Chris Kresser: Okay, next question from Helen, “[There’s a] teenage female with a history of necrotizing enterocolitis at birth with subsequent removal of two-thirds of her colon. What are the implications for [the] gut microbiome with [a] missing colon and large amounts of antibiotics as [a] newborn for the above condition?” She shared some lab testing, has had some botanical programs, and [her] chief complaint is fatigue, ongoing acne, anxiety, and chronic diarrhea, [and] has been on probiotics since infancy with periodic switching to provide diversity.
Yes, in those situations, we don’t really know what the implications are because those populations have not been extensively studied in relation to the implication on the gut microbiome, but we can certainly assume that it would be compromised just using common sense and what we understand about the physiology of the colon and the microbiome. I think in those cases, you probably have to work harder to preserve a healthy microbiome and to also identify and address any other particular problems or pathogens that might appear. So I will typically just do the same kind of testing and treatment that we do with patients that have a full colon, in that situation, but just take that into consideration.