SIBO Diets: Diet Plans and Food ListsSIBO diets are temporary diets that are used to control symptoms of SIBO while other treatments resolve the underlying bacterial overgrowth. Here are the SIBO diets and foods to eat.
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What is SIBO?Small intestinal bacterial overgrowth, better known as SIBO, remains one of the most poorly understood digestive diseases. It refers to excessive bacterial growth in the small intestine and causes multiple issues such as extreme bloating, gas, burping, diarrhea, and constipation.
SIBO is far more common than believed but is hugely under-diagnosed because most doctors are not familiar with this newly discovered illness. So a large majority of people with SIBO are given an incorrect IBS (Irritable Bowel Syndrome) diagnosis, are told to "eat more fiber" (which can make SIBO worse), or they are told there is nothing they can do. Luckily, if you're struggling with gut issues and suspect you may have SIBO, you don't need your doctor's permission, you can get your SIBO home testing kit here.) Many of us who struggle with SIBO are forced to learn everything on our own and treat ourselves. That's why I wanted to write this article and create a resource for those who need it. Here's a video if you want to learn more about SIBO: Signs and Symptoms of SIBOAlthough the symptoms of SIBO are similar to lactose intolerance, IBS, and other gut issues, there are some common indicators that can help you identify SIBO.
SIBO can include:
SIBO can usually be differentiated from other digestive issues like IBS by its sudden onset. For example, if one day you're fine and the next you all of a sudden look like you're pregnant with a firm, bloated belly, the it's a good idea to get tested for SIBO. Another common and unique feature of SIBO is excessive burping. A bad case of SIBO can lead to dozens of burps per minute, especially after eating foods that feed bacteria. Are You a Therapist, Coach, or Wellness Entrepreneur?
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In order to eliminate and avoid reoccurrence of SIBO it's key to figure out what's causing your SIBO and then choose a treatment plan, SIBO diet, and SIBO food plan that helps your SIBO and addresses your underlying cause of SIBO. This way you can ensure that bacteria doesn’t overgrow in your small intestine again.
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Some Common "Underlying Causes" of SIBO
Any illness or condition that affects digestion can cause SIBO, but according to a popular SIBO forum, these are some of the most common causes of SIBO:
This is not a complete list of SIBO causes, but exploring these potential causes is a great place to start when trying to treat your SIBO.
- Overuse of antibiotics
- Food poisoning
- Mold illness
- Parasites
- Stress
- Abdominal surgery
- Eating disorders
- Improper diet (vegan, vegetarian, or Standard American (SAD) diets)
- Slow speed of food moving food through the small intestine (Migrating Motor Complex problems)
- Low levels of stomach acid
- Low levels of liver bile
- Lowered immunity
This is not a complete list of SIBO causes, but exploring these potential causes is a great place to start when trying to treat your SIBO.
Addressing Underlying Causes of SIBO
While treating your SIBO, it's key to address your underlying causes. Luckily, some of the common causes of SIBO have simple fixes. Here's some things you can try:
Mold illness:
Mold can hide in walls, furniture, and food. Thats' why a huge portion of people suffering from mold illness never know it. If you're having unexplained, weird symptoms, test yourself for mold (you can do this at home).
Parasites:
Parasites are another thing that we often don't realize we have. We pick them up from international travel or contaminated food. Get a parasite test here.
Stress:
Stress slows down our digestion, hurts our immunity, and taxes our detox system. That's why stress causes SIBO.
Mold illness:
Mold can hide in walls, furniture, and food. Thats' why a huge portion of people suffering from mold illness never know it. If you're having unexplained, weird symptoms, test yourself for mold (you can do this at home).
Parasites:
Parasites are another thing that we often don't realize we have. We pick them up from international travel or contaminated food. Get a parasite test here.
Stress:
Stress slows down our digestion, hurts our immunity, and taxes our detox system. That's why stress causes SIBO.
Slow speed of food moving food through the small intestine (Migrating Motor Complex problems):
Ginger is helpful for those with sluggish migrating motor complex (MMC), which helps clean out the small intestine between meals. MotilPro is a fairly popular ginger supplement for helping the MMC.
Low levels of stomach acid:
Betaine HCL and Apple Cider Vinegar are helpful for folks with insufficient stomach acid, your guts first barrier.
Low levels of liver bile:
Digestive enzymes, Ox bile, and bitter herbs like coptis or genetian are helpful for folks with a sluggish gallbladder, liver, or pancreas, organs that help keep your body free of invaders.
Lowered immunity:
Take vitamin C and zinc and be sure to get plenty of sunshine to help boost your immunity.
Ginger is helpful for those with sluggish migrating motor complex (MMC), which helps clean out the small intestine between meals. MotilPro is a fairly popular ginger supplement for helping the MMC.
Low levels of stomach acid:
Betaine HCL and Apple Cider Vinegar are helpful for folks with insufficient stomach acid, your guts first barrier.
Low levels of liver bile:
Digestive enzymes, Ox bile, and bitter herbs like coptis or genetian are helpful for folks with a sluggish gallbladder, liver, or pancreas, organs that help keep your body free of invaders.
Lowered immunity:
Take vitamin C and zinc and be sure to get plenty of sunshine to help boost your immunity.
