Small intestinal bacterial overgrowth (SIBO) is the by-product of a chronically imbalanced digestive system, often stemming from a combination of causes including, but not limited to, inadequate stomach acid or digestive function, structural imbalances, an overactive stress response, intake of food intolerances, and gut microbiome imbalances, oftentimes secondary to medication use (ex: antibiotics, birth control pills, NSAIDs). Before ordering any tests I always want to understand how the test results will inform or change a treatment plan. After years of treating patients with SIBO-like digestive complaints, I have found that a thorough discussion regarding presenting symptoms is sufficient. While I am happy to order the test if a patient wishes for these objective findings, in my experience it has not been necessary. When digestive function is restored, structural imbalances are corrected, nervous system activation is calmed, and food intolerances are removed, SIBO resolves.