Has anyone out there had similar surgery to me? I had an emergency colostomy last year ( Hartmann procedure) and have recovered very well. I can eat almost anything, despite the dire predictions from some quarters. However, having read “The Clever Guts” book, I am now wondering if my micro biome is reduced as I have lost a length of gut. Also, I now manage using irrigation, in effect washing out the contents of my bowel every 24hours. It has great advantages in management but I wonder if I am also washing out the good bugs! I have asked several medics but no-one seems to have an answer!

I am in a similar predicament. I have had a Total Colectomy, a Proctectomy and I now have a Kock Pouch (aka BCIR or Continent Stoma). I have purchased very good quality pre and probiotics and I am going to take 1 serve of each orally every morning and a second dose just after I empty my Pouch before bed but instead of taking them orally I will be mixing them into 50ml of water and injecting the mixture directly into my Pouch. My surgeon believes this will give me the best chance of improving my microbiome in light of the unavoidable depletion of my immune system, due to my physical condition. Has anyone else tried this?