The basics of SIBO diets
There are several different diets used in conjunction with the treatment of SIBO, digestive distress, digestive disease, as well as for the prevention of reoccurring infections and SIBO. The most common diets used to help reduce SIBO symptoms, and prevent the return of SIBO include
- SIBO Specific Food Guide
- SIBO Specific Low FODMAP
- Bi-Phasic Diet
- Elemental Diet
- GAPS Protocol
- SCD
- Traditional Low FODMAP
- Cedars-Sinai Diet
- Fast Tract Diet
All of the SIBO diets include foods that are easier to digest and easier to absorb by the body than most modern diets. The theory for these diets is to limit carbohydrates and certain fibers in order to maximize the body’s ability to absorb nutrients, heal, and healthfully rebalance the gut microbiome.
The diets allow the body to use ingested nutrients before unwanted bacteria, fungi, or other unwanted microorganisms steal food and destroy the lining of the intestines by causing unwanted symptoms like gas, bloating, diarrhea, constipation, pain, irritation, inflammation, and destruction.
SIBO Diets Are Intended To Be Customized
Each SIBO patient should determine their diet WITH the help of a qualified medical professional, and should be in line with foods already tolerated. These diets are designed to help accomplish health goals. While people do choose to adhere to these diets long term, the main reason for these diets is to help HEAL the body and return to a healthy and enjoyable long-term lifestyle. For most, using one of these diets should not be a life-long sentence.
Each person with digestive distress, gut dysbiosis, or SIBO will need to custom tailor their diet for their specific needs. Even though these diets are an amazing place to start, tolerated foods are dependent upon the individual case. Each case of SIBO and digestive disease is different and each individual is different.
All SIBO diets are intended to be customized to your needs. No diet is a one-size fits all. While the SIBO diets are strict, they are designed to bring freedom in your healing. Your diet should a decrease in symptoms and should allow for greater tolerances as your body heals.
Your diet needs to be tailored to your unique health and health history. Someone who has SIBO needs a different diet than someone who has SIBO and Candida or someone who has SIBO and histamine intolerance. Please work with your doctor, a dietician or nutritionist to customize your diet to your specific needs.
It is important to understand and remember that personal needs will vary along the healing journey and can change often along the way. This is normal, so be open to new ideas and trying new things. Just be sure to stick to new foods in small amounts to allow the body to adjust without difficulty.
For more details with additional resources and links go to SIBOinfo.com.
The Main Phases of SIBO Diets
SIBO diets are designed with several different phases. The first phase is the most limited and is often called an Intro Diet. The second phase adds more foods, often in line with the Low FODMAP Diet but in more restricted quantities. And the third phase is post-treatment when adding Higher FODMAP foods is allowed.
Intro Diets
Phase 1 of the Bi-Phasic Diet is considered an Intro Diet. For the SIBO Specific Food Guide, it is recommended to follow either the GAPS Intro Diet or the SCD Intro Diet. Intro Diets are designed to lower symptoms and heal the lining of the small intestine. These diets are limited in carbohydrates and are heavy on meats and fats which are the main building blocks for the small intestine. With the limit of carbohydrates, this phase also decreases the bacterial load in the small intestine and decreases symptoms.
The Second Phase of the SIBO Diets
While all of the SIBO diets are broken up into different pieces this second phase is the where SIBO patients spend the majority of their time. This is where restrictions lighten and most people perform their anti-microbial treatments. Foods increase in quantities and restrictions decrease as healing continues. This is Phase 2 of the Bi-Phasic Diet, and it also includes the Green Column and Yellow Column (as tolerances allow and increase) on the SIBO Specific Food Guide.
The Third Phase
The Third Phase of the SIBO diets is adding foods back in to transition to the desired long term diet. This is the post-treatment diet when SIBO is under control, and the digestive system has healed. Adding high FODMAP foods back into the diet should be a slow, and gentle process.
What is a meal?
For most SIBO diets, a meal is defined as food eaten at a given time followed by a 3-4 hour break or fast before consuming food again. Water and other fluids like herbals teas are allowed between meals. There is no limit on the number of meals you can eat during a day. Snacking between meals is not recommended as it can trigger the Migrating Motor Complex or MMC to stop. The MMC is the body’s main mechanism for pushing out infections, bacteria, SIBO, and leftover food from the small intestine and into the colon as waste. For more information on the Migrating Motor Complex and why it is important in healing SIBO, please see this article.
The most successful SIBO diet
The success of SIBO diet is often dependent on the patient’s adherence to the diet they choose and individual tolerance levels. Some doctors have one diet in particular that they recommend for their SIBO patients, however the most successful diet is the diet that lowers symptoms and improves digestion for the individual. Statistically speaking, the Elemental Diet is the most successful in lowering symptoms quickly with the ability to lower breath test results by up to 100PPM. After the Elemental Diet, the most successful diets are the SIBO Specific Food Guide, the Specific Carbohydrate Diet, and the GAPS diet, and the Bi-Phasic Diet.
New To SIBO Diets?
If you are new to a SIBO diet and are wanting more in depth information Shivan Sarna of SIBO SOS and Dr. Allison Siebecker (lovingly known as the Queen of SIBO), the doctor and researcher who created the SIBO Specific Food Guide and helped lay the foundation for SIBO awareness, hope and treatment, have put together a SIBO Diet Masterclass*. This class is currently on sale for $49 (original price of $99). The Masterclass is about 5 hours long, including 2 hours of instructional information from Dr. Siebecker followed by questions and answers for some of the most common and difficult SIBO diet questions. If you are new to a SIBO diet or are struggling with your SIBO diet this Masterclass is hands down the best SIBO diet resource available anywhere.
