Karen, surely you mean something other than annorexia. Please advise.
That's great to hear your experience with the ketogenic diet and helping resolve SIBO. It's basically removing the food source of overgrowth: carbs and starch. Then over time the diet actually lowers ketones such as acetone made by microbes such as clostridium bacteria. Clostridium have a bad reputation these days as high in autism and, of course, the C. diff epidemic. They actually have extremely important function producing butyrate, but overgrown is another story. I don't believe acetone at toxic levels in the brain is generally considered of gut origin. People generally believe the diet raises ketones, opposite of the truth.
I'm hardly expert in anything I've said here, but I'll tell you how I approached it with our clustering dog. The problem is the testing seems very limited. In the future, I'd like to see a Gut Flora Index so we know more about the actual imbalance. This is why gut-healing is more art than science, it's like shooting in the dark. I do believe there are some pretty good tests available now, but I'm not sure how good, the ones I've seen may be quite limited. There's a lab in Georgia USA called Metametrix that may have some good tests, I'm not sure. I know they found high protozoans in autism.
I'll spare you the earlier protocols of the nearly four year gut-healing odyssey even though there are many great products. Basically, I put her on a month of Rifaximin to clean out her gut, stopping when she began bedwetting which went away when I began lots of probiotics. Previous to Rifaximin she could never have taken those probiotics without seizure. Then I started her on bee propolis and things were looking up. I believe propolis may be an excellent natural antibiotic. It's also antiviral, anti-inflammatory and antihistamine. The more I learn about it, the more impressed. It should be used very carefully as it's powerful. I've always wondered if it wasn't the thing that would have resolved her problem because it's able to kill bacterial spores where pharmaceutical antibiotics fail.
Some general ideas, I'm a believer in gelatin, powdered and bone broth. Clays are also good such as French Green and bentonite. Colloidal silver appeared to be the reason she went four months seizure-free, but then things grow back, I guess. Hyaluronic acid has good gut application. Zinc carnosine seems like a good thing. Selenium may be very important; I like the organic selenocysteine stuff and also the Lewis Labs Brewer's Yeast has a lot of selenium (no surprise!!) and is prebiotic (beware prebiotics as counterproductive, but who knows). Ohhh yes, also homemade kefir of three types (dairy, coconut milk, water) are very easy to make and are said to colonize better than capsuled probiotics. Heck, you may as well throw in some grape seed extract, pomegranate extract and boron, feel free to laugh now. Personally, I've been enjoying making beet kvass, basically a water kefir and quite powerful. There's an interesting yeast-based probiotic called Florastor commonly used a few hours after an antibiotic as would bacterial probiotics.
In hindsight, I would have preferred not using an antibiotic other than propolis as I'm concerend about collateral damage to beneficial flora on a deeper level, but maybe that was necessary. These anaerobic or gram-negative bacteria may be hard to reach, especially with biofilm. People use enzymes of several types and there are a class of colitis drugs made with a derivative of salicyclic acid which may be a good thing to dissolve biofilm. A very gentle, yet powerful enzyme seems to be nattokinase.
One more thing I've discovered recently I'm excited about is intermittent fasting (IF). Basically, you give yourself an 8 hour daily eating window such as 12-8pm. There are other ways to do it such as just fasting two days/week, but I think the daily eating window is more powerful in allowing the gut to reset itself, raising stomach acid which drives the system. High stomach acid is crucial for nutrient absorption and defense. SIBO apparently lowers stomach acid, so another natural antibiotic to consider is oregano oil which is extremely powerful, said to help in case of mycoplasma. By the way, that's maybe the third time in my life I've typed the word mycoplasma, oops there's another one. Lots of people take betaine HCL in a capsule, it's stomach acid. Food combing is separating foods to help with digestion such as not mixing protein with carbs. And why not eat salads last like the French and Italians? Chlorophyll shuts down poisons from indigestion such as guanadine and maybe ammonia, I forget at the moment. By the way, carrots and peanuts contain the powerful antifungal, phytoalexin. I believe it's the reason 25% of Europe is supposedly allergic to carrots. It's similar to the dreaded peanut allergy, but not nearly as bad. I believe the mechanism is angry yeast dysregulating immune response as their DNA is strikingly similar to human . . . as if they hold the key to our locks.