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Therefore, customized approaches are necessary in the selection of antibiotics for the management of bowel diseases owing to variations in the gut microbiota and disease characteristics among individuals

For example with infliximab, the first of the anti-TNFs available in Australia, failure to initially respond to IFX therapy, known as primary non-response, has been noted to occur in as many as 2941% of patients with luminal CD and 31% of patients with fistulizing CD

however, there is no significant clinical benefit for patients

There are also certain drugs and health conditions that can increase the likelihood of developing a B12 deficiency such as: alcohol abuse, antacid use, smoking, celiac disease, other digestive concerns, pregnancy, a strict vegetarian or vegan diet, and even natural aging

However, this balance is significantly reduced in neurodegenerative diseases like Parkinsons and Alzheimers