Additional Diet Resources
Tips For Gaining Weight With SIBO
Diets broken down
SIBO Specific Food Guide (75-90% effective in relieving symptoms)
The SIBO Specific Food Guide created by Dr. Allison Siebecker was designed specifically for those with Small Intestine Bacterial Overgrowth (SIBO) and is helpful for anyone with gut dysbiosis (an imbalanced microbiome).
The SIBO Specific Food Guide is a refined version of the Specific Carbohydrate Diet (SCD). The SIBO Specific Food Guide is broken up into four different color-coded columns separated according to fermentability that include
- SCD “Legal” Low FODMAPs (Green- Less fermentable)
- SCD “Legal” Medium FODMAPs (Yellow)
- SCD “Legal” High FODMAPs (Orange)
- SCD “Illegal” (Red- More fermentable)
The Food Guide also includes quantities of foods within each category. Dr. Siebecker recommends keeping your diet in the green column, adding one medium or high FODMAP food item per meal when tolerated. Pay attention to these quantities for greater relief, and you can slowly add more as your digestive system heals. This diet was designed specifically for SIBO.
SIBO Specific Low FODMAP
This is technically not a diet. However, it is a more limited version of the diet that follows the SIBO Specific Food Guide and it happens to be entirely Low FODMAP. This is where many SIBO friends find relief when symptoms are the worst or when coming directly off of a treatment before transitioning into a broader SIBO diet. On Journey Through SIBO all recipes labeled “SIBO Specific Low FODMAP” contain only food items and quantities contained in the green column of the SIBO Specific Food Guide. Ideally, you do not want to live in this limited space forever, but you can come back when symptoms are bad.
Bi-Phasic Diet (Effectiveness unknown- not yet tested)
The Bi-Phasic Diet is an off-shoot of the SIBO Specific Food Guide. The diet was created by Dr. Nirala Jacobi. The diet includes two phases. The first phase is designed to reduce symptoms and repair the intestines. While the second phase is designed to remove unwanted bacteria and restore functionality of the digestive system. The first phase includes a very restricted and a semi-restricted section for the diet while the second phase of the diet, which is less restrictive, is designed to be used in conjunction with an antibiotic protocol. This diet was designed for SIBO.
Elemental Diet (Very effective in relieving symptoms)
The Elemental Diet is often used as a treatment for SIBO without the use of antimicrobials or antibiotics. The premise of this diet is to completely starve the bacteria while still feeding you with the basic elements of food, hence the name. Amino acids, oils, and honey or other simple sugars can be absorbed high up in the small intestine where SIBO bacteria rarely reach. There is a pharmaceutical version of this diet and multiple homemade versions. The downside to this diet is it can encourage Small Intestinal Fungal Overgrowth (SIFO) or Thrush. This diet is not recommended for those who have Candida, yeast overgrowth, or SIFO. This diet is the most effective in lowering symptoms but can be the most difficult to follow.
Specific Carbohydrate Diet (60-75% effective in relieving symptoms)
The Specific Carbohydrate Diet has been around for a long time and is outlined in the book titled, “Breaking the Vicious Cycle.” This diet is designed with an intro diet. The common struggle with this diet is that it does not outline limits on quantities of foods, but requires the user to determine personal maximum quantities. This diet requires intentionality to determine tolerance levels. Until tolerance levels are discovered it can be easy to eat too much of a good thing resulting in unwanted symptoms. This diet does not restrict garlic and onion. This diet was not designed specifically for SIBO.
Gut And Psychology Syndrome Protocol
Gut And Psychology Syndrome Protocol was created after the Specific Carbohydrate Diet and seems much like a variation of the SCD. This diet tends to lean heavier on bone broth than the SCD and follows guidelines for nutrition by the Weston A. Price Foundation. It is also common to use this diet long-term for other diseases and illnesses. This diet is also designed with an intro diet, and does not include quantities of food items in which to adhere. This diet was not designed specifically for SIBO, although offers a little more freedom than some SIBO diets.
Traditional Low FODMAP (reported as hit or miss for effectiveness)
The low FODMAP diet is one of the least restrictive diets used to lower symptoms and prevent the return of SIBO. This diet does include small amounts of grains and sugars, and is designed for longer-term use. This diet is often NOT the best when symptoms are at their worst, but it is more helpful for long-term use. The instructions for this diet are often not clear and can be confusing to follow in a way that is helpful for SIBO. This diet was not designed for SIBO specifically. Because new research is consistently being published on the fermentability of foods, this diet is constantly changing.
Fast Tract Diet (Effectiveness unknown)
The Fast Tract Diet designed by Dr. Norm Robillard is designed for IBS patients specifically and lumps all SIBO cases into IBS. This diet requires the purchase of a book and accompanying app and is based off of a Flexible Point System based off of Fermentation Potential of food to help understand the likelihood of symptoms as a result of consuming the food. The common struggle with this diet is some foods require a math equation to determine the Fermentation Potential that can be difficult to follow as well as the purchase of the book. This diet includes food items that are commonly known to cause problems with SIBO such as garlic, onion, deli meats with fillers, and dairy with fillers.
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