I'm so sorry Bas, this must be really frustrating. With the severity of your symptons, NSD may indeed not be enough.

I've posted quite a bit about the weed and seed protocol that my naturopath introduced me to....6-8 weeks of probiotics followed by 1-2 weeks of herbal antibiotics (e.g. berberine, peppermint oil, oil of oregano, caprylic acid, etc.) It has really worked for me (NSD reduced my pain but this protocol helped me have my first pain free days).

Are you taking a probiotic supplement? I have known many people with severe IBS who have improved dramatically just by adding large amounts of probiotic supplements. Can't recommend this strongly enough as a first step, and one to take before trying herbal antibiotics. And I do mean large amounts - I took mine 3x day for at least 6 months (though I started slowly - 1x day at first)

My own favourite probiotic is Garden of Life Primal Defense Ultra, which contains b. subtilis, a soil-based probiotic known to help with chronic diarrhea. But there are lots of good ones out there.

The other thing that I find helpful for joint pain is gelatin powder. The NSD can stop progression but joint regeneration takes a long time. I first tried it years ago when I was so debilitated I struggled on stairs. I saw great improvement after a few months of the gelatin (1TB 2x daily mixed in water). Collagen hydrosolate does the same thing but dissolves better.

Suspected USpA. HLA B27, xray, u/sound, blood tests all -ve. Ancient history of plantar fasciitis, SI joint pain, knee arthritis. Recent history of tendinitis, neck pain, debilitating finger pain and stiffness (especially mornings). No diagnosis, no meds.

2010 - stopped eating dairy
2012 - stopped eating wheat
2014 - stopped eating all grains
Jan 2017 - discovered NSD - 98% improvement in symptoms, continually amazed by my results, wish I'd found kickAS sooner