26 male. Once a month for 5 years I’ve had oily watery diarrhea with bad lower left abdominal cramping. Only blood oddity was low b12. During an episode mildly elevated amylase and lipase.

Anyway other tests normal, no CT or scope but lots of bloods ultrasound etc. negative celiac as well. Antibiotics so far have seemingly helped but reading up it seems like some sources claim SIBO is always secondary to an underlying gut issue that can be serious. Yet I see some others seemingly imply it’s often isolated.

Guess I’m just curious if most cases are isolated with no underlying etiology or not because that would warrant further investigation wouldnt it?