SIBO Diet: The important dos and don’ts of this gut-healing diet


SIBO Diet- Some Facts and Figures

  • SIBO is a condition that is difficult to diagnose because it is asymptomatic or not reported. In studies, a general prevalence rate of 2.5% to 22% has been observed.
  • The prevalence of SIBO in patients diagnosed with Irritable Bowel Syndrome (IBS) was anywhere between 30% and 85% across various studies.
  • The lack of conclusive statistical data also is probably a result of the underdiagnosis of SIBO.

Your gut feeling

When you have a gut that is feeling good, that is when you are happy. When your gut health is off, your immune system, mental health, and hormonal health may be affected too. This is because 70 percent of the immune system is housed in its lining and 95 percent of serotonin is produced in the small intestine. Eating the right kind of foods can help that gut feeling as healthy as ever. Let us see what actually goes wrong and why we need the right foods.

What is SIBO?

Small intestinal bacterial overgrowth or SIBO is a serious condition affecting the small intestine. It is a disease which is poorly understood even today. It can range from being mildly symptomatic to exhibiting symptoms of pain, diarrhea, etc. In SIBO, the bacteria that aid in digestion and reside in one part of the gut are found excessively in the small intestine. The bacterial overgrowth in the small intestine will also lead to malabsorption.

What causes SIBO?

Small intestine is a place where the nutrients are absorbed from the food, and a slurry of waste is then passed into the large intestine (colon). The water is drained out from the slurry that enters the large intestine and the dry wastes (or feces) are passed out of the body. SIBO can be caused whenever the normal functioning of the small intestine is hampered. Some of the possible causes are:

  • Inadequate stomach acid for the digestion process.
  • Intake of alcohol or other toxins that can damage the small intestine and affect its function. It can slow down the process of absorption, thereby leading to bacterial overgrowth.
  • Reflux, which causes the waste from the large intestine to be flushed back into the small intestine. This leads to a colonizing of the small intestine with bacteria from the large intestine, which affects its normal function and causes SIBO.

Symptoms of SIBO

Some of the symptoms of SIBO are:

Diagnosis of SIBO

The hydrogen breath test can help with the detection of SIBO as well as other conditions such as h.pylori infection. The two types of hydrogen breath test commonly used for the detection of SIBO are the glucose breath test (GBT) and the lactulose breath test (LBT). The tests measure the concentrations of methane and hydrogen in your breath. LBT is preferred to GBT in the detection test for SIBO.

How does it work?

Both hydrogen and methane are gases that are released in the small intestine during the process of digestion. Your body does not produce methane or hydrogen in any other way naturally. This means that an elevated level of these gases in the breath points to increased growth of bacteria (overgrowth) in the small intestine.

The Process

The patient is asked to follow a specialized diet that does not feed the bacteria and promote their growth. On the day of the test, the patient is given a formulated sugar solution that he/she must drink. This allows the doctor to get a better idea of how the patient’s body is now reacting to carbohydrates.  The breath is then analyzed for methane and hydrogen. The doctor then suggests a course of antibiotics as the first line of treatment, if the test is positive for SIBO.

The SIBO Diet: Introduction

Thankfully, SIBO can be managed by following what is called a ‘SIBO Diet’, specially tailored to manage the condition, and by taking antibiotics prescribed for the condition. This will help in full recovery from the condition and provide much-needed relief. Following a SIBO diet helps to reduce the inflammation in the stomach. It also helps to reduce the growth of bacteria in the small intestine.

As always, a balanced diet is not the solution in this case. It is definitely healthy though and many a doctor and dietician will vouch for the SIBO diet. The SIBO diet gradually eliminates certain sugars from your diet that may be causing you more harm than you know.

The idea behind an elimination diet is to identify subtle and gradual reactions that the person following the diet may have to certain food groups. Some of these food groups are gluten, dairy, egg, soy, nuts, etc.

In a few cases, eliminating sugars can help alleviate the symptoms. Avoid carbohydrates that you know the body will not be able to digest easily. When the bacteria do not do their job in the colon, these carbohydrates continue to accumulate in your gut causing bloating and diarrhea. When there are too many bacteria in the small intestine, these carbohydrates are fermented too early.

SIBO: Common Misconceptions

There is a common misconception that SIBO affects only a limited number of patients, such as those with an anatomic abnormality of the upper gastrointestinal (GI) tract or those with a motility disorder.

Actually, SIBO may be more prevalent than previously thought. The wide range of diagnostic tests now available might be a reason scientists have been able to identify more people with the condition.