SIBO Diets
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Finally, we get to SIBO diets! I had to tell you all about SIBO first so that what I'm going to say next makes sense.
Many doctors and online articles on SIBO will claim that there is one SIBO diet. But that's not true at all. The SIBO diet that works for you will depend on your "underlying cause" for SIBO and may depend on what kind of bacteria you have overgrown in your small intestine. |
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What Do SIBO Diets Have in Common?
SIBO diets are aimed at improving nutrient absorption, minimizing inflammation of your digestive system, and controlling your symptoms. So to start, this means eating anti-inflammatory foods—removing inflammatory foods like diary, gluten, sugar, preservatives, and alcohol is a great start.
With this anti-inflammatory diet as a base, choose the SIBO diet below that you feel works best for you. You probably already have some sense of your most offending foods. So choose a diet that seems like it might help you and if it doesn't try a different one.
Another trick that may help (although there may not be science behind this approach) is to think about the types of foods you ate most of before you got SIBO. The bacteria you have in your body will be the ones that eat your diet. So if you ate a ton of sugar before you got SIBO, sugar-eating bacteria are likely to be in your small intestine (meaning you shouldn't eat sugar).
And if you ate a ton of fibrous veggies before you got SIBO, fiber-eating bacteria are likely to be in your small intestine (meaning you shouldn't eat fiber). Looking at your standard diet can help you identify which foods to eat in your SIBO diet. And often the diet that is the opposite of what you ate before, is the most effective SIBO diet for you.
But remember, no diet treats SIBO. So the goal of any SIBO diet is to reduce symptoms and potential complications of SIBO while you treat your SIBO. Measure the success of your SIBO diet by assessing your symptoms after eating certain foods or a certain diet.
With this anti-inflammatory diet as a base, choose the SIBO diet below that you feel works best for you. You probably already have some sense of your most offending foods. So choose a diet that seems like it might help you and if it doesn't try a different one.
Another trick that may help (although there may not be science behind this approach) is to think about the types of foods you ate most of before you got SIBO. The bacteria you have in your body will be the ones that eat your diet. So if you ate a ton of sugar before you got SIBO, sugar-eating bacteria are likely to be in your small intestine (meaning you shouldn't eat sugar).
And if you ate a ton of fibrous veggies before you got SIBO, fiber-eating bacteria are likely to be in your small intestine (meaning you shouldn't eat fiber). Looking at your standard diet can help you identify which foods to eat in your SIBO diet. And often the diet that is the opposite of what you ate before, is the most effective SIBO diet for you.
But remember, no diet treats SIBO. So the goal of any SIBO diet is to reduce symptoms and potential complications of SIBO while you treat your SIBO. Measure the success of your SIBO diet by assessing your symptoms after eating certain foods or a certain diet.
SIBO Diet 1: The Low Fermentation Diet
The low fermentation diet was designed specifically for SIBO. It avoids any foods that bacteria are likely to ferment. Since fermentation is what causes SIBO symptoms, this diet is often quite successful at reducing the symptoms of SIBO. If you're not sure where to start, this diet is a good bet.
Here’s a list of foods to include in your low fermentation SIBO diet:
Limit these foods on your low fermentation SIBO diet:
Here's a complete guide for this SIBO diet. Another similar SIBO diet that also focused on reducing fermentation is the Fast Tract Diet.
Here’s a list of foods to include in your low fermentation SIBO diet:
- Meat
- Eggs
- Fish
- Most fruits
- Any root vegetables like potatoes, carrots, beets, etc...
- Mushrooms
- Fruiting veggies like peppers, tomatoes, cucumber, zucchini, squash, and eggplant.
- Fruit oils such as olive oil, avocado oil, or coconut oil
- Fruit and vegetable juices
- Desserts
- Dairy
- White rice
- White bread or sourdough
- Nuts
Limit these foods on your low fermentation SIBO diet:
- Cruciferous vegetables like broccoli, cauliflower, Brussels sprouts
- Leafy Vegetables
- These fruits: apples, pears, and bananas
- Beans
- Non-absorbed sugars like splenda
- Gum
- Yogurt
- Whole grains or whole wheat
Here's a complete guide for this SIBO diet. Another similar SIBO diet that also focused on reducing fermentation is the Fast Tract Diet.
SIBO Diet 2: The Low Sugar Diet
If the type of bacteria that are in your small intestine prefer to eat sugar, eating a low sugar, low carb diet will be the diet that works best for you. Based on the SIBO forum (and just how many of us eat high-sugar diets), it seems that a low sugar (or low-carb) diet tends to help many people with SIBO.
Here’s a list of foods to include in your low-sugar, low-carb SIBO diet:
Limit these high sugar foods on your low sugar SIBO diet:
Although this SIBO food list is not exhaustive, it gives you some idea of how to plan your meals.
Here’s a list of foods to include in your low-sugar, low-carb SIBO diet:
- Meat
- Eggs
- Fish
- Leafy green vegetables
- Low starch veggies like broccoli, zucchini, celery, etc...
- Nuts
- Fruit oils such as olive oil, avocado oil, or coconut oil
- A small amount of berries such as blueberries, raspberries, strawberries and blackberries
Limit these high sugar foods on your low sugar SIBO diet:
- Desserts
- Grains of any kind
- Fruits
- Starchy veggies like potatoes, winter squash, and root vegetables like carrots
- Agave Nectar
- Honey
- Fizzy Drinks and Soda
- High-fructose Corn Syrup
- Ice-cream
- Cereals that are sweetened
- Sweetened Yogurt
- Dried Fruits
- Beans
Although this SIBO food list is not exhaustive, it gives you some idea of how to plan your meals.
