The SIBO Diet: A Nutritionists Guide for an Effective Treatment
One of the key pieces of a successful Small Intestinal Bacterial Overgrowth (SIBO) treatment is diet and eating habits.
Now I know this is a bit of a controversial opinion as many conventional medicine is of the opinion that all you need to do is take an antibiotic and no changes to diet are necessary. But a study has shown that approximately 45 percent of patients will have recurrent SIBO following antibiotic therapy completion1 so addressing the root cause as well as implementing dietary changes can be one of the best ways to eliminate SIBO.
In my own personal experience with SIBO and in working with my clients, treatment can be more effective when diet, eating habits and food re-introduction is incorporated as it helps address some of the main root causes of why you may have SIBO in the first place (which we’ll talk about later!) as well as starving the bacteria to help lower the numbers.
The second part of the diet, the food re-introduction phase also strengthens your gut microbiome helping to reduce your risk of SIBO relapsing.
Tired of feeling so bloated? This 1 week SIBO meal plan is full of easy to digest recipes so you can fit in your favourite pair of jeans again!
Which is the “Right SIBO Diet”?
Being a foodie, I remember when I was first diagnosed with SIBO I spent so much time researching what I could eat and looking up different recipes.
But there was I found SO confusing!...every SIBO blog, recipe book or even food lists I was finding all had different foods that were allowed on the diet handout my naturopath had given me.
The reality is the right diet for you may vary based on your own body’s unique needs and personal beleifs so it is hard to have one blanket diet for everyone.
However, based on the nature of SIBO and the foods that feed the bacteria (which make your symptoms worse!) the general approach to follow along side SIBO treatment is a one with small amounts of FODMAP containing foods.
The diet guidelines I suggest using is based on the SIBO Bi-Phasic diet.
This diet was created by one of the leading holistic SIBO experts naturopath Dr. Nirala Jacobi. The diet initially eliminates fermentable fibers which are the the primary food source for bacteria in the gut. This helps to minimize symptoms as well as starve the bacteria while you’re also killing them with herbal antimicrobials or antibiotics.
It’s important to remember that this diet is meant for short term use only (which is good news for you as it means you won’t be on this diet forever!). FODMAP containing foods are very beneficial for feeding the good bacteria in your gut and are needed to strengthen your gut microbiome and improve diversity which helps reduce the symptoms you may be experiencing like stomach cramping, bloating, gas, irregular bowel movements and heartburn to name a few.
If you’ve been stuck on a SIBO diet for more than a 3 months and are struggling to overcome SIBO, I’d love to discuss a strategy with you so you can start eating all your favourite foods again. Book your free strategy call below.
How the SIBO Diet Works
As I mentioned earlier, the main purpose of the SIBO diet is to starve the SIBO bacteria while killing with herbal antimicrobials or antibiotics to reduce quantity present in the small intestine. The diet removes some high fodmap foods like garlic and onion while limiting others to certain amounts that contain FODMAPs but are tolerable at lower levels like broccoli and a lentils.
Different phases have been developed which coincide with the part of treatment that you are in.
In my practice, I use a 5 stage diet plan which is based off the SIBO Bi-phasic Diet that adds more clarity during the food re-introduction process once SIBO has been eliminated. The image below illustrates the phase of treatment and corresponding diet phase.
Stage 1- Pre-Elimination:
The purpose of stage one is to give your digestive system a bit of a break! It reduces inflammation foods and higher FODMAP and fiber rich foods that may be contributing to your symptoms. By removing these foods for just a short period of time it allows the body to come down to a baseline state which then makes it easier for you to monitor symptoms from foods as you bring them back in.
This stage is best done before starting the bacteria killing with herbal antimicrobials or antibiotics. This is because as the bacteria die you may experience die off symptoms (read more about them here) which can overwhelm your detoxification system.
Some people start to experience die off just from eliminating the foods that the bacteria like to eat. Starting with the diet will help your body ease through the initial stages of bacterial die off, reducing the overall toxin load.
