Question 1

What do we do if emotional dysfunction is not improving?

Accepted Answer

I view the lack of progress in emotional regulation no differently than the lack of progress with other aspects such as language, socialization, or hyperactivity. If since starting the protocol, most issues are improving except emotional regulation, I would recommend the addition of vagus nerve stimulation to lower inflammation even further. nnIf there has been little to any improvement in most of these areas, I would change the approach to balancing the intestinal bacteria by switching from inulin to monthly rifaximin or from monthly rifaximin to continuous rifaximin.nnIf there had been good progress overall, including emotional regulation, but later on, aggression begins to increase. In that case, I look for external triggers such as infections, pain, emotional trauma, and dental issues.

Question 2

What do we do if emotional dysfunction is not improving?

Accepted Answer

I view the lack of progress in emotional regulation no differently than the lack of progress with other aspects such as language, socialization, or hyperactivity. If since starting the protocol, most issues are improving except emotional regulation, I would recommend the addition of vagus nerve stimulation to lower inflammation even further. nnIf there has been little to any improvement in most of these areas, I would change the approach to balancing the intestinal bacteria by switching from inulin to monthly rifaximin or from monthly rifaximin to continuous rifaximin.nnIf there had been good progress overall, including emotional regulation, but later on, aggression begins to increase. In that case, I look for external triggers such as infections, pain, emotional trauma, and dental issues.