As the name suggests, Small Intestine Bacterial Overgrowth or SIBO is a condition wherein the gut bacteria overgrow in the small intestines. SIBO is defined by a bacterial concentration that exceeds 105 CFU per mL of bacteria in the proximal small bowel and/or more than 103 CFU per mL of isolates normally found in colonic flora.
Depending on the type of bacteria, SIBO can be of two main types – methane-producing and hydrogen-producing. The former causes constipation, while the latter causes diarrhea. SIBO can also occur as a combination of methane-producing and hydrogen-producing bacteria.
The uneven and unbalanced distribution of bacteria can cause diarrhea, stomach ache, and bloating and, if left untreated, may also result in malnutrition.
Symptoms of SIBO include
- Stomach ache
- Weight Loss
SIBO could be a result of:
- An abnormally slow movement of the digestive system (dysmotility)
- A compromised immune system
- Low stomach acid levels
- Physical abnormalities of the small intestine
- Malnutrition or malabsorption disorders
Following a SIBO diet plan, along with an antibiotic course, can help your digestive tract recover faster and eliminate the discomforts associated with SIBO.
[ Read: GOLO Diet ]
Main Goals of the SIBO Diet
The primary goal of the SIBO Diet are:
- To reduce excessive bacterial fermentation in the small intestines and to increase the nutrient absorbing capacity
- Pausing for 4 to 5 hours between meals to increase cleansing waves and to strengthen migrating motor complex waves
- To consume a balanced diet comprising of healthy and whole foods while avoiding processed food items.
Various SIBO Diets
If you are struggling with SIBO, you can choose from any of the following diets outlined below:
1. Specific Carbohydrate Diet
Dr. Sidney Haas and Elaine Gottschall developed the Specific Carbohydrate Diet or SCD. The diet has helped several individuals who suffer from bowel diseases. While the diet is primarily for those with Crohn’s disease(1), celiac disease, ulcerative colitis, cystic fibrosis, chronic diarrhea, and diverticulitis, it has proven itself effective against IBS and is SIBO-friendly.
The foods are profiled on the basis of their carbohydrate composition. You can have simple carbohydrates that are easy on your intestines. However, keep in mind that this diet excludes whole grains and other “good” complex carbs.
2. Low FODMAPs
FODMAP stands for Fermentable Oligo-Di-Monosaccharides and Polyols. These are osmotic carbohydrates present in foods, which can neither be digested nor absorbed effectively. For this reason, the gut bacteria ferment these foods, leading to gas and bloating. The Low FODMAPs diet was developed by Peter Gibson, Sue Shepard, and their colleagues at Monash University in Australia.
The low FODMAPs diet has been scientifically proven to be effective against IBS(2), thereby, proving useful in improving gut health. The diet involves cutting down high FODMAP foods for 2 weeks to 2 months and then reintroducing them in your diet as per your tolerance.
[ Read: Zero Carb Foods ]
3. Cedars Sinai
Developed by Dr. Pimentel at Cedars Sinai, Los Angeles, Cedars Sinai diet encourages meal spacing while eliminating fermentation foods. Unlike most other SIBO diets, the Cedars Sinai is less restrictive and allows for easily digestible sugars and starches.
This diet need not cut down on your eating habits, you can always opt for healthier options. It has a strict “no snacking” policy as it stresses upon meal spacing to accommodate the effective functioning of cleansing waves.
|Foods to Eat||Foods to Avoid|
|Unprocessed meat and fish||
Sugar, corn syrup, honey, agave nectar
Beans and legumes high in galactans
Whole grains like wheat, barley, and rye
|SIBO diet oatmeal||
Garlic and onions
Cauliflower and broccoli
|Rice noodles, or any other gluten-free noodles||Apples|
|Pumpkin and squash||
Ice cream and flavored yogurt
|Peanuts and seeds||
Lactose-free or non-dairy products
Acceptable beverages on a SIBO diet could include:
- Tea without milk
- Lactose-free milk
- Dry wine (in moderation)
- Herbal tea
- Green tea
When following a SIBO-friendly meal plan, you can follow the SIBO diet recipes and meal plans as outlined below:
SIBO Diet Breakfast Ideas
- Gluten-free pancakes
- Strawberry smoothie bowl
- Low FODMAP bone broth
- Carrot or blueberry muffins
[ Read: Benefits of Breakfast ]
SIBO Diet Lunch Ideas
- Buffalo wings
- Chicken tenders
- Greek/Mediterranean salad
- Roasted chicken and vegetables
- Baked salmon
SIBO Diet Dinner Ideas
- Ginger lemon chicken
- Baked salmon with lemon, butter, and thyme
- Grilled pork chop
- Zucchini noodles with spinach pesto
- Steak with Hollandaise sauce
[ Read: Healthy Dinner with Ayurveda ]
- Fat bombs made from nut butter
- Bone broth
- Carrot muffin
- Pecan or pumpkin pie
An antibiotic course is a primary way in which SIBO is treated. However, studies indicate that limiting sugars and lactose can significantly contribute to a reduction in bacterial overgrowth. Further, incorporating probiotic-rich foods and drinking copious amounts of water can also help reduce the symptoms of SIBO. The above diet plan and meal plan can help you through the flare-up days. However, do consider discussing these dietary changes with your physician before implementing them.
Most importantly, do remember to gradually introduce FODMAP in your diet once the symptoms have eased out. Doing so will prevent the loss of healthy gut bacteria.
1. Can SIBO cause weight gain?
Yes, SIBO can cause weight gain(3) in two main ways. First, excessive bacteria produce methane gas, which can slow down the functioning of the small intestine. Second, SIBO adversely affects your metabolism and can also impact your insulin and leptin resistance. These changes will affect your ability to regulate hunger and satiety. Thus, it will leave you craving carb-rich and junk foods, which, when paired with unsatiated hunger, will result in weight gain.
2. Can SIBO make you tired?
Fatigue or tiredness is a common symptom of SIBO. It causes fatigue in the following ways:
- SIBO damages the mucosal lining of the bowels that results in “leaky gut,” which triggers chronic fatigue.
- The excess bacteria consume the vitamins, and amino acids, thereby depriving your body of the nutrients. SIBO retards the Vitamin B12 absorption, the deficiency of which can lead to fatigue.
- As SIBO remains undiagnosed for several years, the cumulative inflammation can cause the release of cortisol, which results in tiredness.
3. Do probiotics help SIBO?
SIBO treatment involves the stoppage of bad bacteria source foods, antibiotics, and reintroduction of gut-friendly probiotics. Hence, adding probiotics to your diet is important in the third-stage of SIBO treatment. However, it is important to understand the kind of probiotic that must be consumed.
In the case of SIBO, one needs to move away from lactobacillus or bifidobacterium and go for soil-based probiotics. The soil-based probiotics that you need to include are Bacillus clausii, Bacillus coagulans, and Bacillus subtilis.