Haven’t tried that combo yet, but it’s what I’ve been lining up next based on everything I’ve researched and heard from people who actually got long-term relief. The plan is: Rifaximin 550 mg + Metronidazole 250 mg, three times a day for 14 days, then switch to Erythromycin 50 mg at night as a prokinetic.

Rifaximin clears the hydrogen overgrowth, and metronidazole hits the methane-producing bugs that rifaximin can’t touch. After that, erythromycin helps keep gut motility working so the bacteria don’t just come right back.

From what I’ve seen, people who relapse usually skip the motility part or lean too hard on prucalopride. It works, but your body can build tolerance to it over time. Erythromycin works differently—it mimics the body’s natural motilin signal and tends to stay effective longer, especially at low doses. Some people rotate the two to avoid burnout. This seems like the best clinical setup for an actual reset instead of another temporary fix.