Thanks for the response, and good on you for fighting for a better doctor and better treatment.

I would be very interested to hear what your doctor has to say about your colonoscopy done 10-11 months ago. My anastamosis (reconnection) was done "side-to-side", which is a relatively old-fashioned way of doing it. There are certainly pro's and cons to doing it one way or the other, but in my case the con was that the excess intestine again left a big flap - not saying it's the case for you, but something to keep in mind.

Another thing to keep in mind is that it took THREE colonoscopies post surgery for a doctor to stop and say "hey this is kind of weird, you don't usually see this and I do 10+ colonoscopies of Crohn-ies a week". They typically go in, see zero inflammation, and call it a day - only because I was having recurrent issues did my doctor stop and snoop around, so to speak.

Again, I would urge you to find out exactly what was "atypical" about your anastamosis, and whether it may lead to these issues. And if your doctor starts talking about surgery, I would shop around and get second and third opinions and find a surgeon you're most comfortable with, even if he or she does not work directly with your doctor. (In retrospect, I was probably pressured to go with the surgeon my doctor wanted even though I had vague misgivings, but I was 23 years old and no one in my family had ever been sick like this, so I did not know any better. )

As far as quality of life goes, have you considered going a more meat based diet? I have no ideological disposition towards any diet being "healthier", but "scientifically" limiting complex carbs seems to help the best with SIBO.

Unfortunately, gluten-free bread doesn't cut it because it's still loaded with complex carbs that the bacteria like to munch on. For me, I make 2-3 lbs of ground beef (a mixture of 85 and 90%) with just enough plain tomato sauce to taste (add more salt than you think you need, it's not gonna kill you), and divide it into 4 - 7 meals depending. I add just enough white pasta to get the texture acceptable - certainly possible to eat the beef on its own and many people do, but it becomes a small chore after a while.

It's not perfect but it certainly is loads better than the terrible issues I get with rice or potatoes. For some reason, when you cool down rice and potatoes, the starches recrystallize and become more "resilient". This is good if you're trying to lose weight (there is a dietician out there who puts his patients on a reheated-potato-only diet to good success), but terrible if you're trying not to starve bacteria. White pasta does not crystallize the same, I have found.

Give it a shot, or happy to further brainstorm with you. Good luck and keep me updated if you want.

Best,
G