Stage 2-Elimination:
The purpose of this phase is to understand which foods and in what amounts feel okay for your body without leading to digestive symptoms. High FODMAP and fiber rich foods are limited to starve the bacteria while anti-microbials are working on killing them. It’s very important to ensure diversity of plant foods even if they’re limited
Stage 3- Post Elimination Food Re-Introduction (remain here if SIBO still present):
The purpose of this phase is to slowly re-introduce and monitor foods to start feeding and growing the good bacteria in your gut microbiome to help strengthen your intestinal function.
Stage 4- Food Re-Introduction of Higher FODMAP Foods:
The purpose of this phase is to continue with slow and monitored re-introduction of foods higher in FODMAPS or fiber.
Stage 5- Re-Introduction of All Other Foods:
The purpose of this phase is to continue with slow and monitored re-introduction of foods that result in common food sensitivities and remaining high FODMAP foods. It’s important to pay attention to any food sensitivity reactions that may appear when re-introducing these including: skin issues, digestive symptoms, headaches, joint pain. As eating foods you’re sensitive to can contribute to development of SIBO, it’s important to minimize foods that cause you symptoms as much as possible.
Why Diet is Necessary in SIBO Treatment
Diet plays an important role in SIBO treatment for 2 main reasons:
Helps to Reduce Bacteria Numbers
The FODMAP carbohydrates that feed SIBO bacteria (and produce the uncomfortable digestive symptoms for you) are reduced in order to support bacteria elimination in early stages of the SIBO protocol. You want to eliminate a pathogen, stop feeding it the food it needs to survive.
Plays a Key Role In Rebuilding and Strengthening Your Gut Microbiome
Your digestive system is complex and your gut microbiomes is shaped by what you eat.
The fibers from plant foods that you put in your mouth (and yes this is why plants are part of a healthy, gut supportive diet!) feed different types of bacteria in your colon. Within days, the composition and diversity of bacteria and the genes they express can changes based on the foods you eat.
So in the case of SIBO, if you’ve eliminated higher FODMAP foods for weeks or months, it’s unrealistic to expect that you’d be able to digest foods higher in FODMAP’s as soon as the SIBO bacteria has been eliminated.
Good luck trying to eat something with garlic the day after you’ve eliminated SIBO!! Of course you’ll be left with pain, bloating or impacted bowel movements.
This is what I experienced in my own SIBO journey and often see happening when people eliminate SIBO through the conventional route when diet isn’t addressed.
Microbiome dysfunction, low stomach acid, poor bile flow and deficiency in enzymes can all contribute to the development of SIBO.
Re-growing the gut microbiome is an important step for you to be able to tolerate and digest FODMAP containing foods and strengthening and balancing the gut microbiome through diet plays a key role in bringing balance back to the gut microbiome to help reduce risk of relapse in the future.
I like to use the analogy of a garden. Having SIBO is like a weedy garden. In order to have a thriving garden, you need to spend time weeding it (eliminating the bacteria), replant the seeds and water them and provide sunshine in order for the plants to thrive (food re-introduction and strengthening the microbiome). Similar to a garden, this process takes time and won’t just happen over night, it takes patience during this process.
Addressing the HOW and WHAT You Eat
Impaired digestion is one of the most prevalent factors contributing to developing SIBO.
A main benefit of working with a nutritionist through a SIBO protocol is focusing on improving your overall eating habits which will help lower your risk of SIBO relapse.
When we trace back to the root cause of impaired digestion, it comes back to how and what you eat. Ask yourself:
Are you eating while stressed?
Are you eating foods you’re sensitive too?
Are you eating 30+ plant based foods each week?
Are you eating on the go or rushed?
Are you eating distracted?
Are you chewing your food thoroughly?
Are you eating before bed?
Are you eating without gratitude?
If your answer is yes to a lot of these then you need to work on transforming your eating routine in a way that supports your overall digestion instead of creating the optimal environment for SIBO to return. In The SIBO Turnaround Method we work on each of these to bring balance to your digestive system.
I know first hand how tough changing the way you eat can be. A food list sometimes create more anxiety like “how on earth am I going to survive just eating these foods”?!
The SIBO Turnaround Method includes 1-2 meal plans for every phase of the SIBO diet so your not stuck eating the same foods and actually enjoy your meals while on the diet! To sample some of the delicious, easy to digest SIBO friendly recipes download our free 1 week SIBO meal plan below!
By Krista Znebel, R.H.N.©
September 24, 2024