My child is still intolerant to a particular food (tomato, citrus, lettuce, etc) in spite of being on inulin. What does this mean? I thought food intolerance should go away after starting inulin.

By intolerance, I will assume you mean visible changes in a child when they consume certain foods and not intolerance determined by blood testing, which is highly inaccurate.nnBacterial overgrowth of the small intestine (SIBO) triggers intolerance symptoms (heartburn, indigestion, cramping, or diarrhea) when particular foods are ingested. Rebalancing intestinal bacteria with inulin or rifaximin will cause the reaction to these foods to improve (lessen) significantly. If the symptoms persist, despite rifaximin or inulin, I will either switch inulin to monthly rifaximin or increase the dosing of rifaximin from monthly to continuous.nnAn exception to this rule of thumb is intolerance that results in a dangerous allergic reaction (tree nuts, shrimp, peanuts, etc.). Patients should always carry their EpiPen if they have such allergies, even if they are successfully recovering on the protocol.