SIBO Diet: Does it Matter?
When a patient has a small intestinal bacterial overgrowth or SIBO infection, they have an overabundance of bacteria growing in their small intestine. If left untreated, SIBO infections can cause pain, severe diarrhea, and in extreme cases, malnutrition due to the body’s inability to maintain nutrients.
SIBO infections often require the assist of antibiotics, whether prescription or natural, to aid in killing off the bad bacteria. Alongside the antibiotic treatment, many doctors believe that improving your diet may also help rectify the patient’s immediate problem and hold off future recurrences of SIBO infections.
Inside of a SIBO infection, one would find their gut bacteria feeding on carbohydrates. SIBO diets tend to limit carbs which help to prevent the bad bacteria from growing out of control. Fermented food should be avoided with any SIBO infection. In some cases, people may be asked to avoid certain FODMAP foods, which are often present in dairy, grains, and certain fruits and vegetables. Reducing the intake of those types of foods can drastically reduce the severity of symptoms being experienced.
FODMAP food includes the following:
- oligosaccharides: wheat, legumes, onions, asparagus
- disaccharides (lactose): milk, yogurt, butter, soft cheeses
- monosaccharides (fructose and glucose): fruits, honey, foods with added sugars
- polyols: fruits that contain pits like cherries, plums and peaches, apples, mushrooms, green beans
Another diet option for those people with a SIBO infection is the elemental diet. It is a liquid-based diet that is used to treat digestive illnesses. Being liquid, this diet is easily digestible which makes it easier for the body to take in the nutrients it needs before the bacteria can get to them and waste them.
The elemental diet can be very beneficial while working on treating your SIBO infection, it is very expensive, complicated and not always sustainable. Patients are not allowed solid food or any drinks other than water during the diet. This diet must be discussed with a doctor before beginning and have a set treatment plan in place once you start. If you are struggling with your diet while dealing with SIBO, reach out to your medical care team to find a better path for your treatment.
Foods to Avoid with a SIBO Infection
The low-FODMAP diet has been proven in numerous studies to help treat irritable bowel syndrome and the related symptoms attached. Many times, those patients who have IBS or IBD also suffer from recurring bouts of SIBO. Eliminating or reducing the intake of FODMAP foods has shown to improve their health and lessen chance of repeat infections.
When you eliminate FODMAP foods, the main categories to focus on for elimination are:
- fructose, simple sugars commonly found in fruits and some vegetables, honey, and agave nectar
- lactose, a sugar molecule in dairy products
- fructans, a sugar compound found in gluten products, fruits, some vegetables, and prebiotics
- galactans, a compound found in some legumes
- polyols, a sugar alcohol often used as a sweetener
This is a list of foods that you may want to consider eliminating from your diet. These have high numbers of FODMAP and include:
- high-fructose corn syrup
- agave nectar
- soda and soft drinks
- butternut squash
- dried fruits
- flavored yogurt
- ice cream
- sweetened cereals
Foods to Eat with a SIBO Infection
After that list, you may be wondering what is left to eat. The list can feel restrictive, but there is still a number of choices for you to enjoy. A SIBO diet should focus on foods high in fiber and low in sugar. Those foods that contain FODMAPs should be limited. Foods to enjoy include:
- crackers, gluten-free
- unsweetened cereal (made from low FODMAP grains)
- spaghetti squash and summer squashes
- broccoli (heads only, less than 3/4 cup)
- leafy greens
- rice or gluten-free noodles
- some fruits like blueberries, grapes, oranges, and strawberries
There are numerous apps and programs online available to help patients on their SIBO diet journey; some even free of charge. This diet is typically done from two to six weeks, although your doctor may continue the diet after your SIBO infection is controlled to help reduce the risk of relapse.
Before beginning any new diet, be sure to speak with your doctor or medical care team. With SIBO infections, as the bacteria dies off, there can be quite an array of symptoms and issues that arise. You can read about that in SIBO: The Die-Off article.