There is no shortage of diets out there, and it can be challenging to keep up with them. You’ve very likely heard of the keto diet, paleo diet, and Atkins diet. But what about the SIBO diet — which is growing in popularity? What foods should you eat more of, and which foods should you avoid? Let’s dig in.
The Basics of the SIBO Diet
SIBO stands for Small Intestinal Bacterial Overgrowth, a health condition that can affect your small intestine. According to the Digestive Health Institute, SIBO occurs when the standard and friendly bacteria from your large intestine invade your small intestine in large numbers.
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The ordinarily friendly bacteria from the large intestine, since they are so prominent in number, can create the following problems:
- Produce toxins and enzymes
- Disrupt digestion
- Cause physical discomfort
- Cause damage to the small intestine
The causes for SIBO include complications from abdominal surgery, structural problems of the small intestine itself. Certain medical conditions like Crohn’s disease, celiac disease, diabetes, scleroderma, or inflammation of the small intestine can also cause SIBO. These conditions may cause SIBO because they all can lead to slower movement of food and waste through the small intestine. The slowed passage of movement can create an ideal environment for bacteria to thrive and multiply.
A Helpful Guide for SIBO Foods to Avoid
|Food||Reason For Avoidance||Possible Side Effects|
|Wheat, Rye, Barley||High in difficult-to-digest carbohydrates (FODMAPs) which can feed bacteria in the gut||Bloating, gas, abdominal pain|
|Certain Fruits (Apples, Pears, Mangoes)||High in Fructose, a type of sugar that can be hard to absorb and can feed gut bacteria||Diarrhea, bloating, abdominal cramps|
|Certain Vegetables (Onions, Garlic, Asparagus)||Contain Fructans and GOS, types of carbohydrates that can feed gut bacteria||Bloating, gas, abdominal pain|
|Dairy Products (Milk, Cheese, Yogurt)||High in Lactose, a type of sugar that some people can’t fully digest||Diarrhea, bloating, abdominal cramps|
|Beans and Lentils||High in GOS and fructans, types of carbohydrates that can feed gut bacteria||Bloating, gas, abdominal pain|
|Honey and High Fructose Corn Syrup||High in Fructose, a type of sugar that can be hard to absorb and can feed gut bacteria||Diarrhea, bloating, abdominal cramps|
|Certain Nuts (Cashews, Pistachios)||Contain GOS and fructans, types of carbohydrates that can feed gut bacteria||Bloating, gas, abdominal pain|
|Artificial Sweeteners (Sorbitol, Mannitol, Xylitol)||Can be hard to absorb and can feed gut bacteria||Diarrhea, bloating, abdominal cramps|
Symptoms of SIBO
Some common signs and symptoms of SIBO include:
- Abdominal pain or cramps
- Acid reflux
If SIBO is left untreated, it can result in severe symptoms like:
- Weight loss and “Failure to thrive”
- Steatorrhea (the body cannot digest fats)
- Bleeding or bruising
- Night blindness
- Bone pain and fractures
- Leaky gut syndrome
- Autoimmune reactions
Antibiotics are typically the first line of treatment for bacterial overgrowth. But, a diet change may help if antibiotics are not an option.
What Are SIBO-Friendly Diets?
Following a particular diet to address SIBO can reduce the severity of symptoms associated with this health condition. One of the diets that can help manage SIBO symptoms is the low-FODMAP diet.
FODMAP is an acronym that stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols which are short-chain carbohydrates or sugars that can trigger specific symptoms of SIBO. The FODMAP diet is purposely low in fermentable carbohydrates (i.e., oligosaccharides, disaccharides, monosaccharides, and polyols). Not easy words to say or spell — hence, FODMAP.
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Foods that may cause further discomfort when dealing with SIBO include foods rich in carbohydrates (fermentable sugars and fiber). The discomfort caused is due to the excess bacteria in your small intestine using the fermentable carbohydrates as fuel, which will produce gas and cause discomfort. Therefore sticking to foods that have low amounts of FODMAPs is critical.
