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Some evidence suggests this drop may begin around age 45coinciding with the transition into perimenopause

While this broad pattern remains consistent, the distribution of gut bacteria varies both over time and along the digestive tract, with significant differences in diversity and bacterial counts as moving from the esophagus down to the colon and distal gut as depicted in Fig

See Section 2.3 above

10.1038/4553 364 WilliamsK

Synergistic action of microbiota modulation and metabolic surgery The significant improvement of NAFLD by metabolic surgery (such as sleeve gastrectomy) is partly attributed to its remodeling of the gut microbiota, providing a theoretical basis for combined microbial intervention in the perioperative period