I understand that many who have CFS also have SIBO. I read an article which describes a possible connection- exertion leading to more gut bacteria (SIBO) which spill over into the blood, leading to an immune response (CFS). But was hoping people might explain if this is the prevailing theory or if there are others- what are they? The reason I ask is I have been diagnosed with both CFS and SIBO. My initial hydrogen breath test peaked at ~30. After Rifaximin and supplements, I tested again and it was negligible at 3; and my symptoms related to SIBO have mostly gone away. But I still have the fatigue. Can I expect that my fatigue (or post extertion malaise- PEM) will go down over time now that the SIBO has been addressed. Or does that component of CFS have to be addressed independently. (For what it's worth, I have tested high for a number of markers related to inflammation; tested positive for two auto-antibodies, and had a positive test for bartonella; however the subsequent more granular bartonella test came negative).