IBSD and SIBO does anyone else have bad reflux with this also?

I have SIBO and have had a breath test and it is IMO ( intestinal methagan overgrowth). I tried to get rifaximin but I couldn’t get it because of the pharmacy said that the FDA has not approved it yet for IMO . I’m on Ciprofloxacin (replacement) and MetroNIDAZOLE. Soon I will be getting 2 probiotics for 3 months. I have heard that there is a high chance of recurrence in some cases. I am not sure if the FOTMAP diet that I on will help with not having a recurrence or not, but I’m hopeful.

I have a moderate hiatal hernia, best advice I got was to not lie down for two hours after a meal. Realized I had a habit of snacking at night! Replaced it with a well brewed cup of green tea.

Yes your doctor needs to say you have IBSD to get Rifaximin, most will do that, but then its a big copay for you as most insurance will only cover part of it and the patent is until 2029! Unfortunately there is a high recurrence rate, because what is causing the SIBO is not fully understood, So far what IS understood is that people with IBS have SIBO, but there is high probability something else like Biofilm is keeping the antibiotics from being fully effective at eradicating SIBO as the bacteria are protected in the Biofilm. You could read about that, I just started a "Biofilm buster" herbal treatment to try to get rid of the biofilm as well. Also check out Dr Pimentel recommended anti anti inflammation diet, its not as restrictive as LOW FODMAP, but if you can handle that you're very self disciplined, I had a hard time with it and you are not supposed to stay on LOW FODMAP for too long as its not enough nutrition, so Dr Pimentel developed the other one people can stick to better. There can be other causes of SIBO like hiatal hernia or motility dis order etc, also, but once they take over, the latest thinking is the biofilm may make then able to come back because the biofilm protects them from all being killed off. Some lucky people do not have recurrence though. Good luck to you!

Hello. I can relate as I have IBS-D as well as being diagnosed with SiBO through the breath test. I also have reflux so originally took a PPI that was ineffective. An endoscopy showed bile in my stomach, so I was diagnosed with bile reflux vs acid reflux. (Side note - my gallbladder was removed which also made me think it could be bile reflux). Here is a link to a Mayo article:

I had to use a couple rounds of Xifaxin to feel like the SIBO was taken care of. It does often recur unfortunately. You can research what foods to avoid.

I use the Mayo Clinic website to do a lot of my research. My GI doc also ordered a CSID breath test to see if that was causing issues. It can be seen in some IBS-D diagnosis and tested positive for that (look up on internet). This resulted in a huge diet change and an RX, with the help of a Registered Dietitian who was part of my GI clinic.
It’d be interesting to see if your reflux is acid or bile and also if you have CSID (or ASID). Best of health to you!

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.

Good idea on the second consult. I’m wondering if you take anything for the cramping? Here is a link to some RX meds but there are also OTC meds such as gas-x post meals. Also, with your meals do you use any digestive enzymes or probiotics? A dietitian can help get you going on those. With SIBO you want to get on the proper ones.

https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/use-of-antispasmodics-for-the-treatment-of-abdominal-pain/mac-20526520
I only waited a week between my 2nd 2 week treatment with Xifaxin. I can’t say I’m confident I no longer have SIBO, but I am much improved.
Your dietitian will likely suggest a food diary which in addition to the foods you eat and quantity, your reaction and timing. I’d suggest starting that now as you may start to see patterns. I like your plan of following an anti-inflammatory diet.
Question regarding chills; that is not a symptom I’ve experienced.
Good sleep is so important. While it isn’t the most comfortable, I did sleep elevated as much as possible during severe reflux times. I also didn’t eat past 7pm or have caffeine, alcohol or spicy foods. It’s amazing how certain foods can affect our health.
Best to you.

Thanks so much for your helpful info, I too have my bed elevated and also usually have to use a couple extra pillows although have been told by one doctor extra pillows not a good idea as makes your sleeping position constrict you to much. But its the only way I can sometimes not have reflux at night. To add to the fun I also have a varicose vein that benefits from being elevated, but with the top of the bed elevated the leg is lower so now my vein is hurting, will have to wear compression stocking now. Like you, I have no alcohol, no chocolate, no caffeine , nothing spicy, do not eat after 7, also going to try no sugar although the Dr Pimentel anti inflammatory diet allows it. His diet a lot less restrictive than Low Fodmap but follows some of the same principals. I'll check out the antispasmodics etc on the Mayo site you referenced, thanks. I have a feeling I have a motility issue, doing the barium test on Mon, its the only abnormal test I had a year and a half ago, now being retested for that. Hmm I have a prescription waiting for another round of Rifaximin I will prob go ahead and fill it and see what the 1st Gi doctor says on Mon about trying a 2nd round. My insurance said they'll only cover it until May 9, which is before my doctor appointment so I'll have to get it ahead of time, and I still have the $650 Co pay! insurance such a pain! Rifaximin us under patent until 2029 too bad! But I've paid so much out of pocket for this thing over 2 years, if it made me better I'd gladly pay for one more expensive item. When I go to the next GI doctor I'm definitely going to ask for a dietician, thanks for that idea, they are covered by insurance with that doctor. I feel like this site is "true confessions" we tell people we don't know so many details about ourselves, but I've found some of it like your info very helpful. Hope I eventually feel better and have some things that can help other people!