SIBO Diet 3: The Low FODMAP diet
There is evidence which supports that avoiding high FODMAPs in your diet can help improve your digestive health and reduce symptoms of irritable bowel syndrome (IBS). Some people report that the Low FODMAP diet also helps ease symptoms of SIBO.
In a Low FODMAP diet, the foods to be avoided are any foods that include fructose, lactose, mannitol, sorbitol, fructans, and oligosaccharides. For a large, detailed list, check out this FODMAP food list.
Figuring out which food to eat and how much of them you can eat on this SIBO diet is a huge pain. So if you plan to try it, I highly suggest getting the Monash FODMAP diet app. The app lets you search for most foods and see if they are okay or not.
Here's a video with more information on FODMAPs:
In a Low FODMAP diet, the foods to be avoided are any foods that include fructose, lactose, mannitol, sorbitol, fructans, and oligosaccharides. For a large, detailed list, check out this FODMAP food list.
Figuring out which food to eat and how much of them you can eat on this SIBO diet is a huge pain. So if you plan to try it, I highly suggest getting the Monash FODMAP diet app. The app lets you search for most foods and see if they are okay or not.
Here's a video with more information on FODMAPs:
SIBO Diet 4: The Low Fiber/Low Residue Diet
While some people with SIBO have bacteria that primarily eat sugar, others have bacteria that primarily eat fiber. That means that eating foods with fiber feed your gut bacteria and give you unpleasant SIBO symptoms.
Here’s a list of foods to include in your low fiber SIBO diet:
Limit these high fiber foods on your low fiber SIBO diet:
Here's more information on starting a low-fiber diet.
Here’s a list of foods to include in your low fiber SIBO diet:
- Meat
- Eggs
- Fish
- Low fiber veggies like lettuce, cucumber, and tomato
- Low fiber fruits like cantaloupe or watermelon
- White or sourdough bread
- Skinless white potatoes
- Fruit oils such as olive oil, avocado oil, or coconut oil
- Fruit and vegetable juices
- Desserts are usually okay
Limit these high fiber foods on your low fiber SIBO diet:
- Most vegetables
- High fiber fruits like apples
- Whole wheat or other whole grains
- Beans
- Nuts
Here's more information on starting a low-fiber diet.
SIBO Diet 5: The Bi-Phasic Diet
The Bi-phasic Diet is based on the low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) and SCD (Specific Carbohydrate Diet). Although the low FODMAP diet was designed for IBS, it can be helpful for SIBO. But it limits foods in ways that can lead to nutrient deficiencies over time. So phasing your way back into eating other foods can be important.
As the name implies, the Bi-phasic Diet uses a phased approach to the diet and treatment which limits the side effects of bacterial and fungal “die-off”. Phasing the treatment through stages also aims to prioritize the repair of disturbed digestion over the use of antimicrobials. The first phase of the diet eliminates all grains, legumes, dairy, sugar, and certain vegetables. Canned, processed, and fermented foods are to be avoided in Phase 1 but some will be introduced again in Phase 2.
Learn more about the Bi-phasic Diet here.
As the name implies, the Bi-phasic Diet uses a phased approach to the diet and treatment which limits the side effects of bacterial and fungal “die-off”. Phasing the treatment through stages also aims to prioritize the repair of disturbed digestion over the use of antimicrobials. The first phase of the diet eliminates all grains, legumes, dairy, sugar, and certain vegetables. Canned, processed, and fermented foods are to be avoided in Phase 1 but some will be introduced again in Phase 2.
Learn more about the Bi-phasic Diet here.
Another Gut Health Diet: The GAPS Diet
With bad cases of SIBO it is possible that the gut has sustained more serious injury. In these cases you may benefit from mixing a SIBO diet with a gut healing diet like the GAPS diet, or using the GPAPS diet after you've eradicated your SIBO to heal the gut.
The GAPS Diet was developed by Dr Natasha Campbell-McBride to help treat digestive conditions such as SIBO, IBS, IBD and leaky gut as well as neurological issues such as ADHD, autism, anxiety and depression.
The diet is comprised of a meal plan that helps repair the gut wall and restore gut health. The diet has six stages that you advance through as your gut heals and can handle a wider range of foods. If you are dealing with more complex gut issues, the GAPS diet can be helpful. But given the the foods you eat are often heavy in probiotics, be careful with the GAPS diet if you're still dealing with SIBO.
The GAPS Diet was developed by Dr Natasha Campbell-McBride to help treat digestive conditions such as SIBO, IBS, IBD and leaky gut as well as neurological issues such as ADHD, autism, anxiety and depression.
The diet is comprised of a meal plan that helps repair the gut wall and restore gut health. The diet has six stages that you advance through as your gut heals and can handle a wider range of foods. If you are dealing with more complex gut issues, the GAPS diet can be helpful. But given the the foods you eat are often heavy in probiotics, be careful with the GAPS diet if you're still dealing with SIBO.
