SIBO is so difficult to get rid of, as I've discovered, especially if you have methane SIBO. You probably had SIBO before some of these other diagnoses. I am on 2nd round of xifaxin which I didn't want to take but I finally gave in. after six months of alternative efforts. I also take Atrantil and megaspores, which stopped the constipation, along with an antibiofilm. My initial test was 71 and then with fodzymes I cut it to 54. Not sure what the score is now but hoping stuff is finally gone. I'll stay on atrantil and megaspores forever. Once you get SIBO it comes back if you aren't careful, as I have learned. They build colonies and they are organized, little devils.