How the SIBO diet can help reduce bloating, gas, and diarrhea

  • Small intestinal bacterial overgrowth (SIBO) is a condition that causes gas, bloating, and diarrhea.
  • The SIBO diet can help relieve symptoms by eliminating foods that digest more slowly in the gut.
  • SIBO diets cut out whole grains, legumes, soft cheeses, and fiber-rich fruits or vegetables.

Bacterial overgrowth (SIBO) occurs when too many bacteria, usually coliform bacteria, grow in the small intestine. E. coli ferment carbohydrates, which often cause symptoms such as excessive gas, bloating, abdominal pain and diarrhea.

The idea of the SIBO diet is to maintain intestinal health by eating foods that start to ferment in the gut and to feed on coliform bacteria.

Although SIBO is initially treated with antibiotics, “we think the diet prevents the bacteria from coming back,” said Mark Pimentel, director of the Medical Science and Technology Program and associate professor of gastroenterology at the Cedars-Sinai Health Organization.

Relatively few studies have been performed on the SIBO diet, but it has many overlaps with the low FODMAP diet, which has more scientific support for the treatment of gastrointestinal problems.

Here you will find out what you need to know about the risk of developing SIBO and how the SIBO diet can help.

Foods to avoid on the SIBO diet

Although a low FODMAP diet was originally designed to treat IBS, it is often intended for the treatment of SIBO. Similar to the low FODMAP diet, the SIBO diet aims to reduce the amount of food that can be fermented in your gut, which means that foods that normally digest more slowly, such as fiber and certain sugars, such as lactose, should be excluded.

The main difference between the SIBO diet and the low FODMAP diet is the level of restriction, says Pimentel. For example, a low FODMAP diet excludes most fruits and some vegetables such as onions and garlic, while a SIBO diet is milder.

On the SIBO diet you should not eat:

  • Any kind of sugar alcohol — these are often found in “sugar-free” products and often end with “ol” like sorbitol
  • Soft cheeses and milk
  • Probiotic supplements and foods containing probiotics like yogurt
  • Whole grain bread or oatmeal
  • Beans or legumes, including whole or ground up, like in hummus
  • Cruciferous vegetables like cabbage and leafy greens
  • Apples, pears, and bananas should be eaten in limited amounts

Foods to eat on the SIBO diet

Foods that break down quickly into simple sugars are good for SIBO because they give you nutrition without feeding bacteria to the lower part of the gut. SIBO diet-friendly foods include:

  • Any type of meat
  • Eggs
  • Hard cheeses and lactose-free milk
  • White bread, pasta, cream of wheat
  • Root vegetables like carrots and beets
  • Fruit vegetables like peppers, tomatoes, cucumber, and squash
  • Mushrooms

A daily example meal plan on SIBO diet

  • Breakfast: Scrambled eggs, puffed rice cereal with Lactaid milk, and orange juice
  • Lunch: Turkey sandwich on white bread, carrots, and grapes.
  • Dinner: Pasta with mushrooms, baked chicken, and a tomato and cucumber salad.
  • Snacks: Baby carrots and pretzels

How effective is the SIBO diet?

Although there is less scientific evidence on the efficacy of the SIBO diet compared to the low FODMAP diet, Pimentel recommends that patients taking SIBO take the SIBO diet after taking antibiotics.

“The FODMAP diet is being studied much more, but it has certain risks due to its restrictive nature,” says Pimentel, adding that following a low FODMAP diet for more than 3 months can lead to a risk of malnutrition.

Pimentel recommends that people should not try to follow their own diet, but should always work with their doctor. Although people with conditions such as IBS or SIBO often feel better on a strictly restrictive diet, they can damage their overall health to prevent symptoms. “Under the guidance of a nutritionist, the right way to do this is to avoid falling into the trap of dieting,” says Pimentel.

If one round of antibiotics and a SIBO diet do not help relieve the symptoms of SIBO, you may need to take several courses of antibiotics, says Pimentel. If you have a condition, such as diabetes or intestinal obstruction, that causes SIBO, you may have a recurrent SIBO and need to treat a bigger problem or take regular courses of antibiotics.

Risk factors for developing SIBO

Many people assume that SIBO is caused by “bad bacteria” in the gut, but the problem is not in the type of bacteria, but rather in the amount.

It is normal to have a lot of bacteria in the colon, where digestion moves more slowly, but an overgrowth of bacteria in the small intestine causes problems like gas and bloating or more concerning symptoms, like diarrhea and constipation.

Here’s what can increase your risk of developing SIBO:

Age. : There are not enough studies to determine how many young people have SIBO. However, SIBO is quite common in older adults, with about 15% of older people suffering from the disease. Older adults are more susceptible to SIBO because they are more likely to have slow digestion and undergo gastrointestinal surgery, which can upset the bacterial balance in the gut.

IBS and other diseases. : The symptoms of irritable bowel syndrome (IBS) and SIBO also overlap, and some estimates suggest that one-third of IBS patients have SIBO. If you have an indigestion such as Parkinson’s disease, hypothyroidism or diabetes, you may be at higher risk of developing SIBO.

Intestinal obstruction. :Intestinal obstruction or intestinal deformity due to surgery may also increase the risk of developing SIBO.

Proton pump inhibitors: If you have a condition such as acid reflux in which you are taking proton pump inhibitors such as omeprazole, it will reduce your stomach acid levels. Gastric acid is important because it prevents the bacteria from growing too much in the upper part of the small intestine, so without it you are more likely to get SIBO.

Insider’s takeaway

The SIBO diet can help relieve the gas, bloating and diarrhea caused by the intestinal overgrowth of small bacteria. This requires the cutting of whole grains, legumes, soft cheeses and high-fiber fruits and vegetables.

Although low-fermentation diets for the treatment of intestinal disorders such as IBS have promising results, there is no evidence that this type of diet has the same effect as SIBO. No matter what diet you follow, make sure you are always under medical supervision.

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