The Elemental Diet for SIBO
If all other SIBO treatments fail, doctors may recommend the elemental diet. This diet includes consuming liquid "predigested" nutrients for 2-3 weeks. These nutrients are digested at the top of the digestive track enabling the majority of the small intestine to rest and heal while the bacteria that reside there die or get pushed through to the large intestine where they belong. One study found that the elemental diet cured SIBO in 80% of patients after 2 weeks and 85% of patients after 3 weeks [2].
Elemental Diet for SIBO Supplies
There are just a few choices when it comes to doing the elemental diet. None of them are cheap, but this route can be cheaper than prescription antibiotics, and it has been shown to be more effective. If you've had a difficult case of SIBO or had SIBO for more than a year (which is not uncommon), the elemental diet can start to look pretty good.
Here are some choices:
You can also do Dr. Allison Siebecker's Homemade Elemental Diet. This includes:
Here are some choices:
- Nestle Vivonex RTF Elemental Diet
- Vivonex Total Enteral Nutrition Elemental Powder Unflavored
- Elemental Heal
- Collagen (this can help save money and supplement, but you'll need at least one of the other products to get all your amino acids/protein each day).
You can also do Dr. Allison Siebecker's Homemade Elemental Diet. This includes:
- Jo Mar Labs Black Label Pure Form 21 Blend 1000g Amino Acid Powder
- 63-93 oz honey (The more processed the honey, the better. You really don't want Raw honey here since you want your body to absorb it as quickly as possible)
- ~1890 ml easily digestible oil (e.g., MCT, olive, coconut). (2 bottles of this will do.)
- Unrefined salt
- Pure encapsulations 950 multivitamins
Elemental "SIBO Soup" recipe
The homemade elemental diet kind of tastes like soup broth, so instead of drinking the homemade elemental diet, I turn it into soup. Here is the recipe:
Put everything in a pot and bring to a boil. It's ready to eat when it's hot. This makes 3 servings.
Note. I used this "SIBO soup" as an occasional meal replacement even before doing the elemental diet to calm my SIBO symptoms. Even my husband will eat it, which means it's not half bad.
- 7 tbls Jo Mar Labs Black Label Pure Form 21 Blend 1000g Amino Acid Powder
- 2 tbls honey (The more processed the honey, the better. You really don't want Raw honey here since you want your body to absorb it as quickly as possible)
- 3 tbls coconut oil
- 7 tbls olive oil
- 1 tsp unrefined salt
- 1 capsule oregano oil (let it dissolve in the pot)
- 3 small chili peppers (let soak in the pot, then remove)
Put everything in a pot and bring to a boil. It's ready to eat when it's hot. This makes 3 servings.
Note. I used this "SIBO soup" as an occasional meal replacement even before doing the elemental diet to calm my SIBO symptoms. Even my husband will eat it, which means it's not half bad.
What Happens When You Do a SIBO Diet?
While treating SIBO or doing a SIBO diet, your body will be removing bacteria and maybe also parasites or viruses. This can cause you to feel kinda ill, an experience which is called a herxheimer reaction, also known as "die-off" symptoms.
Die-off symptoms can include fatigue, brain fog, gastrointestinal distress such as nausea, gas, bloating, diarrhea or constipation, low-grade fever, headache, sore throat, itching, muscle and joint soreness, chills, lethargy, intense sweet cravings, and irritability.
Be careful not to confuse die-off symptoms with a nutrient deficiency, which can also make you feel tired and sick. Die-off symptoms tend to come on suddenly (whereas insufficient nutrients can leave us feeling chronically bad). Some people also find that they have die-off symptoms only at a certain time of the day—morning, afternoon, or evening—possibly after taking an antibiotic.
Die-off symptoms can include fatigue, brain fog, gastrointestinal distress such as nausea, gas, bloating, diarrhea or constipation, low-grade fever, headache, sore throat, itching, muscle and joint soreness, chills, lethargy, intense sweet cravings, and irritability.
Be careful not to confuse die-off symptoms with a nutrient deficiency, which can also make you feel tired and sick. Die-off symptoms tend to come on suddenly (whereas insufficient nutrients can leave us feeling chronically bad). Some people also find that they have die-off symptoms only at a certain time of the day—morning, afternoon, or evening—possibly after taking an antibiotic.
How to Minimize Die-Off Symptoms from SIBO Diets
- If your die-off symptoms are making you feel miserable, then you're killing bad gut bugs too quickly. Slow down, support your liver (with supplements like Milk Thistle, DIM, detox tea, and NAC), take epsom salt baths to support your body's ability to get those dead gut bugs out of your body as quickly as possible, and take collagen to heal leaky gut and keep the bad bacteria in your gut and out of your bloodstream.
- If you feel fine one day and then complete crap the next, you might be getting die-off from parasites. It can be confusing because they have weird lifecycles, they die, reproduce, and create symptoms at weird times. It might be worth getting tested for parasites (you can do this from home).
- If your symptoms are consistently getting worse or staying the same over time, even though you haven't been adding new gut healing strategies, then it's likely NOT a result of die-off. See a doctor to make sure your symptoms are not a result of another health issue.
