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Yes always

They're like, This is your land

One study in diet-induced obese mice found that an NNMT inhibitor combined with a calorie-restricted diet was associated with shifts in gut bacterial populations, suggesting metabolic intervention can have knock-on effects on gut composition

We also look for certain symptoms to indicate impaired digestion and cross-reference these with the markers on testing identified above: Belching, gas or bloating within one hour of eating Heartburn or acid reflux Halitosis (bad breath) Aversion to high protein foods Feeling of excess fullness after meals Greasy or undigested food in stool Alone these are not likely SIBO root causes, but they all contribute and are often the result of impaired motility or medications