John21, what was your diet composed of between the improvement and the setback?
Now, I always seem to get heavy POIS symptoms after periods of bloating and bad smelly gas. I think this happens when I eat more starch (potatoe, bread etc), milk, yoghurt, sugar/syrup, ice cream and some vegetables. In the beginning of this year I experiened the best period so far in my POIS history, and i think that is because of that my FODMAP-protocol was giving effects, in combination of a liver-detox-tincture. I think a healthy bile production is of very importance for killing off the bad bacteria! and when I have POIS the poop becomes yellowis - a sign of low bile (the liver gets inflamed during POIS and cannot produce as much bile).
I think many cases of POIS can be boiled down to the following:
1. Long time stress messes with the gut on many ways: It lowers stommach acid production (HCL). When less acid realeases in to the intestine the bad bacteria can grow. Stress also slows down the bowel movement which gives time for bacteria to grow and produce gas. Raw material for hormones cannot be absorbed in the upper intestine (Vitamin B12, Vitamin D, Vitamin A, Vitamin E, Iron, Vitamin B1 (Thiamine), Vitamin B3 (Nicotinamide/Niacin).
2. Food hight in carohydryte, starch, fruit sugar and sugar favour the bad bactera and aggravates the hormonal imbalances (yes, no fruits! except possibly small berrries).
3. Bad sleeping habits, sedimentary lifestyle and low sun exposure messes with the circadian ryth (watching computerscreens too late) and aggravates hormonal imbalances.
4. On top of this comes orgasm - the releasing factor for many POIS:ers. Orgasm create an inflammation (When you have hormonal imbalances there are not enought antiinflammatory substances beeing released on orgasm) that do much harm in the body: it weakens all organs but specifically the walls of the intestines so they leak and cause auto-inflammatory symptoms (POIS), it also adds to the vicous circle by weakening the enzyme producing organs so proteins are not beeing properly digested, it weakens the liver so there are not enough bile to surpress the bad bacteria in the upper intestine. Bile is essential for the detoxification of the liver, as well as for the digestion and absorption of fats and fat-soluble vitamins (A, D, E, K). Bile is required for vitamin A. Proper bile output is important for preventing SIBO. Bile also have an anti-inflammatory effects. A healthy liver make up to one litre of bile every day!
The sollution? Exactly what John21 did! Get rid of the bad bacteria and get on a diet that support the non-gas-producing bacteria (FODMAP or carnivore diet). This might have immidiate results. But you cannot go back to the "bad diet" before your gut has healed 100%, and that can only be accomplished be reducing the stress. I don't think you have to work with a multitude of supplements, pharmaeuticals or testosterone patches for handeling POIS if you do the other things. It will just clear out by it self. However, adding the missing vitamins/minerals might be a good idea, and any supplement that are good for the intestine, such as gutamine, aloe vera, bonebroth or mangosteen (there were some member here who reported improvement after trying mangosteen juice).