SIBO Diet

What is SIBO?

Small Intestinal Bacterial Overgrowth, AKA SIBO, occurs when there is an abnormal increase in the overall bacterial population in the small intestine. Bacterial overgrowth (SIBO) is not an infection. The bacteria are technically not "bad" - it's simply too much of the normal kind in the wrong place. Most of the bacteria live in the colon or large intestine, however, in SIBO patients, something is causing the bacteria to migrate into the small intestine.

What causes SIBO?

Current research shows that anything that slows down gut mobility can cause SIBO. Leading SIBO researchers are finding that an episode of food poisoning can cause nerve damage to the villi of the small intestine.

If you have been diagnosed with SIBO, you were likely recommended to start on an antibiotic to support the first step: eradication. Of course, it is best to treat SIBO from two angles: medication and diet.

What Diet Should I Follow?

While there are a lot of diets online (overwhelming and contradicting, I know), the Low Fermentation Diet is the easiest and most effective diet to date. The Low Fermentation Diet was created by Cedars Sanai researchers and has been an effective diet to treat SIBO. Keep in mind that most SIBO diets are very restrictive and should not be a long-term dietary solution. Restrictive SIBO diets can negatively alter the diversity of your gut microbiome, so it is best to follow this diet for 4-6 weeks.

If you are currently on the Low Fermentation Diet or any elimination diet, such as a Low FODMAP diet, it would be best to talk with your dietitian regarding the reintroduction and personalization phases of these diets.

Low Fermentation Diet Guidelines:

Avoid:

• Avoid dairy (which contains lactose) - cow's milk, cheese, and yogurt.
• Avoid artificial sweeteners, especially sugar alcohols, such as sorbitol, erythritol etc. Others to avoid: sucralose, lactulose and aspartame.
• Avoid sugar-sweetened beverages (soda, juice, energy drinks, lattes), especially those sweetened with high-fructose corn syrup. Also minimize foods with added sugars.
• Avoid beans, lentils, and hummus (made with chickpeas)
• Avoid cruciferous vegetables such as broccoli, cauliflower, cabbage, and brussels sprouts.
• Limit apples, pears, and bananas
• Discontinue all PROBIOTIC SUPPLEMENTS temporarily, unless otherwise directed by a physician
• Alcohol and caffeine

Include:

• Simple, easy to digest carbohydrates such as white rice, white pasta, potatoes, sweet potatoes, sourdough bread, French bread, and potato bread. Crème of wheat or Ripe Krispies cereal are good breakfast options.
• Proteins such as eggs, fish, chicken, beef, and pork
• Healthful fats such as olive oil, avocado oil, nuts, and seeds
• Vegetables that grow under the ground such as onions, garlic, potatoes, yams, beets, carrots, and turnips.
• Vegetables that grows off a plant such as peppers, tomatoes, cucumber, zucchini, squash, eggplants.
• Mushrooms are okay. Ginger is encouraged.
• All fruits besides apples, pears, and bananas are okay.

Approved Beverages:

• WATER (64+ oz. daily)
• Nut milks
• Lactose-free milk
• Herbal tea (ginger tea, chamomile tea etc.)

If you have further questions regarding diet and lifestyle for SIBO remission, please contact our office to schedule an appointment with our dietitian. 

Author

Tatiana Keay, MS, RD  Tatiana Keay is DDCOC's in-house registered dietitian. She helps lots of our patients who are serious about improving their gastrointestinal symptoms with dietary interventions.