From a FitEyes member:
Supplements
I was diagnosed with SIBO. I had been taking probiotics in an attempt to resolve this issue but found that it actually made the reflux worse (no acid mind you because I'm on a PPI, just reflux) so I stopped.
Oh, and not taking an enzyme supplement with EVERY meal makes the level of upper GI gas skyrocket. Apparently when you don't have sufficient acid in the stomach, the pancreas decides that it isn't going to produce as much enzyme. It's an endless cycle.
FODMAPs
I've made significant changes in my diet. The low FODMAP diet (even if not followed 100%) which calls for zero wheat has been helpful and is recommended for people with SIBO. Since dropping wheat I have reduced my level of upper GI gas (evidenced by belching) significantly but I still have a lot of it, which I think is an indication that there's still too much bacteria.
The low FODMAP diet eliminates wheat, fructose (e.g. apples are out, bananas are in) and other foods that have a tendency to ferment or go undigested in the small intestine. I'm supposed to eliminate beans but that's very difficult to do so I cut back on them. Sucrose and glucose are OK with the low FODMAP diet while fructose is the problem sugar.
There are still some foods that are a problem for me as I continue to have bouts of reflux (no acid but still very irritating to the esophagus) so I'm continuing to eliminate and reintroduce foods and gauge the impact before/after. This is very challenging to do when the effects of a food may not be evident for hours later after which I might have eaten again, perhaps just a snack. Was it the food I ate three hours ago? Or was it the snack? Or is there mold in the air today (after it rains)? I cough whenever there is mold in the air and I cough when I have reflux (or maybe it's a reflex cough). There are so many variables. Argh!
Medications
I am using Carafate, but I really don't want to take it long term. I have really bad reflux (both acid and bile) and it's the only thing that protects against the bile reflux. I take Nexium OTC once per day first thing in the morning and Carafate 4 times per day 1 hour before each meal and once at bedtime. In addition I take 1 H2 blocker (now using Zantac 75) at bedtime to make sure I don't have any acid reflux in the middle of the night when the Nexium is wearing off. This protocol appears to be producing a progression of healing that I haven't experienced before so I'm not inclined to stop just yet.
Hiatal Hernia
If one's problem isn't SIBO, the other likely candidate is a hiatal hernia. I've only begun to explore the possible therapies to address that problem. For example there are ways to massage the stomach down to dislodge it from the diaphragm. I tried this for short period of time and saw some benefits but I don't want to mix up diet changes and hiatal hernia massage because that would add too many variables, e.g. is my stomach sore because of bloating or is it the massage I did a few hours ago. Again, too many variables.
Options
I'm trying to take the diet changes to their ultimate conclusion first (i.e. either I will find a solution or I won't) and then go to the next step. I asked my doctor if it would make sense to do an X-ray to rule out hiatal hernia and his response was "The treatment is the same either way". Of course, he means that HIS recommended treatment is more Nexium and more Carafate. Not too much help that one.
