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I am a 23 year old female, who has been suffering for 2 and a half years with terrible gas. It began with an aggressive sequence of antibiotics for tonsillitis. The gas is far worse in the evening, with or without eating dinner. In the last 6 months I have added another symptom of Levator Ani Syndrome (chronic muscle pain/spasms in rectum/pelvic floor), probably from trying to hold in gas so frequently.

I have seen several GI doctors and tried a variety of treatments, both pharmaceutical and OTC ideas as seen on this site. I have tried many different probiotics, since my first thoughts were that it was gut flora-related from antibiotics (Florastor, Align, VSL3 double strength, Digestive Advantage Gas Defense, LP299v, kombucha, kefir, yogurt). I got the hydrogen breath test for SIBO; results slightly +, took Xifaxin, tested again, negative, but didn't change symptoms. Negative breath tests for fructose malabsorption. Tried levsin, nortriptyline, Iberogast, aloe vera juice, L-glutamine, Mikes hypnotherapy tapes. Digestive enzymes may help slightly.

I have had colonoscopies, endoscopies, ultrasounds, stool tests - all normal enough (besides a peptic ulcer, which as since healed).

Diets: 3 months no gluten, allergy elimination diet, low FODMAPs (worked for ~a week)

I eat healthy, don't drink soda, avoid all potential notorious gas-causing foods.

I'm currently taking Librax 3x/day half hour before meals, and this definitely helps during the day, which is an improvement, but the chronic nightly gas is unrelenting.

I recently started CBT and started Cymbalta 30mg (for the Levator Ani Syndrome pain and also depression).

This has completely ruined my social life and mood. Does anyone have any suggestions of things I could try, either pharmaceutical or life style-wise?

Thanks.
 
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