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If you're dealing with any combination of the following, SIBO should be on the list of things to rule out: Bloating that worsens throughout the day or after meals Chronic gas, cramping, or abdominal distension Alternating diarrhea and constipation Food intolerances that seem to multiply over time Nutrient deficiencies despite a decent diet Fatigue, brain fog, or skin issues that track with digestive flare-ups Previous food poisoning followed by ongoing digestive problems History of PPI use If you've already been diagnosed with IBS and treatments aren't working, testing for SIBO is a logical next step that many gastroenterologists skip