Tightening the stoma can delay emptying of food into the small intestine, which means increased digestion in the stomach and less occurrence of undigested food particles entering the small intestine, which leads to bacteria in the small intestines that do not belong there.

Also, I have a motility issue so bypassing more of the intestine means less transit time, and less time for food to ferment in the bowels, which also is a cause of SIBO.

Of course, motility can also be increased with the use of pro-kinetics. And digestion can be aided in the stomach with digestive enzymes and fully chewing the food in the mouth until it is liquid. And I do understand how to rebuild my gut and the diet that I will need to follow afterwards so that the good bacteria outnumber the bad. And in theory, I understand how to kill the bad bacteria and parasites and candida/fungi. But all this is a life-long battle. So if the surgery could return my digestive system to normalcy then I will further explore it. As with any surgery there is always risk... and if it is more likely that the surgery will cause more harm then good then of course I will not explore it.

Most people lose weight with SIBO and go underweight. I assume this is because the bacteria are taking so much of the nutrients from the food -- this part is of particular concern to RNY patients who are already receiving less nutrients from our food. That's also a concern with further bypassing more intestines, although is this any worse than the DS?

I have worked with many healthcare professionals allopathic to naturopathic and tried every treatment modality that I can get my hands on across the past 4-years. Instead I have gotten worse rather than better. It was only at my insistence that my current GI did the SIBO test, which seems a no-brainer to do given that my condition manifested when I swam in bacteria-contaminated water. As well, anyone with IBS should be tested for SIBO in my opinion. As well, they are doing a stool test at my insistence to check for parasites. I cannot believe no one has done these tests until I insisted.

Would you like to guess how many times in my life that I have been right and my doctors have been wrong? More times than I can count. And my first GI that I went to with this condition was the head of digestive disorders at IU Health and a key opinion leader in his field. So I wish that I knew then what I know now.

And this is part of the reason that I won't necessarily trust a bariatric surgeon if s/he tells me that the revision will help/cure my digestive health, and why I want to hear from patients.

I also need to be tested for Lyme. There is a link between Lyme and SIBO. And a Lyme Literate MD can heal not only Lyme but it's co-infections, as well as treat for parasites and fungi. This is what I am going to do next, although I am currently doing a partial elemental diet and using other things to kill off the SIBO.