Thanks so much for that info, I will definitely talk to my Gi doctor at next week appt about bile reflux concept. I took PPI's before but didn't help much, although I was not totally taking them reliably. I'm also going to see another GI doctor in a month, think its a good idea to have some fresh eyes on my situation. I've had it for almost 3 years now, with a few breaks that didn't last long, need some relief to put it mildly! How long did you wait between rounds of rifaximin? I've also seen research on line that Elemental Diet can get rid of SIBO, was thinking of trying that in hope it would also give me relief from the reflux for a while. When I see the new doctor I'm going to ask for referral to dietician, I was thinking that might be a good idea. I have been trying the Dr Pimietel anti inflammation diet, its less restrictive than Low Fodmap, so people stick to it better. It did lessen the diarrhea but still having the constant GI cramping and constant reflux day and night. My sleep terrible, just saw Rheumatologist who diagnosed me with Fibromyalgia he thinks is brought on my my interrupted sleep pattern by being awakened so much with reflux and cramping. I also have chills a lot, did you have that with the bile reflux? wondering if that is a symptom of that? Thanks so much for your input, very helpful.