My constipation was catastrophic, my IBS-C label didn’t explain it, and my lactulose breath test finally showed IMO
Current status
Still struggling- Still struggling
- Somewhat resolved
- Mostly resolved
- Fully resolved
The story
32y/o Female. Struggles with chronic constipation from youth. Got really bad along with food intolerances and fatigue and brain fog in 2025. Noticed these symptoms beginning to increase back in 2023 but ignored them. Finally in early 2026 I was having so much joint pain and fatigue and I couldn't eat anything without getting extremely bloated (10/10). I started losing weight significantly because everything I ate caused pain. So I ate very little. Discovered underlying Hashimotos, then treated in early 2026. Slowed motility still an issue. Became constipation switching to diarrhea. Diagnosed IBS - C. Was searching for the problem. Parasites negative, IBD negative, Celiacs negative, h pylori negative, normal gastric emptying. Went to low fodmap diet in March of 2026 which helped symptoms tremendously. Tested positive for IMO using lactulose breath test (25ppm methane across any point during the test) in July 2026. Taking pruclopramide 1mg daily after my 2nd round of rifaximin(550mg TID)/Neomycin(500mg BID) 14day course. The first round included Sunfiber along side the antibiotics. The first round didn't help, symptoms returned. Although I didn't go back to low fodmap/LFE after that round. There was no relief period. Symptoms of bloating and gas and reflux returned immediately. Have been meal spacing 4hrs since June (pre antibiotics, during, and after, up until now). The 2nd round of rifaximin/Neomycin included Priority One Phase2 biofilm disruptor (1-2 capsules per day for 1.5wks before introducing the antibiotics again) and then 3 capsules per day throughout the 2wk course. Now doing 14days elemental diet (mBIOTA), just finished day 1, immediately following the 2nd course of antibiotics. Bloating is less, but dealing with hunger and hypoglycemia. Praying it eradicates the IMO. Will continue to use low fodmap/LFE for several months along with planned starting a Spore based probiotic and continuing pruclopramide. Investigating anismus and Ileocecal valve dysfunction in the coming months.
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Symptoms
Tests & diagnoses
Treatments
Each treatment this contributor tried, in the order that mattered, with their own reported result. The ones marked with a trophy are the treatments they credit as decisive.
Started in March 2026; plans to continue low fodmap/LFE for several months.
Used 1-2 capsules per day for 1.5 weeks before antibiotics, then 3 capsules per day throughout the 2-week course.
Doing 14 days immediately after 2nd antibiotic course; just finished day 1; bloating is less, but hunger and hypoglycemia present.
Has been meal spacing 4 hours since June, before/during/after antibiotics up to now.
Took rifaximin/Neomycin 14-day courses; first round did not help, symptoms returned immediately; second round just completed with less bloating afterward while starting elemental diet.
Included alongside antibiotics in first round.
Updates
Contributors keep their stories current, so a pattern is a living thing, not a one-time snapshot.
- October 2026Still strugglingNo Change
update from Oct 18: After a second round of antibiotics immediately followed by an elemental diet.... The test came back negative. No more methane. I did a 2 breath, not a trio. However, im still having symptoms. Really bad bloating after food and drink. And sometimes pain. Loud noises in my tummy all the time. Still on lowfodmap and low fermentation. And still losing weight. It's frustrating that the test is negative but they symptoms are still there. I guess it's just a result of having a really poor and imbalanced gut microbiome now. So will start to work on rebuilding.
- October 2026Still strugglingNo Change
Well I thought I was out of the woods because my imo treatment worked (antibiotics plus elemental diet). The lactulose breath test showed no more methane. Great. But I still felt terrible. Arguably worse than before. But I'll go with "about the same". So I monitored that for a while and the bloating continued to get worse and worse. Turns out it's likely SIFO. So now starting a course of Nystatin with biofilm busters and NOW candida support. Hopefully this helps.
- September 2026Somewhat resolvedGot Better
Day 4 of mBIOTA elemental diet. Bloating significantly decreased!
This is one person's reported experience aggregated by GutPattern, not clinical advice, a treatment protocol, or a diagnosis. What helped one contributor can do nothing — or harm — for someone with a different underlying cause. Sudden, severe, bloody, feverish, or worsening symptoms belong with medical care. Always discuss care decisions with a qualified clinician.
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Sign in to replyAfter a second round of antibiotics immediately followed by an elemental diet.... The test came back negative. No more methane. I did a 2 breath, not a trio. However, im still having symptoms. Really bad bloating after food and drink. And sometimes pain. Loud noises in my tummy all the time. Still on lowfodmap and low fermentation. And still losing weight. It's frustrating that the test is negative but they symptoms are still there. I guess it's just a result of having a really poor and imbalanced gut microbiome now. So will start to work on rebuilding.