What About Probiotics on a SIBO Diet
Probiotics are complicated when it comes to SIBO. To keep your gut healthy and strong through all this, it can be good to take a probiotic. But since SIBO is all about having too much bacteria where it doesn't belong, certain probiotics may aggravate symptoms of SIBO. That's why some practitioners suggest you actually avoid probiotics and probiotic foods like yogurt, kombucha, fermented pickles, etc... while treating SIBO.
After you've healed your SIBO it's a good idea to help rebuild good bacteria in the large intestine by taking a probiotic with billions of CFUs. Probiotics may also be an alternative to try for treatment-resistant SIBO (to learn more about homemade probiotics to treat SIBO, check out Super Gut by Dr. William Davis). Here are some that tend not to aggravate SIBO: Saccharomyces Boulardii, L. Reuteri, L. gasseri, & Bacillus coagulans
After you've healed your SIBO it's a good idea to help rebuild good bacteria in the large intestine by taking a probiotic with billions of CFUs. Probiotics may also be an alternative to try for treatment-resistant SIBO (to learn more about homemade probiotics to treat SIBO, check out Super Gut by Dr. William Davis). Here are some that tend not to aggravate SIBO: Saccharomyces Boulardii, L. Reuteri, L. gasseri, & Bacillus coagulans
My SIBO Diet Journey
The reason I could write this article is because I had a bad case of SIBO. So now that you've got all the important SIBO diet info, I want to tell you about my experience, which may also be helpful.
I was living in a moldy apartment, has a parasite (blastocystis hominis), and had COMT, CYP and GST genes that prevented me from detoxing effectively. I lost 20 pounds in 2 months. Doctors were completely useless and I had to figure this all out on my own (and with the help from other SIBO sufferers in the SIBO forum!)
Most SIBO sufferers have to figure out and solve what causes their SIBO before it'll go away. For me, my secretory IgA (my gut's immune system) was dangerously low from living with mold for 7 years, having an undetected parasite, and not having the genes to detox from the mold and parasite toxins.
So none of the SIBO solutions helped my SIBO until I got my immune system working better. That meant vitamin C, sunlight/vitamin D, and sleeping a ton. I then did a parasite cleanse, moved to a non-moldy home, and did a stress detox to remove all the stress hormones and toxins that had made me so sick. Even then, I developed treatment-resistant SIBO—or SIBO that doesn't respond to antibiotics.
I was living in a moldy apartment, has a parasite (blastocystis hominis), and had COMT, CYP and GST genes that prevented me from detoxing effectively. I lost 20 pounds in 2 months. Doctors were completely useless and I had to figure this all out on my own (and with the help from other SIBO sufferers in the SIBO forum!)
Most SIBO sufferers have to figure out and solve what causes their SIBO before it'll go away. For me, my secretory IgA (my gut's immune system) was dangerously low from living with mold for 7 years, having an undetected parasite, and not having the genes to detox from the mold and parasite toxins.
So none of the SIBO solutions helped my SIBO until I got my immune system working better. That meant vitamin C, sunlight/vitamin D, and sleeping a ton. I then did a parasite cleanse, moved to a non-moldy home, and did a stress detox to remove all the stress hormones and toxins that had made me so sick. Even then, I developed treatment-resistant SIBO—or SIBO that doesn't respond to antibiotics.
Managing SIBO while Dealing with Root Causes of SIBO
I tried all the SIBO diets here and did best on the low fermentation diet. To manage my SIBO symptoms during this time, I ate the low fermentation diet and alternated through multiple rounds of antimicrobial herbs. Over time this protocol did reduce my SIBO symptoms immensely. I could function again and didn't have any pain! But after 2 years since getting sick, my healing had plateaued. I was still bloating and burping from dinner until bed time and the antimicrobial herbs weren't helping much anymore. So I decided it was time to do the elemental diet.
I knew that my biggest challenge would be the lack of variety in my diet, so I bought a variety of things. I bought 1 tub Collagen , 2 tubs Absorb Plus Vegan, 1 tub Whey-free Elemental Heal, and all the ingredients to make the homemade elemental diet.
I know that the elemental diet can be tough, so I planned ahead and scheduled a lighter work load for myself for 2 weeks. I hoped I could beat SIBO in 14 days, but planned to do 21 days if my burping didn't stop by day 10 or so.
I knew that my biggest challenge would be the lack of variety in my diet, so I bought a variety of things. I bought 1 tub Collagen , 2 tubs Absorb Plus Vegan, 1 tub Whey-free Elemental Heal, and all the ingredients to make the homemade elemental diet.
I know that the elemental diet can be tough, so I planned ahead and scheduled a lighter work load for myself for 2 weeks. I hoped I could beat SIBO in 14 days, but planned to do 21 days if my burping didn't stop by day 10 or so.
My Elemental Diet for SIBO
I'm currently intolerant to dairy (thanks SIBO!), so I only got vegan or meat based powders. Here's exactly what I did for my elemental diet:
Morning:
*Note: Splitting calories up into more meals can help balance blood sugar better.
Morning:
- 1 mug herbal detox tea with Collagen and a tbls oil. (I was concerned about my body's ability to detox dying bacteria, so I felt I needed my detox tea). - 170 cals
- 1/2 serving Absorb Plus Vegan - 185 cals
- 2 servings Whey-free Elemental Heal (This one tastes weird. If I hadn't already spent the money, I might have swapped this out for a second Absorb Plus Vegan drink). - 240 cals
- Herbal dandelion root tea (to support the liver and aid detox. This tea has been one of the most helpful tools to support digestion and detox). I roast a 2-week batch of dandelion root on the stove for a nice coffee-like flavor tea. - 0 cals
- 1/2 serving Absorb Plus Vegan - 185 cals
- 1 serving "SIBO soup". - 675 cals
- One-two more servings of whatever I want to get enough calories for the day.
