Additional Details: I completed phase 2 & have done extended purging for 3 weeks with GSE, Olive Leaf Ext, Oregano Oil, SF722. My diet is clean meat, cooked green leafy veggies & coconut oil. I space meals out 5 hours, no snacks, chew well. I take digestive enzymes, HCL, pepsin & ox bile. Haven't used allicin, cinnamon, neem, peppermint or berberine yet. Do you suggest any of these? What protocol & duration?
Simply put, you're not yet finished with the antimicrobials. While Phase 3 continues that effort, you're not ready yet. The strategy is built on the "concerted effort" of multi-ingredients providing "nowhere to run, but out" for the pathogens and their synergists. With SIBO, the offending pathogens cause changes in the intestinal tissue and terrain, and thus become hard to root out. Once rooted out, they can come back easily because of that altered terrain and other reasons such as a leaky illeocecal valve, lowered motility, and altered immune response (i.e. - lazy against that species.) So success is also a timing issue. We can be buy some time for the tissue to change and for the lower GI and digestion to improve. Methane producers are "tough guys." and sometimes "heroic" efforts are needed. A heroic effort refers to strength of the program and the stronger the anti-pathogenics, the more likely adverse reactions can occur. In your case, you've primed the body to accept stronger anti-pathogenic agents, and you've accomplished a good percentage of the work already. You literally might be at 90% completion, and likely are. But the "grizzly bear" is that last 10%.
So what's needed is to renew the effort and incorporate a combination of elements, some being the same ones you've used and some being new influences. Do consider the Allimed or a garlic type product. If concerned about the price of Allimed, you can use fresh garlic (provided you tolerate it well), and can stand down wind of the rest of humanity. Actually, fresh garlic is amazing, but not everyone can tolerate it, nor can bystanders, so an allicin product would add a new dimension to your "final push" effort. A probiotic enema is also good. By helping the bowels, there seems to be a reflexive or sympathetic improvement in the lower small intestines. Also be sure the illeocecal valve is closed (pressure point). As a wild card in the mix, in your case, add the Neem and just give it all a final push. It’s too early to do ferments as they will contribute to bloating. When the "bugs" are diminished, so is the bloating. Then with motility improvement and continuance of your improved diet, you should not have bloating. With a little time, your tissues will heal and a new relationship between your innate immunity and the microbial world will preclude SIBO returning.