The low-FODMAP diet can help with irritable bowel syndrome (IBS), but its benefit to individuals with SIBO needs further research. The low-FODMAP diet does not require you to avoid FODMAP foods indefinitely; there is an elimination phase for 4 to 6 weeks, then foods can slowly be reintroduced with very close monitoring of symptoms returning.
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Here are five foods that you should avoid (at first) if following the SIBO-friendly diet:
1. Processed Sweets
Processed sweets like pastries, candy, soda, and other snack foods often contain high fructose corn syrup. And fructose is one of the nutrients that will help feed and fuel the excess SIBO-related bacteria in the gut instead of encouraging the bacteria population to return to average numbers. And at the end of the day, we all want a balanced bacteria population in our gut.
2. Certain Fruits and Veggies
Fruit like apples, cherries, watermelon, peaches, and dried fruit contain high amounts of fructose and polyols, resulting in unpleasant symptoms associated with SIBO when consumed. Vegetables like asparagus, cauliflower, peas, mushrooms, and onion should be avoided because they contain polyols (sugar alcohols), fructans, galactans, or multiples FODMAPs at once.
3. Lactose rich products
Lactose is the sugar found in dairy products like cow’s milk, yogurt, ice cream. They can cause discomfort when consumed because they contain disaccharides, one of the FODMAPs.
4. High Fiber Cereals
When shopping for SIBO-friendly cereal, avoid ones that have fiber content over 2 grams per serving. Common examples of such cereals are oatmeal, whole grain, granola, and bran.
High fiber foods contain fructans which produce food and fuel for the excess bacteria hanging out in your small intestine. Continuing to feed the excess bacteria can cause you some severe discomfort in the form of gas, bloating, and abdominal pain. (Not fun!)
5. Fruit Juices and Drinks
Like fruits, fruit juices contain high fructose and possibly high fructose corn syrup, which can further fuel the small intestine’s bacterial overgrowth. The easiest thing SIBO eaters can do is to avoid any product that has “high fructose corn syrup” on the label.
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Another SIBO-Friendly Option: The Elemental Diet
The Elemental Diet is also an emerging choice for a diet to combat severe symptoms of SIBO. This diet has pre-digested food. So the fats, protein, and carbohydrates present are in their simplest form and absorbed early on in the small intestines. This diet is not widely utilized yet due to the expense of the pre-digested food, the inconvenience, and the high risk of nutrient deficiencies if not under medical supervision.
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SIBO-friendly Foods to Eat More Of
When following the FODMAP diet, there are plenty of foods you can safely include:
- Fruit: Bananas, blueberries, oranges, honeydew melon, raspberries, kiwi
- Veggies: Carrot, celery, bok choy, bamboo shoots, lettuce, chives, green spring onions, tomato
- Dairy: Lactose-free cow’s milk and yogurt, hard cheeses like brie, camembert, sorbet, butter
- Cereals and grains: Gluten-free and spelt bread or cereals
If your doctor or registered dietitian has recommended you follow the low-FODMAP diet to reduce SIBO symptoms, it is essential to pay attention to which foods can help or harm you. SIBO is a bacterial overgrowth that occurs in your small intestine. SIBO can result from conditions that slow food movement through the small intestine because this allows bacteria to breed and multiply at rapid rates.
To possibly mitigate symptoms of SIBO via the diet, avoid FODMAPs for 4 to 6 weeks.
The most important FODMAP foods to avoid include processed sweets, high fiber cereal, fruit juice or drinks, lactose-rich food, and certain fruits and vegetables.
If you ever have questions about which food and drinks to avoid, and why, always feel free to ask your registered dietitian. We’re here to help!
Kaelyn Johnson is a Registered Dietitian from Southern California who has worked as a clinical dietitian and is now a freelance writer. She has written for WebMD, produced an e-book, and written case studies for healthcare practitioners.