One of the issues with prolonged PPI use is that it restricts acid production. And acid production is critical for maintaining your flora health. One of the ways to get better with SIBO while on PPIs is to make homemade bone broth and drink about
1-2 mugs of it daily for a couple of weeks then bump it up to 3-4 mugs a day (or more).
Stay away from ALL sugars and slowly introduce probiotics to your diet. I think it's critical to work with someone who specializes in this (I found an awesome nutritionist who guided me through this process).
But the key here is to kill off the bad flora in your gut with the bone broth and staying away from all sugars and taking probiotics everyday, slowly increasing your intake. So yes, you can overcome SIBO while on PPIs.
Suffering from gastritis and erosive esophagitis since 2011. Conquered it once and am going to conquer it again because this time I've taken total ownership of my health. Gluten, dairy, MSG, sulfite free now and don't plan on eating out again until I am healed.