SIBO Diet Tips

If you struggle with IBS symptoms such as gas, bloating, constipation, and/or diarrhea, then you may have a condition known as small intestinal bacterial overgrowth, or SIBO.

We discussed the link between SIBO and metabolism in Monday’s video. Click here to watch.

Today we’ll discuss an effective diet protocol to help manage and reduce the symptoms of SIBO. We’ll also discuss the best test for SIBO.

If you need help diagnosing and treating SIBO, click here

SIBO Diet Tips - C March 2014 Gut 2

SIBO Diet Tips

Today we’ll discuss an effective diet protocol to help manage and reduce the symptoms of SIBO. We’ll also discuss the best test for SIBO.

Several different diets are recommended for digestive problems. When it comes to SIBO, the low FODMAP diet has proven to be a very effective option. Many people with SIBO who start a low FODMAP diet notice symptom improvement soon after starting.

FODMAP refers to a group of sugars and starches that are highly fermentable. Generally, foods high in FODMAPs are healthy because they feed the bacteria in the colon. However, if you have SIBO, then bacteria from the colon has migrated up to the small intestine, which is causing your symptoms. In this case, high FODMAP foods will feed that bacteria and likely worsen your gas and bloating.

(Click to enlarge)
(Click to enlarge)

A low FODMAP diet excludes the following:

  • Gluten-containing grains
  • Certain sugars such as fructose and honey
  • Dairy foods that are high in lactose, such as milk, ice cream, and soft cheeses
  • Fruits such as apples, pears, and peaches
  • Vegetables such as Brussels sprouts, cauliflower, onions, and garlic
  • Nuts and seeds in moderate to large quantities
  • Beans/legumes

Animal protein and fats are naturally low in FODMAP.

If you think you may suffer from SIBO, consider trying this diet protocol and getting tested. The gold standard for diagnosing SIBO is a breath test that measures both hydrogen and methane gas levels.

If you need help diagnosing and treating SIBO, click here

What do you think? I would like to hear your thoughts or experience with this.

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

16 thoughts on “SIBO Diet Tips

  1. If you can tolerate more an more fodmaps but still have to eat AIP, is it a sign of sibo going away and an irritated gut still? Why is the gut not healing if sibo is reduced or gone. Is reduced sibo with minimal symptoms a place I should be happy with. Or keep cycling antimicrobials? I did the high dose of oil of oregano and Microb-X and it made my gut soooo irritated. I had diarrhea for 11 days while in it and sibo symptoms coming back that were gone before. I have been worse ever since. Does that make any sense? My histamine reactions have been worse also.

    1. Hi Tracey,
      Sounds like you are improving, which is good, but your questions are very hard to answer in a generic fashion – a lot depends on context. Yes, sometimes patients don’t react well to herbals and they can cause a flare. You may want to work with a provider to try another one of the SIBO treatment methods, if SIBO has been diagnosed. Sometimes you just need to find the treatment that works best for you.
      Hope this helps!

  2. Hi Dr. Ruscio,

    This is confusing because the SCD diet recommended by Dr. Siebecker includes honey, aged cheeses and, nuts and seeds. It’s restrictive and doesn’t even insure it will work.
    I’ve just retested after FIVE months on the SCD/FODMAPS diet and after a 6 week SIBO protocol in the middle of that time period, and my numbers are worse than before I began. Truly disheartening! My symptoms have lessened but that’s not good enough considering I still have SIBO. I’m reluctant to repeat the same treatment as recommended by the ND. Doing the same thing and expecting different results; isn’t it the definition of insanity? I’m thinking it may be wise to change ND or/and look for a FMD.
    Thanks for your insights on the matter.
    I always learn a great deal with your podcasts and emails.
    Rock on :))

    1. Hang in there Frankie! Sometimes it can take a little while to find the right approach. I would focus more on your symptoms than your lab values. We have talked about this in previous post – you can be symptom free but still have + labs values… don’t get overly wrapped up in a lab value. Hope this helps!

  3. If you can tolerate more an more fodmaps but still have to eat AIP, is it a sign of sibo going away and an irritated gut still? Why is the gut not healing if sibo is reduced or gone. Is reduced sibo with minimal symptoms a place I should be happy with. Or keep cycling antimicrobials? I did the high dose of oil of oregano and Microb-X and it made my gut soooo irritated. I had diarrhea for 11 days while in it and sibo symptoms coming back that were gone before. I have been worse ever since. Does that make any sense? My histamine reactions have been worse also.

    1. Hi Tracey,
      Sounds like you are improving, which is good, but your questions are very hard to answer in a generic fashion – a lot depends on context. Yes, sometimes patients don’t react well to herbals and they can cause a flare. You may want to work with a provider to try another one of the SIBO treatment methods, if SIBO has been diagnosed. Sometimes you just need to find the treatment that works best for you.
      Hope this helps!

  4. Hi Dr. Ruscio,

    This is confusing because the SCD diet recommended by Dr. Siebecker includes honey, aged cheeses and, nuts and seeds. It’s restrictive and doesn’t even insure it will work.
    I’ve just retested after FIVE months on the SCD/FODMAPS diet and after a 6 week SIBO protocol in the middle of that time period, and my numbers are worse than before I began. Truly disheartening! My symptoms have lessened but that’s not good enough considering I still have SIBO. I’m reluctant to repeat the same treatment as recommended by the ND. Doing the same thing and expecting different results; isn’t it the definition of insanity? I’m thinking it may be wise to change ND or/and look for a FMD.
    Thanks for your insights on the matter.
    I always learn a great deal with your podcasts and emails.
    Rock on :))

    1. Hang in there Frankie! Sometimes it can take a little while to find the right approach. I would focus more on your symptoms than your lab values. We have talked about this in previous post – you can be symptom free but still have + labs values… don’t get overly wrapped up in a lab value. Hope this helps!

  5. Hi Dr. Ruscio,
    I am happy to have found your site and look forward to your thoughts:
    What are your thoughts on combining the SCD with Low-FODMAP?
    What about Pimentel’s diet which is a little different and includes pasta, rice, bread, cereals and potatoes?
    Which approach do you feel is better?

    Thank you,
    Colleen Francioli, CNC

    1. Hi Colleen,
      I think the combo can be a good starting point for more severe cases. It’s not about better, in my opinion, but about using these diets to help a person gain awareness of the foods that do and do not work for them. There all viable starting points but there is still the personalization aspect that needs to be worked through. I think the biggest thing Pimentel’s diet offers is a non-gluten-extremist perspective. Too many in this space have dogmatic views on gluten, which is sad. I am hoping some of my info will help us all have a more balanced view. Search gluten in search box for more 🙂 Hope this helps1

  6. Hi Dr. Ruscio,
    I am happy to have found your site and look forward to your thoughts:
    What are your thoughts on combining the SCD with Low-FODMAP?
    What about Pimentel’s diet which is a little different and includes pasta, rice, bread, cereals and potatoes?
    Which approach do you feel is better?

    Thank you,
    Colleen Francioli, CNC

    1. Hi Colleen,
      I think the combo can be a good starting point for more severe cases. It’s not about better, in my opinion, but about using these diets to help a person gain awareness of the foods that do and do not work for them. There all viable starting points but there is still the personalization aspect that needs to be worked through. I think the biggest thing Pimentel’s diet offers is a non-gluten-extremist perspective. Too many in this space have dogmatic views on gluten, which is sad. I am hoping some of my info will help us all have a more balanced view. Search gluten in search box for more 🙂 Hope this helps1

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