SIBO Diet Guide: Best SIBO Foods and What to Avoid

Tagged in: Diet & Nutrition Digestive Health

by Dr. Bryan Do, D.O. Last Updated: September 25, 2019

What is a SIBO Diet?

Small intestinal bacterial overgrowth, or SIBO, is a condition characterized by excessive aerobic and anaerobic microbes colonizing the small intestine. SIBO most commonly presents with gas, bloating, abdominal discomfort, and diarrhea. The mainstay of treatment for SIBO involves the use of antibiotics to regulate bacteria colonies in the small intestine.¹

Some patients may also benefit from dietary changes. A SIBO diet plan may help to relieve symptoms and ensure greater comfort by preventing bacteria from growing and spreading in the small intestine.²

Elemental Diet for SIBO

The elemental diet is a liquid-based diet for treating severe digestive issues. The elemental diet for SIBO is often reserved for patients who cannot tolerate or do not respond to antibiotic therapy.¹ The elemental diet comprises all essential vitamins, minerals, fats, and amino acids in an easily digestible liquid form. This allows the body to absorb the nutrients before the bacteria gets to them.²

Some limited observational studies suggest that an elemental diet may be effective in causing remission of SIBO symptoms. In a study, 124 patients with forms of SIBO were treated with the elemental diet for at least two weeks.

If carbohydrate breath tests for SIBO did not normalize at the end of two weeks, the patients continued the diet for a total of three weeks. By the end of two weeks, 74 of 93 patients had a normal breath test. Five of the 19 patients who continued for another week showed normal breath test results by day 22. Patients who normalized their breath tests showed a statistically significant improvement in SIBO symptoms, suggesting that the elemental diet may be an effective treatment.¹

Although the elemental diet for SIBO is promising, it is not for everyone. The diet is expensive, and while they are on the diet, patients are not allowed to eat any solid foods or have any drinks other than water.²

If an elemental diet is effective for inpatient clinic treatment of SIBO then a similar diet may be helpful as a home remedy for SIBO.

SIBO Diet Food List

The main goal of the SIBO diet is to help reduce bacterial growth in the digestive tract. The general SIBO diet food list comprises foods high in dietary fiber with a focus on vegetables, some fruits, and lean sources of protein. This includes:

Meat, fish, eggs
Leafy greens
Carrots
Pumpkin and other squashes
Peanuts and seeds
Some fruits (strawberries, blueberries, oranges, grapes)³

Some studies also suggest that probiotic supplements and probiotic-rich foods may be incorporated into the SIBO diet to further help reduce symptoms.⁴ Probiotics may be able to alter existing gut flora to one that produces less SIBO systems.

Foods to Avoid for SIBO Diet

The SIBO diet plan generally limits carbohydrates, which are the main food source for gut bacteria. The SIBO diet mainly calls for low FODMAPs, a series of fermentable foods comprising a variety of short-chain carbohydrates present in grain, dairy, and certain fruits and vegetables. This primarily includes:

Oligosaccharides (asparagus, wheat, legumes, onions)
Disaccharides (most every lactose product, including milk, butter, soft cheeses, and flavored yogurts)
Monosaccharides (comprising fructose and glucose sources)
Polyols (mushrooms, green beans, apples, any stone fruit)⁵

Eliminating or reducing FODMAP intake may help to improve digestive health and prevent the growth of bacteria.⁵

While it has its limitations, the SIBO specific diet may be effective when used on its own or combined with antibiotics to reduce the symptoms of SIBO and improve gut health.

SIBO Diet Recipes

While the SIBO diet comes with limitations, it still offers plenty of options for tasty, balanced meals.

SIBO Smoothies

A SIBO smoothie is a tasty and convenient meal to work into your SIBO diet.

Combine:

1 cup of almond milk
A half tbsp. of coconut oil
1 tsp. raw organic honey
A half tsp. vanilla powder
Ice cubes
A half cup of any fruit of your choice

This offers a refreshing helping of healthy fats, fruit, and almond milk for a quick, easy, and nutrient-rich breakfast.

Chai-Spiced Banana Muffins

Whether you need a mid-morning snack or something to satisfy your sweet tooth, these chai-spiced banana muffins are rich, moist, and packed with flavor without any dairy or gluten.

Preheat your oven to 350 degrees Fahrenheit. In a food processor, combine:

4 eggs
2 bananas
2 tbsp. raw honey
3 tbsp. melted ghee or coconut oil

Add half a cup of coconut flour, along with one teaspoon ground cinnamon and half a teaspoon of:

Ground nutmeg
Ground ginger
Ground cloves
Ground cardamom
Baking soda
Baking powder

Pour the batter into a well-oiled muffin tin and bake for 20 to 25 minutes. Allow to cool completely before serving.

Warm Winter Kale Salad

This winter kale salad is high in antioxidants, iron, calcium, and vitamins A, C, and K. It’s also easy to prepare and surprisingly hearty for cold nights spent indoors.

Place two cups of diced pumpkin and two cups of pumpkin seeds in a bowl, seasoning with salt and pepper and a drizzle of olive oil. Transfer to a baking tray and place in an oven preheated to 350 degrees. Bake for 45 to 60 minutes or until the pumpkin is golden brown and well-cooked.

As you put the pumpkin in the oven, place one red capsicum alongside. It should take about as much time to cook (45 to 60 minutes), but you want to look for a black outside with soft flesh.

At the same time, halve about a pound of cherry tomatoes, drizzle with olive oil, and place in the oven. These will take slightly less time, about 30 to 45 minutes.

Place five large kale leaves in a bowl and massage with olive oil. Mix in some vinegar, mustard, salt, and pepper. Cool the roasted veggies, toss with the kale, and enjoy.

Aussie Burgers

Eating a SIBO specific diet does not mean you have to deprive yourself of burgers. Even without a bun, these Aussie burgers offer a lean, meaty meal when paired with healthy carrot chips. The patties comprise ground beef, egg, parsley, oregano, salt, and pepper.

For the carrot chips, simply drizzle some carrot sticks with olive oil, salt, and pepper, and place into a 400-degree oven for 30 to 45 minutes.

Stack the burger with a slice of beetroot, two slices of bacon, and an egg.

Chocolate Chip Ice Cream

Ice cream is no longer off limits with this chocolate chip ice cream recipe. Pour a mixture of one cup of coconut milk, one cup of almond milk, three tablespoons of raw cacao powder, and two tablespoons of honey into an ice cream machine and enjoy.

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About the Author:

Dr. Bryan Do, D.O.

Dr. Bryan Do, D.O. is an osteopathic physician whose research interests include gastroenterology, immunology, and dermatology. He is particularly interested in the role of probiotics in the gut-brain-skin axis and has written many articles on the topic. He graduated from University of California, Los Angeles (UCLA) before graduating from Marian University College of Osteopathic Medicine in Indianapolis, Indiana and becoming a Doctor of Osteopathic Medicine. Osteopathic physicians are taught to take a holistic approach to medicine and to consider mind, body, and spirit when treating a patient. Osteopathic physicians receive training in Osteopathic Manipulative Medicine (OMM) in addition to the standard rigorous medical school curriculum. Both physicians with a Doctor of Osteopathic Medicine (D.O.) degree as well as a Doctor of Medicine (M.D.) can practice medicine.

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