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Chris my symptoms are very similar to yours, with the exception they started about 12 years later in life for me. My GI told me (actually GI number 5 the first 4 were useless) that all of us who switch back and forth between C and D are C predominant despite the fact that the D usually interferes with our lives worse than the C. I was on Amtrip before I went to see here and she immediately took me off it because it is known to make C worse. She switched me to an SSRI (Lexapro) instead. You may want to think about switching over as the lexapro did not make me sleep for 15 hours a day, and I could actually take it in the morning without getting knocked out.

That said the Lexapro didn't help me one bit but it made me feel better to at least be seen by a doc that wasn't completely clueless and actually took the time to listen to me.

Also I find that rifaximin having that strong of an affect on you to be quite odd. The antibiotic attacks the gut bacteria to try to bring it into balance. I'm guessing it knocked out your good bacteria which is what left you so ill for a month. All of your issues could be explained by bacterial imbalance. There are companies online where you can send them a sample and they will test the bacteria for you. Also there is a clinical trial right now in NY/NE that performs FMT for ibs. If you dont want to do the clinical trial and you can brave out a really gross procedure you may want to think about an at home FMT.

Good luck.
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