Medical Mystery - Need Help!

I've got a medical mystery that has so far stymied four doctors, three specialists, and possibly a partridge and a pear tree to boot. I'm at a loss for what to do next and using the internet as a Hail Mary play to attempt to put a name to my condition.

I'm a male in my mid/late 30s, and this condition has been going on for nearly 15 years, but getting more and more frequent as I age. Other than this, I have no major health issues, do not take any medications, am very physically active, and have always maintained a healthy weight.

The episodes I'm about to describe happen seemingly at random. They average 4-5 times per year, but are often in relatively close succession. I'll go maybe 4-5 months without an attack, and then often have 2 attacks within a week or two. There are no absolutes, though. I've gone as long as a year without an attack, and I've sometimes had 10+ in a year.

Typically, the first sign is that during the daytime, usually the evening, and I'll begin having sulphur burps. My mom called it sour stomach growing up. These burps are terrible. Next, I'll begin feeling bloated. Sometimes a lot, sometimes not. Occasionally, I'll be fortunate enough to skip the sulphur burp stage and have bloating as my only hint about what's to come.

After going to bed and sleeping for a few hours, I'll wake up to the urgent need to use the toilet. I've been told that this is unlikely to be IBS because it always wakes me up from sleep rather than happens during the day.

During the night, I will have severe diarrhea. Typically, 10-20 times over the course of the next 4-8 hours. By the end, the output will be almost entirely clear. It is common for one of these attacks to result in 8-14lbs of weight loss in a single night.

I've been to doctors and specialists both. The specialists had no idea and told me to come back in 6 months if symptoms persisted. They did run a couple of tests including a scope, but found nothing. Blood work is all normal except extremely minor liver elevations. My primary doctor told me that they weren't even in the ballpark of concerning. One doctor seems to think my gallbladder may be involved, but I'm not sure why, as that was probably a decade ago. Another doctor believes it's SIBO, but I don't think it fits because this issue alway begins in my stomach. That doctor recommended some diet changes and a probiotic. I did both, felt fine for 4-5 months, and then had another attack. Same as usual. Keeping the diet changes and priobiotic has not altered the trajectory of this at all.

I'm at my wit's end. When these situations arise, I'm completely tied to the toilet and unable to function. Afterwards, I have zero energy and feel deeply fatigued.

I am open to ANY thoughts, guesses, or potential rabbit holes. If I could just put a name to it, I'd have something to start with. Without that, it feels hopeless.

Thank you so much for making it all the way to the end of this gross novella.

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