Yes your doctor needs to say you have IBSD to get Rifaximin, most will do that, but then its a big copay for you as most insurance will only cover part of it and the patent is until 2029! Unfortunately there is a high recurrence rate, because what is causing the SIBO is not fully understood, So far what IS understood is that people with IBS have SIBO, but there is high probability something else like Biofilm is keeping the antibiotics from being fully effective at eradicating SIBO as the bacteria are protected in the Biofilm. You could read about that, I just started a "Biofilm buster" herbal treatment to try to get rid of the biofilm as well. Also check out Dr Pimentel recommended anti anti inflammation diet, its not as restrictive as LOW FODMAP, but if you can handle that you're very self disciplined, I had a hard time with it and you are not supposed to stay on LOW FODMAP for too long as its not enough nutrition, so Dr Pimentel developed the other one people can stick to better. There can be other causes of SIBO like hiatal hernia or motility dis order etc, also, but once they take over, the latest thinking is the biofilm may make then able to come back because the biofilm protects them from all being killed off. Some lucky people do not have recurrence though. Good luck to you!