Mutliple rounds of treatments still not working

Diagnosed with methane-dominant SIBO via breath test on 2/21/25. Colonoscopy and endoscopy followed on 3/18/25. First antibiotic course, Rifaximin (Xifaxan) plus Neomycin, ran 3/13/25 through mid-April, 14 days each. Omeprazole, started 3/20/25 for a focal erosion, was stopped 7/7/25 once it became a suspected contributor to SIBO recurrence.

The overgrowth returned. Flare-up 8/1/25, a second flare-up 1/18/26. Around this time I suspended Mounjaro (2/4/26), a GLP-1 medication linked to slowed gut motility and higher SIBO risk.

After the January flare, treatment restarted with a herbal antimicrobial regimen (berberine, Allimax, oregano oil, peppermint, Saccharomyces Boulardii). A breath test in March 2026 showed methane had dropped substantially but was still positive, and hydrogen had newly spiked, meaning the overgrowth had shifted to mixed hydrogen + methane. Around the same time, stool markers (calprotectin, lactoferrin) came back elevated, and the herbals weren't holding the line, so treatment moved to a targeted 2-week Ciprofloxacin course starting 4/9/26, then a 2-week pause waiting on Rifaximin delivery, then a second Rifaximin + Neomycin course, 14+14 days. Since finishing, I've been on prokinetic support (Motility Activator) to protect the migrating motor complex and prevent another relapse and Bentamine HCL and DGL to balance stomach acid.

Symptoms have persisted despite that second round. Bloodwork came back normal. Stool calprotectin, rechecked to follow up on the earlier elevated marker, also came back normal. No breath test has been repeated since March, so it's not yet confirmed whether the current regimen has cleared the overgrowth. A CT scan of the abdomen was ordered 8/7/26 to look for a structural explanation and is still pending.