If you have fatty stools (yellower, sticks to the bowl, smellier) that is not something to take lightly and indicates you are not breaking down food properly, in particular fat. This can be gallbladder related with inadequate bile salts being produced and delivered and/or exocrine pancreatic insufficiency (EPI), where you are not producing or delivering enough pancreatic enzymes to break down food. This causes nutrient deficiencies, dysbiosis and slowly breaks down the body. Please have a look at the following thread for EPI (and SIBO, Candida):
https://forums.phoenixrising.me/thr...y-epi-and-chronic-fatigue-syndrome-cfs.62997/
Please ask your doctor for a pancreatic elastase and 24 hour fecal fat stool tests for EPI. Or you can do the Genova stool test I mentioned earlier.
Although I use prescription pancreatic enzymes (Creon), you can get over the counter versions as an immediate stop gap, as the doctors will unlikely prescribe it until confirmed. They will need to be taken with each meal or snack in order to get more of the nutrients from food by breaking it down properly. Undigested food particles can cause autoimmune reactions, overgrowths of bacteria and yeast in areas where they should not, systemic inflammation, etc.
It might be best to find a functional/integrative medicine doctor who has experience with SIBO and Candida treatments. In my experience Rifaximin alone is not effective for methane related SIBO. You will also need supplements to attack the biofilm, pre- and pro-biotics. I took a 10 day course of both Neomycin and Rifaximin together along with all the other steps. For Candida yeast overgrowth some of the steps are similar, but the anti-fungal I used was Nystatin (From a compounding pharmacy, 1 million units per day for a month is what I did) along with things like botanical agents, enzymes, molybdenum, probiotic yeast, biofilm attacking supplements. But you have to also tackle food and beverage intake and be quite strict for a few months to not overfeed the critters whilst trying to rebalance the microbiome. I dedicated a chapter to the SIBO and Candida steps I had to take to rebalance as it requires a multi-pronged approach. Temporarily stricter on yeast containing products (if you have Candida overgrowth), no milk, very limited fruit, no juices, no sodas, no alcohol, no deli meat (sugar), no gluten, etc. Have a look at what Mark Sisson or Chris Kresser mention about food, SIBO, Candida. There are herbal anti-microbial drops like Biocidin, oregano oil, molybdenum, Serralase (enzymes), Interfase Plus (biofilm disruptor), coconut oil (MCT), cinnamon, garlic, mustard, thyme, that are all non-prescription things that helped me.
Here is a study that might be of interest which covers a few of those natural treatments:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030608/
Regarding food I follow a roughly primal style ( or what my grandparents would have just called food):
- As little processed, packaged, canned, non-organic as possible
- Avoid toxins where possible: preservatives, additivies, coloring, food glue, flavoring, chemicals, herbicides, pesticides, plastic chemical leaching, etc.
- Many types and colors of vegetables, preferably local organic
- Healthy proteins: happy pastured chickens, grass fed beef, non-farmed fish, hemp, etc.
- Healthy fats: nuts, olive oil, seeds, grass fed butter, fish, avocado, etc.. High fat dairy in moderation with grass fed and full fat preferred, unsweetened of course, aged and fermented also good options.
- Avoid unhealthy, highly processed, partially hydrogenated GMO oils (canola, corn, soy, etc.) and trans-fats. This is used almost everywhere these days: restaurants, cafes, processed food, condiments, etc.
- I do not drink any calories (just unsweetened tea, coffee and water).
- Regarding starches, potato, rice, legumes, pasta, grains, cereals, bread, the quality is extremely important and in very limited amounts. Organic wheat only (to avoid more glyphosate exposure) for bread.
- Real fresh fruit limited and more seen as a treat, but never liquid, dried, processed, preserved, canned. It was a seasonal thing even when I grew up. Some berries, perhaps a kiwi or 1/2 banana, but not every day. Avocado is an exception as it is low sugar and high healthy fat.
I track my ketones to be in nutritional ketosis (0.5-3mmol), which is a great indicator of excess sugar and carbohydrates. HbA1c blood test (5.2% or less) is also a good indicator of how much damage sugar has been doing to your cells through glycation and I use it as an indicator of my carb intake. Usually ~100 or fewer grams per day.
A little side note, have you had your water supply tested? Is it chlorinated? Water quality is often overlooked as possible causes of microbiome dysbiosis and chronic health issues.