@oelkesm - I take a the probiotics 3-4 times per week and the grapefruit seed extract (GSE) daily, I also take a Now brand Super Enzyme pill with each high protein meal. The GSE and the Enzyme / stomach acid replacement pill not only keeps the SIBO down but, at least for me, keeps the IBS away. I have to avoid some foods, but I can still have a little of them on occasion (for me uncooked dairy and chocolate are the main offenders. I also avoid high fructose corn syrup, the "blue" and "yellow" artificial sweeteners ("pink" and stevia are fine) and transfats. I think the damage that was done effects the man-made food products the most.
When reading all of this remember that if your stomach and small intestine aren't working correctly your symptoms can show up at either end of the GI (diarrhea and GERD) and everything in between.
Here is the long version of what I did to fix my problems (the short version might also work but I threw everything at it):
I had all of the normal GERD symptoms, as well as very bad diarrhea, food staying in my stomach way too long, constant GERD, leaky gut syndrome, constant lower stomach pain (to the point where I couldn't bend over) and other aliments caused by poor vitamin / mineral absorption (including back / neck pain!). I was a real mess and it was having a huge impact on my personal life and work. A few years ago my doctor prescribed Prilosec, over time this only made things much worse. I was diagnosed with SIBO, gastritis, GERD and the endoscope noted damage to my esophagus, yet all I got was a PPI that ended up making my problem worse.
Unless you have a condition that is causing your LES to stay open, or its badly damaged, I would say try what worked for me. Basically, your whole GI track needs your stomach to do its job and digest the food properly, if it doesn't all subsequent GI processes are messed up. In order for the stomach to digest its food correctly you need stomach acid, strong stomach acid. For many people with GERD (if not most) their body produces to little stomach acid, not too much. The cause of most GERD is the stomach acid gets past the the LES and in to the esophagus, where it doesn't belong, but this isn't caused by too much stomach acid. This is because of poor food transport (from poor digestion). When the food sits in the stomach it ferments, producing gas, and what stomach acid you do have gets blown past your LES (weakening it) in to your esophagus. Read the book mentioned below for more information. The Candida and/or bacterial imbalance (you probably have both, as I did, but this regime fixes both in most cases) starts all of this and causes inflammation of the stomach lining (gastritis) and small intestine. The inflammation causes the stomach to produce less acid (and actual damage to the stomach lining, which, luckily can usually heal within a week or two) which only promotes more bad organisms. Adding a PPI to this scenario only makes things worse, especially over time. I recommend reading the book below, taking it to your GI, and then get his/her OK on the following:
Here is what I took (you can search for these on Amazon or Vitacost, etc):
$11 Vitacost Probiotic 10-20 - 20 Billion CFU - I took two, twice per day, between meals
$14 Jarrow Saccharomyces (yeast based probiotic) - I took 1, twice per day, between meals (with above)
$14 Nutribiotic - Gse Liquid Concentrate, 4 fl oz liquid - I followed the bottle instructions on dose and took once per day
$17 Now Foods Candida Clear Formula, Veg-capsules, 180-Count - I followed the bottle instructions
$12 Super Enzymes 180 Tablets - I take one with every meal and one with protein / fiber containing snacks. Large protein / fiber containing meals I take two. You may have to do this for life if your stomach doesn't completely heal. But believe me, its worth it!
$0 a no sugar, low carb diet for 2 weeks. Reduced sugar and refined carbs for a few months after that.
$?? a good multi-vitamin, good nutrition. A good garlic supplement can also help
I recommend you read all of the product reviews on Amazon for these products.
All of the above helps GERD. Bad bacterial in the lower intestine prevents digestion, this causes fermentation of food both there and in the stomach, as well as causing food to stay in the stomach far longer than it should. With too much food in the stomach and fermentation you get stomach acid bubbling up through the lower esophageal sphincter (LES) under pressure. We all know what happens after that. Digest the food properly with the HCL/Enzymes, kill the bad bacteria / yeast that slows food transport and causes fermentation gas (and causes inflammation), replace the bad bacteria with the good stuff (probioitcs) so that the lower intestine moves food properly (and addresses IBS) as well as fights bad bacteria / yeast. It all makes since, your GI won't disagree, he/she just won't prescribe it, ask them (I've asked 3 of them).
I highly recommend the book "Why Stomach Acid Is Good for You: Natural Relief from Heartburn, Indigestion, Reflux and GERD" by Jonathan V. Wright, $11 on Amazon. It also discusses Candida, gastritis, SIBO, but not in great detail. According to the author (who has been writing about this for years) HCl actually helps strengthen the LES. I think just getting rid of the reverse pressure (bubbling acid / gas from the stomach) probably helps the most!
After you have your GERD under control I recommend trying Magnesium Malate and quiting calcium supplements for a while. Search Google for "magnesium breathing difficulty". A lot of people with poor food absorption end up with low levels of magnesium.
If you try this please come back and let us know how it worked!