https://github.com/twbs/bootstrap/issues/19555#issuecomment-197549158
I would highly recommend this "tool-assisted" approach. One such tool they mention that I like is this one:
https://github.com/MohammadYounes/rtlcss
And here is a post-css plugin that uses it to create Moodle-style combined RTL & LTR CSS. (Note, I don't think that's a good idea or best practice, better to send RTL or LTR depending on the current page direction, but since we already do it, I thought it would be interesting to note that it can be partly-generated).
I've implemented an earlier version of this in a Bootstrap 3 theme and the big blocker was core Moodle's requiremnet to send both LTR and RTL to every page, but this newer tool could work around that if it really needed to. But ideally only the CSS required for the current page would be sent, and this could have a dramatic impact on Moodle's total CSS download size, so that's an important co-benefit.