u/HoldOk4092

I have been experiencing SIBO symptoms (has, bloating, incomplete emptying) for 2 years and tested positive for methane last year. GI prescribed doxycycline even though GPT says most common prescription is Rifaximin and prucalopride. Symptoms went away for a couple weeks but have returned. I took gastric emptying study which was normal. GI is prescribing Bactrim. Refuses to prescribe Rifaximin or prokinetic.

I have a virtual appt set up at a major national clinic in 2 months. In the meantime should I take the Bactrim? Nothing I have seen on the internet recommends this antibiotic. The GI does not seem knowledgeable about SIBO. In fact I had to ask for the test (GPT's advice). I am convinced they never would have thought to test me if I didn't ask. Their line is anything that doesn't go away from PPI's can only be treated with low FODMAP diet. (I have cut down on garlic, onion, and beans and nothing works).

I am taking MMC artichoke and ginger supplement and gentian bitters.

Symptoms: constant gas, occasional ab pain. No constipation. Also occasional POTS.

Tested positive for methane sibo about 3 months ago. Treated with a round of doxycycline. ChatGPT recommended Rifaximin + prucalopride but GI refused due to cost of Rifa and possible side effects of prokinetic. Symptoms got better for a couple weeks.

Have been trying artichoke & ginger supplements to help with MMC. However, symptoms are back.

GI suggested gastric emptying study to test for slow stomach. While preparing for the test I noticed stools are containing undigested food from 2 days prior, so 36+ hour total transit time.

Just went through GES today and it came back normal. This seems to confirm transit issue must be in the small intestine.

My thought is to ask again for prucalopride. Anything else I should be doing at this point? GPT is also suggesting gentian bitters.