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Common symptoms include: Chronic bloating and abdominal distension Excessive gas (flatulence or belching) Abdominal pain or cramping Diarrhea, constipation, or alternating bowel habits Nausea or early satiety Malabsorption of nutrients (especially B12, iron, and fat-soluble vitamins) Fatigue or brain fog Unintentional weight loss Symptoms worsened by probiotics or high-fiber foods Because of its vague presentation, SIBO is frequently misdiagnosed as irritable bowel syndrome (IBS)—yet up to 80% of people with IBS may actually have SIBO