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The French Neurogastroenterology Group (GFNG) initiated the drafting of recommendations for the diagnosis and management of small intestinal bacterial overgrowth (SIBO) and intestinal methanogen overgrowth (IMO) in adults. A working group developed a total of 25 proposals based on the most recent data from the international scientific literature, addressing the following topics: definition, symptoms, risk factors, diagnostic modalities, and therapeutic approaches. Each statement was assessed using the GRADE methodology to determine its level of evidence (“high,” “moderate,” “low,” or “expert opinion”) and, where applicable, a level of recommendation (“strong,” “moderate,” “weak,” or “very weak”). The proposals were submitted to 22 experts for a two-round vote, in accordance with the Delphi method, resulting in consensus—with over 80% agreement— for 19 proposals on SIBO and 3 on IMO. One proposal on SIBO and 2 on IMO failed to reach consensus, reflecting the complexity of these conditions.