Dr. Brown here. If you asked for this checklist, there’s a good chance something about your digestion feels confusing.

Maybe you feel fine when you wake up, but by the end of the day your stomach is tight, swollen, or uncomfortable. Maybe foods you thought were “healthy” suddenly make you feel worse. Maybe you’ve been told it’s IBS, stress, or just something you have to live with.

SIBO is one of those conditions that gets missed because the symptoms can look like a lot of other things. This checklist will not diagnose you, but it can help you recognize the pattern so you know what to bring up with your doctor.

Check any that sound familiar.

☐ You feel noticeably worse after meals, especially within a couple hours of eating.

☐ Your stomach gets tight, swollen, or distended as the day goes on.

☐ You wake up flatter, but by dinner your pants feel tighter.

☐ You feel full quickly, even when you did not eat much.

☐ You have a lot of gas, pressure, burping, or abdominal discomfort.

☐ You deal with constipation, diarrhea, or you swing back and forth between the two.

☐ You feel like food just sits there instead of moving through normally.

☐ Your symptoms get worse with foods that are usually considered healthy, like garlic, onions, beans, lentils, certain vegetables, or high-fiber foods.

☐ Fiber powders, probiotics, protein bars, or “gut health” foods make you feel more bloated instead of better.

☐ You have food intolerances that seemed to come out of nowhere.

☐ You have brain fog, fatigue, or that heavy sluggish feeling after eating.

☐ You feel like you’re reacting to more and more foods, but you can’t find one clear trigger.

☐ You have been told you have IBS, but no one has explained why your symptoms keep coming back.

☐ You have had food poisoning, abdominal surgery, diabetes, celiac disease, Crohn’s disease, motility issues, or another condition that can affect how your intestines move.

☐ You have taken repeated antibiotics, acid blockers, or medications that seemed to change your digestion afterward.

Here’s the pattern I pay attention to: