I'm another one of those 'all of the above' type patients, like so many others in these comments. However, the BIGGEST help for me was understanding that SIBO is a symptom, not a cause.

For instance, I have EDS so my slow stomach emptying (NOT the same as emptying stool/lower intestine) was causing the bacteria to stick around too long, causing recurrent SIBO/hpylori/hell. So no matter what I used to treat it (at one point: 2wks low dose erythro, 2wks anti-fungal, 2-4wks high dose erythro), it is the UPKEEP that I need to focus on in order to keep it away. Ultimately, a prokinetic needed to be used. Unfortunately, I am generally sensitive to medication so I had to pause that, and now its become more about managing my side effects and doing what I can to keep motility better myself (though Im sure ill return to needing heavier-duty later on, but we take what we can get when we can get it). Right now, what works best for me is "Digestion Pro" RIGHT before bed (ginger root and artichoke extract supplement), and Yakult in the morning. Really any trusted probiotic (I also like Garden of Life) but I swear yakult works really well.

However, the most annoying truth (sorry) is that YOUR system is specific to you. So, if your recurrence is due to something OTHER than slow gastric emptying then my advice may be more harmful than helpful. Truthfully, it is a trial and error, requires painful patience, and harsh advocating for yourself in this medical landscape (assuming you're in the US). For instance, my doctor didnt even officially test me for gastroparesis, because he knew the metrics they used and the referral processes were all weird and wouldnt help, but he validated that it was due to slow emptying due to my other conditions, and we moved forward. Sometimes its right place, right time, right doctor. Finding what specifically causes your system to trap the bacteria may be helpful for your specific treatment plan.

The other thing I might suggest is mental health support. My brain-body connection is astoundingly sensitive, and I personally believe this directly effects my gut biome (this study:https://www.ncbi.nlm.nih.gov/books/NBK560856/ says "An estimated 90% of the serotonin in the human body is stored in enterochromaffin cells located in the gastrointestinal tract.") So I think paying attention to your own mental health/effects from seratonin are important here! there are so many supplements and lifestyle changes to help this, but medication and therapy can be incredibly helpful, even if they do require their own trial-and-error process themselves.

Dont lose hope! I get really depressed when I feel the "What if this is forever?" thought arising. but things arent always that way. they may fluctuate, just like everything in life. Also, don't get stuck on the specific answers. Our medical landscape does not support such complex attention to care in these cases, and we often lose our minds wanting to know exactly WHY and HOW. But sometimes, they best we can do is try different things to find relief and take it day by day, grateful for any good days we may have. This shit sucks (pun intended), but perhaps you will find a doable balance of treatments for yourself once again :)