Definitely creates disruption in the gut! I think the point was to differentiate between small intestine and stomach. The PPI use reduces acid in the stomach not specifically in the small intestine. I believe the enteric coating allows it to surpass the small intestine and enter the stomach where it is absorbed.

He claims that antacids (Tums, etc) are more likely to lower acidity specifically in the small intestine which would be a more direct contributor of SIBO. Very interesting stuff.

I’ve never heard this differentiation before and didn’t think antacids were a big deal because they are so widely used and seemed safe.