If gut bacteria are so important for human health...

great question!

Maybe having the right gut bacteria are only important when you have a colon?

BTW, you do have a lot of bacteria in the small bowel, too. Those help you with digestion quite a bit.

My GI said to stop my probiotics. VSL3ds. Said there was no need. Wouldn't that be good for the bacteria! I stopped taking them . I see no difference.

Do they tell you to take any vitamins after getting your colon removed?

Yeah, but the small bowel contains a low number of bacteria. You don't want too much bacteria in the small bowel, because then it leads to small intestinal bacterial overgrowth (SIBO), which can cause malabsorption in its own right.

Anyway, removing the colon does cause metabolic changes, but less so in those who have a pouch. I can't say I've noticed the slightest bit of trouble in absorbing every last calorie from my food, but there you go. The pouch, to some extent, appears to become a replacement colon. (Same deal with the 'continent' ileal reservoir, which also becomes colonised by colon-like flora.)
Metabolic consequences of total colectomy

If anyone just happens to have a subscription to the British Journal of Surgery, I'd appreciate a copy of the full article, ta:
Metabolism of body water and electrolytes after surgery for ulcerative colitis: Conventional ileostomy versus J pouch

But J-pouchers don't get away entirely scott-free:
Adverse Metabolic Sequelae Following Restorative Proctocolectomy with an Ileal Pouch

And, thank god, it's dinner. Later folks... <_<

Hey NCOT - You could actually say in some weird way you may outlive us all! All depends on how you look at it.

I posted this on another thread but I think it applies quite well to your question:

(This comes from two of my textbooks)

It helps to answer that by taking a look at germ free animals...

As far as Germ Free goes:

- Overall they (germ free animals) actually have fewer diseases and even live longer when kept in the germ free environment. So this tells us that the gut flora is NOT needed to thrive. At the same time it tells us that the gut flora IS actually a source of infections that shorten our lifetime.

- Take them out of this environment however and wham - they usually die very fast due to a hyperactive response to pathogenic bacterial exposure and inability to defend against some pathogenic bacteria. Equally interesting though, take them out of this environment and put them with other conventional or normal animals and their gut bacteria composition will look the same soon. So this shows they acquire the new bacterial make-up from their environment and can actually be easily colonized. But even though they now have a similar intestinal bacterial make-up they are less tolerant and can die from infection from bacterial species that are somewhat harmless to normal/conventional animals.

So the above is interesting from an evolutionary or adaptive perspective where their bodies (organs) are physically different and geared towards functioning within their specific environment (the germ free environment).

- We have a trade off - we give up life span for the ability to resist/deal with bacterial infection (so immune system development) and for easier access to specific required nutrients. So we acquire tolerance.

- Interestingly their immune response to virus and parasites are very similar to conventional/normal mice. So again pointing to bacteria as a wild card I guess you could say and the role of adaptive immunity in regards to bacteria.

It's kind of all quite interesting.

Also there is physical differences in the appearances of their organs in germ free animals - specially their intestines - but this is again more due to adaption to now be able extract the required nutrients/vitamins etc etc. that we get from bacterial byproducts. So their intestines are actually more suited or ummm, more "efficient" in many ways. They thrive very, very well and live very long lives when they can eat whenever they want and access required nutrients from their diets (non-scheduled or restricted feeding) - There's a Latin term for this but looking back I can't find what it was called. Does not matter.

In any case - you have developed your tolerance already, and your body has already made some adjustments to make up for the lack of your colon... So perhaps one could make an argument where as long as you can access all your required nutrients you might outlive and "out health" us all !!!

Lately I've wondered this myself. My dad had UC and had a permanent ileostomy when he was 19. Honestly I never thought about it until I got Crohn's colitis, but since I've read so much about gut flora and gut health. The research seems to be pretty much in its infancy, so it will be interesting to see what can be found from more research.

I've read about the brain gut axis, but I can't say I know a lot about it. Serotonin is created in the gut, but I haven't been able to find if it is produced solely in the large intestine or elsewhere, but it makes me wonder if there is a loss of serotonin production in people who have colectomies. Also I've read a lot of anecdotal stories of people who had a colectomy who gained a lot of weight after, which it looks like they will be studying in the trial link you posted. I'm assuming that has something to do with not having the gut flora they had when they had a colon, but who knows.

I'm particularly interested in how it could affect mental/neurological health due to the brain gut axis. Of course having a colon and having IBD can affect mental health as well, and I've read that inflammation in the gut can cause inflammation in the brain, so I guess either way colon or not your brain is affected.

Thanks for an interesting post, Octobergirl, and raising up a new point for discussion: serotonin. The vast majority of serotonin is produced in the digestive tract, but it is also made in the CNS as well.

Again, what effect would losing all that gut serotonin have? I don't know... :-/

But to answer Mark's question: No, I've always been a depressive bunny... >.> I don't think that's any worse than it was pre-surgery or even pre-Crohn's.