For hard cases, it may be beneficial to do a biofilm cleanse.  Below is the basics of the cleanse that we got from one of our doctors, but you should work with your doctor to tailor a plan for your child.

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Re-establish gut balance. For us, this one took a while. One thing that really helped us to clear out the pathogenic gut bacteria and then decolonize with beneficial bacteria was a biofilm cleanse. It took two weeks. This was recommended by our doctor. I don't know if there would be a medical reason not to do it for your child. It was an important step that began our gut healing. I don't see it discussed often but I do see lots of folks constantly struggling without doing this.

Interfase from Klaire labs. Three times a day. For the first three days. After that, Interfase plus is used for 10 more days.

Avoid all minerals during this period. The biofilms are held together and strengthened by minerals so you want to stay away from most supplements during the cleanse. Vitamin C and ACE and phosphatydl serine would still be ok.

Eat very light foods and mostly liquids for the first three days. This coincides well with the beginning intro stage of SCD.  This light diet is for the duration of the cleanse (13 days total).

An 8 ounce bottle of Magnesium citrate liquid to him during the evening of day 1 to clear out the gut, stay near the bathroom for the next couple of days.

Flucanazole:  one course starting on day one (we gave twice per day until the course was complete)

Antibiotic: we used Flagyl twice per day until the course was complete.

That's it. We had to make sure my son was well hydrated. We relied on metagenics ultrainflamx to make sure that easily digested medical food was available for nourishment.