My child is on the full protocol (continuous Rifaximin, fish oil, olive oil) and added daily VNS for 5 minutes a month ago. We haven’t seen any improvement in that at all? What should we do?

If there is little to no improvement with continuous rifaximin, the small intestine is overgrown with bacteria not sensitive to rifaximin. These organisms can be archaebacteria from the colon or bacteria from the oropharynx.nnAdding daily inulin (1/4 tsp per day) to the rifaximin can improve the response and trigger improvement.nnThe use of additional or different antibiotics would otherwise need to be guided by a gastroenterologist.