Complex GI, recurrent SIBO, dysbiosis and motility patterns
For digestive cases that relapse after each round of treatment, where the question has become why the environment keeps reselecting the same pattern.
This page is for people whose digestive problem has been treated more than once and has come back each time. Breath tests that turn positive again, stool reports that keep naming the same organisms, bloating and transit changes that respond for a few weeks and then return. The analytical question here is not which organism to remove next; it is what about the host environment keeps making that organism a reasonable occupant.
What records in this area tend to contain
These are descriptions of records, not diagnostic criteria. Recognising several of them does not mean you have a condition, and none of them is being asserted about you.
- Repeated positive breath tests after courses of antimicrobials, herbal or pharmaceutical
- Symptom relief that lasts weeks rather than months, with a consistent relapse interval
- Stool or microbiome reports naming the same overgrowths across years
- Post-prandial bloating, distension, reflux, or a sense of delayed emptying
- Transit that swings between constipation and looseness without a dietary explanation
- Escalating food restriction that reduces symptoms without changing the underlying course
- A functional dyspepsia or gastroparesis question raised but never mechanistically resolved
The analytical work on a case like this
- Full chronology of gut symptoms against infections, antibiotics, surgery, pregnancy and travel
- Every breath, stool, and specialty microbiome result read together rather than in isolation
- Motility and migrating motor complex considerations, including what would and would not support them
- Barrier and mucosal-energy considerations, including colonocyte oxygen handling and short-chain fatty acid supply
- Bile flow, gastric acid history, and pancreatic-enzyme questions where the record supports them
- Response pattern to each prior intervention, treated as data about the environment
What the work is trying to answer
These are the questions the reconstruction is built around. They are questions, not promises — some records answer them clearly and some do not, and the written synthesis says which.
- Is the recurrence best explained by microbial persistence, by a structural or motility factor, or by a host environment that reselects the pattern?
- Which prior treatments failed for reasons the record can identify, and which failed uninformatively?
- Do the available tests actually measure the thing being blamed, or are they being over-read?
- What testing or clinical question would most efficiently separate the leading explanations?
What would argue against the leading reading
Every synthesis states the alternatives it could not exclude. For this area, the most important ones are:
- A structural or post-surgical anatomical factor that no amount of ecological reasoning will change
- A primary motility disorder with a neurological or medication-related cause
- Visceral hypersensitivity, where the sensory signal rather than the ecology carries the symptom
- Carbohydrate-malabsorption or bile-acid-diarrhoea patterns misread as overgrowth
- Test artefact — breath testing in particular has known specificity limits
This is mechanistic analysis of a digestive record, not gastroenterological care. Nothing here diagnoses SIBO, IBS, gastroparesis or any other condition, prescribes antimicrobials, or replaces endoscopic, imaging, or motility workup ordered by your clinicians.
Mohammed Attallah is the founder of BiomeLogic and developed the Host Capacity Model independently; it is a working framework, not medical consensus or a clinically validated instrument. He is not a licensed clinician. Every output is educational analysis prepared for review, modification, or rejection by your own medical team. Full scope statement →
The service is chosen by scope, not by condition
There is no separate price for any pattern on this page. Gate 1 is free, takes a few minutes, needs no files, and ends with a written reply about whether the analysis suits your case and which engagement would fit.
Comprehensive Systems-Biology Case Analysis
$995The whole case: full-record reconstruction, a live working session, and a written synthesis with an intervention discussion framework.
Read the full scope →Complex Case Deep Dive
$1,500Unusually extensive or internally contradictory records needing expanded chronology and cross-test reconciliation. Scope, not a better method.
Read the full scope →Lab Pattern & Results Review
$500A defined set of results you already hold, where chronology and multisystem history do not materially change the reading.
Read the full scope →
Related reading on this site
Bile acid and enterohepatic patterns
For cases where fat handling, post-cholecystectomy change, bile-acid diarrhoea questions, or sequestrant responses sit at the centre of the record.
Mitochondrial and cellular-energy patterns
For exertional intolerance and post-exertional patterns, where organic-acid or metabolic findings have been read as mitochondrial failure without a coherent case for it.