinical care. It wasn't until a significant leap in data and computing resources in the 2010s that modern deep-learning approaches would be able to turn theory into practice.

Before we look at how AI may be useful in medical care, we should clarify the statistics you cited. Despite a widespread desire for an authoritative number, estimates of deaths due to medical error vary widely, depending on how those errors are defined. Some studies stick solely to point-of-care mistakes. Others include system-level failures, such as a lack of coordinated care, a lack of access to appropriate care, medical insurance practices, faulty or incomplete safety nets and inadequate follow-up care. The analysis associated with that 200,000 figure takes this broader view and does not reflect only point-of-care mistakes.

Proponents of AI believe these tools can be harnessed to improve medical care. Pattern-recognition models, in particular, have already proven effective at analyzing medical imaging scans, often with gains in both speed and accuracy. A study done here at UCLA found that AI models were able to identify pancreatic tumors in CT scans months, and sometimes years, before the human eye could see them. Another real-world use is screening for diabetic retinopathy, a complication of diabetes in which high blood sugar levels damage blood vessels in the retina. AI systems have also shown promise as early warning tools for sepsis, in detecting heart arrhythmias in ECGs and for reading mammograms in breast cancer screenings.

While acknowledging the possible benefits of these powerful tools, many clinicians and researchers advise a measured approach to adopting them. Medicine is, at its core, a deeply personal science, and context matters. For that reason, most experts emphasize that artificial intelligence should be used as an aid, not treated as an authority.

When incorporated thoughtfully and with proper oversight, AI systems have the potential to improve medical care. They can scan large amounts of data quickly and identify patterns associated with early-stage diseases or conditions that might otherwise go unnoticed. They can improve accuracy in imaging review, detect early signs that a patient’s vital signs are signaling future problems, identify gaps in follow-up care and reveal breakdowns in coordination before they lead to harm. As AI tools evolve, keeping humans firmly in the equation will be key not only to their success but to their eventual acceptance.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: My wife started getting sick a few days before Halloween. We were worried that it was going to turn into a bad respiratory illness, but it stayed in her nose and throat. That's a common cold, right? Why is having a cold so different from when you get the flu?

Dear Reader: Both of the illnesses you mention in your letter -- the flu and a cold -- fall into the broad category of upper respiratory infections. Because different types of viruses cause each one, the body's response can vary a lot. The flu can cause serious illness and can lead to hospitalization and even death. The common cold, by comparison, is shorter in duration, with symptoms that are not as bad. Having a cold isn't fun by any means, but it's not a serious threat to health. To understand why, we need to take a closer look at the microbes involved.

Influenza, commonly known as the flu, is caused by specific subtypes of the influenza virus. Most often this is influenza A and influenza B. The flu hits hard and fast due to the nature of the influenza virus. People shed the influenza virus through droplets primarily spread by coughing or sneezing. When others inhale the flu virus, it absorbs through their mucous membranes. Then the flu virus penetrates deep into the tissues that line the airways. The virus can evade early immune detection by shielding itself from the sentinel cells of the immune system. By the time the immune system finds this invader, the viral infection has grown, so the body triggers a powerful inflammatory response to fight it.

The common cold, by contrast, is a milder infection. Symptoms usually start gradually over a day or two. Colds are most often caused by rhinoviruses. These viruses tend to stay in the upper airways and trigger fewer and less intense immune responses. The immune system also recognizes the infection earlier, so the body has a slower and more measured inflammatory response.

An interesting fact: There are several types of rhinovirus that can cause the common cold. That’s why it’s possible to have two colds in a row. You aren’t catching the same cold twice, but responding to two separate rhinoviruses.

Medical care for a cold and the flu also differ. Treatment for a cold focuses on managing your symptoms. Usually, over-the-counter meds help ease pain and relieve sinus and nasal congestion. Getting plenty of rest helps, as does drinking lots of fluids to replace what the body uses to produce mucus. For a mild case of the flu, a similar treatment, along with cough medicine, can be enough. But for serious flu symptoms, you want to check with your doctor. They may recommend a prescription of antiviral medications. Starting these medications in the first two days of an influenza infection can shorten the illness. If someone with the flu has worsening symptoms, including chest pain or high fever, they should seek immediate medical care.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

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