Abstract We report a case of a very low‐birth‐weight infant with a high‐output stoma following necrotizing enterocolitis. The patient exhibited villous atrophy and microbial dysbiosis. Supplementation with glutamine and partially hydrolyzed guar gum (PHGG) was initiated, leading to reduced stoma output, improved feeding tolerance, and appropriate weight gain. Histological analysis revealed villous elongation, and microbiota analysis showed a shift from Proteobacteria dominance to increased Firmicutes and Actinobacteria abundance, along with increased alpha diversity. These findings suggest that glutamine and PHGG may support intestinal adaptation and microbiota modulation in infants with high‐output stomas. However, conclusions should be drawn cautiously due to the limited generalizability of a single case.
Kawaguchi et al. (Mon,) studied this question.