*Note: Splitting calories up into more meals can help balance blood sugar better.
My Experience on The Elemental Diet for SIBO
This is currently in progress. I'll share my experience of the Elemental Diet as I go.
Diet Day 1:
My blood sugar felt pretty erratic because the diet contains sugar that digests quickly. I forgot my afternoon shake and my afternoon detox tea and was shaky by dinner time. But I didn't feel hungry, I didn't have any issues with the taste of the shakes, I didn't have too many food cravings, and I didn't feel crampy or bloaty from drinking them as some people do.
My dinner SIBO soup was were I started having issues. And my SIBO symptoms (mainly burping and bloating) are worse in the evening between dinner and bedtime. I first got intense brain fog. It was my weekly online card playing night with friends and I kept losing track of what was going on. I hadn't had brain fog like that since I first got sick. Later, my face got pale, and I got some nausea, lethargy, muscle aches, and diarrhea. I also still had my regular SIBO burping and bloating symptoms. These symptoms are all die-off symptoms.
Many people on the elemental diet don't have die-off symptoms that are this bad. My hunch is that my die-off symptoms are bad for one of 3 reasons.
1. My bacteria come out to eat at night. This is when I have all my symptoms and this is the first time they haven't been fed. Perhaps they are dying and it's a god thing.
2. In the SIBO soup tonight, I used coconut oil and oil of oregano, which are both powerful antibacterial and antifungals. I already include these in my regular diet so I know I'm tolerate them normally. But without any other food, they may be killing more bacteria than normal causing die-off.
3. I'm actually missing an entire detox gene. So my body may be struggling to remove the toxins being released from dying bacteria. I knew this would be an issue for me and will try to drink more detox tea tomorrow.
Diet Day 1:
My blood sugar felt pretty erratic because the diet contains sugar that digests quickly. I forgot my afternoon shake and my afternoon detox tea and was shaky by dinner time. But I didn't feel hungry, I didn't have any issues with the taste of the shakes, I didn't have too many food cravings, and I didn't feel crampy or bloaty from drinking them as some people do.
My dinner SIBO soup was were I started having issues. And my SIBO symptoms (mainly burping and bloating) are worse in the evening between dinner and bedtime. I first got intense brain fog. It was my weekly online card playing night with friends and I kept losing track of what was going on. I hadn't had brain fog like that since I first got sick. Later, my face got pale, and I got some nausea, lethargy, muscle aches, and diarrhea. I also still had my regular SIBO burping and bloating symptoms. These symptoms are all die-off symptoms.
Many people on the elemental diet don't have die-off symptoms that are this bad. My hunch is that my die-off symptoms are bad for one of 3 reasons.
1. My bacteria come out to eat at night. This is when I have all my symptoms and this is the first time they haven't been fed. Perhaps they are dying and it's a god thing.
2. In the SIBO soup tonight, I used coconut oil and oil of oregano, which are both powerful antibacterial and antifungals. I already include these in my regular diet so I know I'm tolerate them normally. But without any other food, they may be killing more bacteria than normal causing die-off.
3. I'm actually missing an entire detox gene. So my body may be struggling to remove the toxins being released from dying bacteria. I knew this would be an issue for me and will try to drink more detox tea tomorrow.
Diet Day 2:
Day 2 was almost the exact same as day 1. I was fine until dinner. I actually had a little extra SIBO soup for dinner. And I felt horrible until bed time. I'm going to remove coconut oil and oregano from my SIBO soup tomorrow and see if I feel better.
Diet Day 3:
I've been sleeping more on the elemental diet—like 9-10 hours per night. Today I woke up feeling icky, tired, and groggy. Thank goodness it's Saturday! My body just feels tired from the stress of the diet and the die-off symptoms.
I made SIBO soup tonight with olive oil instead of coconut and no oregano oil, and guess what? No more die-off symptoms. I guess I need to go easy on the coconut oil.
I made SIBO soup tonight with olive oil instead of coconut and no oregano oil, and guess what? No more die-off symptoms. I guess I need to go easy on the coconut oil.
Diet Day 4
Uneventful. Generally kind of tired, but otherwise fine. I am missing food more today as I usually go out to eat on Sundays.
Diet Day 5
Another day without food. I felt nauseous today after dinner again. I seem to only be able to tolerate a tablespoon of coconut oil at a time.
Diet Day 6
None of my SIBO symptoms have gone away. In fact, I'm burping and bloating even more today. My burps do feel different though. It's almost like they are coming from further down in my gut. Perhaps this is a good sign?
Diet Day 7
I feel a bit like I'm finally adjusting to not eating food. I just get up and make my drinks and go about my day. I even have been considering extending the diet for up to 3 weeks since I'm not seeing any change in my symptoms yet. We'll see if I still feel that way in a week ;).
