Key Points: Eating the right diet can help you manage unpleasant SIBO symptoms like bloating, abdominal pain, diarrhea, and constipation. Research has shown that three diets are helpful for SIBO: the low FODMAP diet, the Elemental diet, and the Specific Carbohydrate diet. All of these elimination-style diets are temporary and meant to help you find a longer-term, less restrictive diet that you can easily maintain.
The goal of any SIBO diet is to figure out which foods trigger your symptoms, as every gut is different, and develop a dietary approach that works for you specifically. Since SIBO is a bacterial overgrowth of the small intestine, dietary changes are meant to reduce bacterial populations in the digestive system. This is done by reducing the foods that feed gut bacteria.
Some SIBO patients believe they must follow restrictive diet guidelines forever and live in fear of eating the wrong foods. This is a big mistake. Instead, use the guidelines for what to eat and not to eat as a starting point only.
Be strict about eliminating foods for the first two to four weeks and monitor your symptoms. Once your symptoms have improved, you can try some reintroductions. Low-FODMAP diet [5] Specific Carbohydrate Diet (SCD) [6] Elemental diet [7] Each of these diets is an elimination diet designed to remove fermentable foods that may trigger symptoms.
The low-FODMAP diet is the least restrictive. The most restrictive is the Elemental diet, which replaces all normal foods with a liquid meal replacement. However, the Elemental diet is the most short-term option, with a two-to-four-day gut reset being enough for some to quell symptoms.
FODMAP is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These categories of foods are all high in fermentable carbohydrates and are the most likely to cause digestive symptoms. Lentils and beans Wheat and rye Natural and artificial sweeteners, including agave syrup, xylitol, sorbitol, and high-fructose corn syrup Dairy products like cottage cheese or ice cream Certain vegetables, including onions, garlic, artichokes, cabbage, and cauliflower Certain fruits, especially apples, pears, and stone fruits (peaches, plums, apricots) Dried fruit and fruit juices Prebiotic fiber (supplements intended to feed beneficial bacteria) Meat, poultry, fish, seafood, and eggs (without standard gravies, breading, or marinades) Rice, oats, corn meal, quinoa Many types of vegetables, including green beans, zucchini, tomatoes, lettuce, and cucumbers Most starchy vegetables, including potatoes, yams, parsnip, and taro root Many types of fruits, including blueberries, strawberries, grapes, cantaloupe, and oranges Lactose-free dairy products The purpose of any elimination diet is to reduce symptoms and identify your trigger foods.
Over time, you should be able to expand your diet while avoiding the foods you know cause problems. The best approach for long-term success is a combination of treatments that address overall gut health. These may include probiotics [13], fasting periods [14], digestive supports [15], and herbal antimicrobials [16].
Probiotics can be very effective in treating SIBO, improving both symptoms and lab values [17, 18, 19, 20]. A low-FODMAP diet combined with high-quality probiotics can reduce symptoms in a matter of weeks for many patients. Research shows a significant connection between SIBO and irritable bowel syndrome (IBS), with more than one-third of IBS patients testing positive for SIBO.
[21] Both conditions are the result of an unbalanced gut microbiome and benefit from similar treatment approaches. Rosacea [22] Restless leg syndrome [23, 24] Blood sugar, cholesterol, and potentially weight [25, 26, 27] Depression (improved by probiotics) [28, 29, 30] Rheumatoid arthritis [31] Nonresponsive celiac disease [32] Don’t be reluctant to try an elimination diet. With a bit of planning and preparation, following a low-FODMAP diet doesn’t need to be difficult.
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