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Strategies include: Prokinetics: Support the migrating motor complex and prevent relapse Examples: Ginger, MotilPro, low-dose erythromycin, prucalopride Probiotics (cautiously): Spore-forming strains like MegaSporebiotic may help without worsening symptoms Use only after clearance and once tolerated Dietary reintroduction: Begin with a low-FODMAP or Specific Carbohydrate Diet (SCD) Gradually reintroduce fermentable fibers as tolerated Lifestyle optimization: Stress reduction (mindfulness, breathwork, vagal stimulation) Meal spacing (4-5 hours between meals to allow MMC activity) Quality sleep and circadian rhythm alignment How to Prevent SIBO from Coming Back Recurrence of SIBO is common without addressing the underlying causes

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Purification from rat kidney and mapping of the substrate binding sites