Diet Day 8
I woke up with more upper intestinal gas (belching). There were gas bubbles around my Ileocecal valve, causing pain on my lower right side. This used to happen to me a lot when I first got SIBO but not in many months. I used a massage technique to get my valve unstuck and it felt better (see video below on how to do this).
This was a bit worrisome since my very first SIBO symptoms started after getting pain in my Ileocecal valve. This likely meant it was stuck open and my lower intestine gut bugs entered my upper intestine. So I am going to try to do this massage each night from now on.
This was a bit worrisome since my very first SIBO symptoms started after getting pain in my Ileocecal valve. This likely meant it was stuck open and my lower intestine gut bugs entered my upper intestine. So I am going to try to do this massage each night from now on.
Diet Day 9
I had some Ileocecal valve pain again this morning. But... I think I might be burping less. It could be a fluke, but I'm optimistic.
I'm also feeling a bit less anxious. SIBO really amped up my anxiety. I read once (sorry, I can;t find the reference) that gut bugs can create anxiety. They do so to slow down digestion so there is more food for them to eat. So it's possible that I'm starting to see some improvement in my symptoms today. :)
Overall, I've gotten used to the diet and am not having die-off or cravings much anymore.
I'm also feeling a bit less anxious. SIBO really amped up my anxiety. I read once (sorry, I can;t find the reference) that gut bugs can create anxiety. They do so to slow down digestion so there is more food for them to eat. So it's possible that I'm starting to see some improvement in my symptoms today. :)
Overall, I've gotten used to the diet and am not having die-off or cravings much anymore.
Day 10
Feeling pretty good overall. I did forgot to mention that my lower back pain (which is once of my lingering SIBO symptoms) has been worse since I started this diet. It seems to be some kind of reflex pain caused by the gut. I suspect this because when I did a vitamin C flush earlier, my back pain went away entirely. And when I did a colonic, my back pain was the worst it's ever been. It's coming from the gut somehow.
Here's a video that explains the relationship between gut health and low back pain:
Here's a video that explains the relationship between gut health and low back pain:
Diet Day 11
Omg the cravings were so bad today. Sunday is normally junk food day in my house and my body misses it today. My will power is dwindling.
Diet Day 12
I haven't had any bowel movements in a few days, so I started this Monday morning off with a salt water cleanse. It was fast and effective.
Later in the day, I got really tired, cold, and my muscles ached. I took a 2 hour nap and then slept 9-10 hours more this night.
Later in the day, I got really tired, cold, and my muscles ached. I took a 2 hour nap and then slept 9-10 hours more this night.
Diet Day 13
The cravings are getting harder to ignore. My symptoms have only improved a little bit (still burping a lot, but a bit less than before and bloated less but still quite a bit after meals), I felt a bit flu-ish tonight, and I'm having a hard time imaging doing this diet another week.
Diet Day 14
I feel like Homer Simpson when he went 30 days without beer. When he goes to cross off the last day on the calendar, his hands are shaking from the struggle he just went through. The sad thing for me is that I had my mind set on completing 14 days, but I don't think I'm cured yet.
I really should do the full 21 days to give myself the best chance for success, but the thought of it is depressing. I feel my brain trying to convince me to just eat a little bit of chicken (since I don't react to meat), and I'm not sure which part of me will win the argument going on in my head.
I really should do the full 21 days to give myself the best chance for success, but the thought of it is depressing. I feel my brain trying to convince me to just eat a little bit of chicken (since I don't react to meat), and I'm not sure which part of me will win the argument going on in my head.
Reintroduction Diet Day 1
Well, I'm not up for another week of pure elemental diet. But I'm not also not ready to back to my low-fermentation diet. So I decided to do an extended reintroduction diet with low fiber foods.
Today I did my normal elemental shakes all day but I added a little bit of chicken and some rice noodles to my dinner soup—wha la! SIBO chicken noodle soup. I also started taking biofilm busters in the morning. I am also taking 3 HCL pills with meals (to increase stomach acid), ginger prokinetics (to speed digestion), and berberine (an antimicrobial) with my solid meals.
Today I did my normal elemental shakes all day but I added a little bit of chicken and some rice noodles to my dinner soup—wha la! SIBO chicken noodle soup. I also started taking biofilm busters in the morning. I am also taking 3 HCL pills with meals (to increase stomach acid), ginger prokinetics (to speed digestion), and berberine (an antimicrobial) with my solid meals.
Reintroduction Diet Day 2
I ate the same as yesterday accept I added some butternut squash into my soup. I felt a little more anxious in the evening (which sometimes happens when I eat later in the evening).
Reintroduction Diet Day 3
I ate my drinks for breakfast and had chicken noodle soup with butternut squash for lunch and dinner. I also had a rice cake for some crunch.
After lunch I did some yard work and ended up feeling ill. I'm not sure if what from the exertion or pills or food or what, but I took a 2-hour nap and felt better.
After lunch I did some yard work and ended up feeling ill. I'm not sure if what from the exertion or pills or food or what, but I took a 2-hour nap and felt better.
Reintroduction Diet Day 4
Had shakes for breakfast and lunch today and had my first regular meal for dinner. It was a chipotle bowl with white rice, fajitas, guac, chicken, and lettuce with a few chips and salsa. I then got chills and mild migraine.