Some people also feel that SIBO cannot be cured. This is not true. SIBO can in fact be cured and it does go away for prolonged periods. A healthy and balanced diet will further ensure that the relapse does not happen anytime soon.

What is FODMAP?

FODMAP is an acronym for short-chain, fermentable carbohydrates (low–fermentable oligo-, di-, and monosaccharide and polyol). High FODMAP foods are avoided in the diet if the person faces the symptoms of irritable bowel syndrome. This is because these foods cause the volume of liquid and gas in your small intestine to increase, causing inflammation and irritation. A low FODMAP diet restricts high FODMAP foods. The benefits of this diet have been tested across as many as 30 studies across thousands of people. Follow this diet if you have IBS or SIBO and have not shown:

  • Mental improvement with stress management techniques
  • A reduction in the severity of gut symptoms with time
  • A reduction in symptoms through reduction of alcohol, caffeine, and spicy food

SIBO Diet: Foods to avoid

The SIBO diet is a low FODMAPs-based diet that attempts to fight bacterial overgrowth with foods that are high in fiber content and low in sugars. It typically takes 2–6 weeks to achieve the desired results, that is, help decrease bacterial overgrowth.

Often IBS is a comorbid condition with SIBO. Eliminating foods that are high in this kind of carbohydrates can improve your digestion and reduce the symptoms of IBS. The more FODMAP-rich foods you eliminate from your diet, the healthier your gut would be. Some of them are:

  • Fructose, found in fruits, honey, agave nectar
  • Fructans found in fruits, gluten, certain vegetables, and prebiotics (a type of fiber that the human body cannot digest)
  • Lactose, a major component of almost all dairy products
  • Polyols, often used instead of regular sugar
  • Galactans, a necessary component of some legumes

Foods you may want to consider eliminating from your diet that includes higher amounts of FODMAPs include:

  • Sweetened cereals
  • Flavored yogurt
  • Corn syrup
  • Artichokes
  • Garlic
  • Rye
  • Peas
  • Agave nectar
  • Cauliflower
  • Soft drinks
  • Soda
  • Ice cream
  • Beans
  • Honey
  • Apples
  • Asparagus
  • Sausage
  • Barley
  • Dried fruits
  • Onions

Foods that you must eat

While on a SIBO diet, there are plenty of foods that you must avoid. Some foods are having a lower amount of FODMAPs in smaller servings, but in bigger servings, they can increase in FODMAPs. There are also still a lot of foods that you can include in your diet and are still quite tasty and delightful. Such foods are generally sugar-deficient and fiber-rich. Some of these foods are:

  • Pumpkin
  • Potatoes
  • Carrots
  • Gluten-free noodles and rice
  • Leafy greens
  • Eggs, meat, and fish
  • Peanuts
  • Broccoli
  • Seeds
  • Oatmeal
  • Quinoa
  • Unsweetened cereal (composed of low-FODMAP grains)
  • Spaghetti squash and summer squashes
  • Olives
  • Oranges, strawberries, blueberries and grapes
  • Crackers with no gluten

Scientific support for the SIBO diet

Antibiotics remain the first line of treatment for a person affected by SIBO. However, the SIBO diet slowly finds its place, as it has now been proven to fight bacterial overgrowth in the gut. You can use both probiotics as well as antibiotics when on a SIBO diet.

Drinking more water while following a SIBO diet cannot only help reduce the pain but also improves digestion as well.

Remember though that the low-FODMAP diet being restrictive can lead to nutritional inadequacies in the end and can even foster disordered eating. Always discuss the risks of implementing a new diet or following a new course of treatment with your dietitian or doctor first. Do the same with the SIBO diet and check back with your dietitian regularly to see if your condition has improved.

A little less sugars and lot of healing

A low FODMAPs-based diet, the SIBO diet attempts to fight bacterial overgrowth with foods that are high in fiber content and low in sugars. It typically takes 2–6 weeks to achieve the desired results, that is, help decrease bacterial overgrowth.

The SIBO diet aims to treat the symptoms and may not treat the main cause of the medical condition. For this reason, you must not ignore traditional methods of treatment. Always consult a doctor or dietitian before embarking on the SIBO diet.

Also, bring back the FODMAPs in your diet once the symptoms of SIBO reduce. This will stop the depletion of healthy bacteria in your gut.  This is vital for your body and must be done. It is also possible that a fiber-rich diet could cause problems in some people. If you develop any symptoms after following the SIBO diet, please consult a doctor or dietitian immediately.

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