SIBO, or small intestinal bacterial overgrowth, is in a category all its own as far as diet goes. Although a gluten-free and lactose-free diet may work for some with this digestive condition, it usually warrants a more specific diet. No particular eating regimen has been standardized as a SIBO diet treatment. However, follow these tips to help you create a diet regimen that will work best for you and your SIBO treatment.
One option that has been found to be effective in initial treatment of SIBO is an elemental diet. This type of diet is highly recommended to be done under medical supervision and involves a very restrictive program of shakes composed of proteins broken down into amino acids, fats in liquid form, and carbohydrates as glucose and maltodextrin (the latter of which is low FODMAP as verified by Monash University), and a variety of essential vitamins and minerals.
On the elemental diet, the shakes are usually consumed for 14 days with a breath test performed before and after this diet period. Some elemental diets can be done for up to 21 days, but no more effectiveness has been observed at 4 weeks. After the 21 days, food is slowly reintroduced, starting with liquids and staying low FODMAP. It is important to note again that this diet should be completed under medical supervision for safety and to help track progress of your SIBO.
Low FODMAP to the extreme
If the elemental diet does not sound like a good fit for you, then some SIBO improvements have been anecdotally observed with a low FODMAP diet alone, or combined with a specific carbohydrate diet (SCD). The low FODMAP-SCD diet regimen basically means that you would follow the same guidelines as you would for the low FODMAP diet. However, in addition to this you would also cut out complex carbohydrates, grains, and sugary vegetables such as sweet and white potatoes, corn, beets, oats, quinoa, and rice, to name a few.
This is because the bacteria feed on carbohydrates, so it is thought that cutting out such foods will help prevent the bacteria from optimally thriving. The SCD diet also suggests avoiding processed foods and most dairy products except aged cheeses and butter.
Real food diet
However, some doctors feel that avoiding carbohydrates completely may make the bacteria go dormant and in turn, will reduce effectiveness of antibiotic treatment. In this case, they recommend cutting out processed foods and just focusing on whole, unprocessed foods.
There is no research evidence to confirm or deny any one diet for helping those with SIBO. Therefore, it is best to just work with your healthcare professional and dietitian to help you experiment with different eating regimens and see what works best for you. Some general tips that may be useful as you start to explore your own SIBO diet include the following.
- Start by cutting out concentrated sugars and sweets, as well as certain high carbohydrate foods that you may eat a lot of, such as bread or pasta.
- It may be helpful to incorporate a low FODMAP diet.
- Regardless of what diet you place yourself on for SIBO treatment, allow your gut to heal. This means small meals about 5 or 6 times a day, chew your food well, and drink plenty of water.
- It may be helpful to start a food diary to note which foods cause symptoms, so that these foods can be avoided. This way you can create a customized eating plan that works best for you.
Throughout your SIBO journey, be sure to speak with a qualified health care professional to help you along the way to help control and track progress of your symptoms.
Written by Staci Gulbin, MS, RD a Board-certified dietitian.