My SIBO Diet Over The Next Weeks
Over the next couple of weeks my die-off symptoms eased off and I started to feel mostly okay. But food reintroduction was harder than I expected. Fibrous foods that I had could tolerate before the elemental diet started bothering me again. For example, tomatoes hurt my stomach but if I cut the skin off the tomatoes, they were okay. All greens were problematic and food, in general, started to seem unappetizing again (like when I first got sick). I continued to burp and bloat.
About a month after the elemental diet my symptoms are largely unchanged. I am having fewer reactions to specific foods (I can even eat beans and broccoli again!), but I burp constantly no matter what I eat. I retested and I am still positive for both hydrogen and methane SIBO. I'll add updates here after I try other approaches.
About a month after the elemental diet my symptoms are largely unchanged. I am having fewer reactions to specific foods (I can even eat beans and broccoli again!), but I burp constantly no matter what I eat. I retested and I am still positive for both hydrogen and methane SIBO. I'll add updates here after I try other approaches.
Next Efforts
A few months later, I got a prescription for rifaximin. I took 550mg 3 times per day for 16 days. I took my pills with biofilm busters (Interphase) and PHGG, both suggested by research to make the antibiotics more effective.
I felt really good for the first few days with less burping and bloating, then I started getting headaches, lethargy, and dizziness. That persisted until the end. After completing rifaximin, my digestion felt a little better, but my burps remain at 100%. Some people say they feel better a bit after the antibiotics, so I'm waiting to see if anything changes but an also planning next steps.
When my rifaximin ended, I immediately started taking Candibactin AR and BR plus ginger in the evenings as a pro-kinetic. I've taken Candibactin AR and BR before and they kind of hurt my gut, so I'm hopeful that they will be okay. Now I'm just trying to keep the bacteria weak as my next plan to to try the carnivore diet.
The carnivore diet can starve out the bugs and give them nothing to eat. It's kind of like the elemental diet except on the elemental diet the bacteria can still eat sugar high in the digestive tract. Since burping is my worst symptom, my bacteria may be rather high up. The carnivore diet is pretty much my last resort.
I felt really good for the first few days with less burping and bloating, then I started getting headaches, lethargy, and dizziness. That persisted until the end. After completing rifaximin, my digestion felt a little better, but my burps remain at 100%. Some people say they feel better a bit after the antibiotics, so I'm waiting to see if anything changes but an also planning next steps.
When my rifaximin ended, I immediately started taking Candibactin AR and BR plus ginger in the evenings as a pro-kinetic. I've taken Candibactin AR and BR before and they kind of hurt my gut, so I'm hopeful that they will be okay. Now I'm just trying to keep the bacteria weak as my next plan to to try the carnivore diet.
The carnivore diet can starve out the bugs and give them nothing to eat. It's kind of like the elemental diet except on the elemental diet the bacteria can still eat sugar high in the digestive tract. Since burping is my worst symptom, my bacteria may be rather high up. The carnivore diet is pretty much my last resort.
Important Reminders about SIBO Diets
Here are a few things about SIBO diets that you should keep in mind
- A SIBO diet can help you while you treat your SIBO with antibiotics or antimicrobials.
- Although a SIBO diet is instrumental in easing symptoms, it does not solve the underlying issue.
- When using a SIBO diet, it can be helpful to talk to a SIBO-informed medical practitioner.
- In case your condition starts to worsen due to a SIBO diet, consult a doctor immediately as nutritional deficiencies are not uncommon with SIBO and SIBO diets.
Our gut health influences everything from our weight, to our mood, to our cognitive ability. It can be the reason for our back pain, the root of our depression, and of course, the cause of our digestive issues. That's why healing SIBO is essential.
Here's a few more videos with more SIBO diet help:
More about SIBO symptoms and why SIBO is an issue:
How a Keto diet can help with SIBO
References
1. Chedid, V., Dhalla, S., Clarke, J., Dunbar, K., Koh, J., Justino, E., & Mullin, G. (2012). Herbal Therapy is Effective for Rifaximin Non-Responders with Small Intestinal Bacterial Overgrowth (SIBO) and the Irritable Bowel Syndrome (IBS): 1754. American Journal of Gastroenterology, 107, S714.
2. Pimentel, M., Constantino, T., Kong, Y., Bajwa, M., Rezaei, A., & Park, S. (2004). A 14-day elemental diet is highly effective in normalizing the lactulose breath test. Digestive diseases and sciences, 49(1), 73-77.
3. Ojetti V, Petruzziello C, Migneco A, Gnarra M, Gasbarrini A, Franceschi F. Effect of Lactobacillus reuteri (DSM 17938) on methane production in patients affected by functional constipation: a retrospective study. Eur Rev Med Pharmacol Sci. 2017 Apr;21(7):1702-1708. PMID: 28429333.
2. Pimentel, M., Constantino, T., Kong, Y., Bajwa, M., Rezaei, A., & Park, S. (2004). A 14-day elemental diet is highly effective in normalizing the lactulose breath test. Digestive diseases and sciences, 49(1), 73-77.
3. Ojetti V, Petruzziello C, Migneco A, Gnarra M, Gasbarrini A, Franceschi F. Effect of Lactobacillus reuteri (DSM 17938) on methane production in patients affected by functional constipation: a retrospective study. Eur Rev Med Pharmacol Sci. 2017 Apr;21(7):1702-1708. PMID: 28429333.
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