How to Find the Right SIBO Diet For You
It’ll likely be different than your friends.
It’s 8 pm, you’re excessively full, have a stomach ache, and so much bloating you feel like an entire olympic size swimming pool is sitting in your stomach. This was me one night, as I lay in my bed trying to study for a physiology exam the next day on, you guessed it, the digestive system. So I did what any logical human being would do, I typed in “why am I so bloated” into Google. Several rabbit holes later led me to something called Small Intestinal Bacterial Overgrowth (SIBO).
Eventually, I discovered that certain “healthy foods”can really exacerbate bloating and belly pain in people who have SIBO. These include things like broccoli, brussel sprouts, onions, garlic, and even my beloved guacamole. While I was never formally diagnosed with SIBO, as soon as I removed some of these “healthy” foods, my symptoms went away!
If you find yourself saying, “Ya know, the healthier I eat the worse I feel.” Or, “I went gluten- and dairy-free for a week and I don’t feel any different,” that means you might not have found the right diet for you. Fear not, as we’re going to discuss strategies you can employ to help you find the perfect diet for you, and get rid of that olympic size pool in your belly.
The Internet Says…
Type into your web browser, “SIBO diet” and you’ll see countless PDFs, websites, and videos claiming that they have the perfect SIBO diet for you. How overwhelming is all that? Which one do you choose? How do you know who knows their stuff and who’s trying to sell me timeshares in the Caribbean? In reality, these people have no idea what the perfect diet for you is. While yes, they have experience working with people who have SIBO, each person reacts so differently to so many different foods, you can’t put everyone in the same box. But hey, it’s a free market, and titles need to be catchy to grab your attention, kind of like this one 😉.
One thing the internet does get right, is that there are likely general themes, or highly problematic foods, that are worth a trial of elimination. This includes wheat products, most dairy products, legumes, added sugars, and dried fruits. There’s also general themes around eating habits that are worth experimenting with, consisting of pre-meal mindfulness (breath work or prayer), avoiding drinking large portions of liquid with a meal, and chewing each bite of food enough to turn it into liquid.
The Research Says…
If you understand that upwards of ⅔ of Irritable Bowel Syndrome (IBS) cases can be attributed to SIBO, you can start to look for dietary influences on IBS as a proxy for SIBO. What do we find? The Low FODMAP diet has several systematic reviews and meta-analyses (highest standards of research) supporting its use for IBS, including improvements in bloating, diarrhea, and quality of life. (1)(2). Therefore if it’s beneficial for IBS, it might be beneficial for up to 67% of SIBO cases.
Some consider SIBO to be a type of autoimmunity, which is where the Paleo and Autoimmune Paleo (AIP) diets have merit. AIP can be helpful for other autoimmune conditions such as Inflammatory Bowel Disease (IBD) and Hashimoto’s Thyroiditis (3).
There are several overlaps between AIP and low FODMAP, including the elimination of wheat, dairy, legumes, added sugars, and nuts. I guess the internet buzz terms of “gluten-free, dairy-free” have their place.
Even though they are considered elimination diets, I like to re-frame them and think about what foods you should focus on eating. Foods such as minimally processed meats, sardines, oysters, berries, leafy greens, sweet potatoes, yams, and avocados. Putting that positive, optimistic spin on it can be a more attractive option for some vs. the “white knuckling” approach of just straight up elimination.
Structure Your Own
I think many of us have this sort of “sixth-sense” when it comes to which foods we might be reacting to or probably shouldn’t be eating. Start simple. If you think peanut butter might be bothering you, but you eat it everyday, maybe reduce consumption to 3 days/week for the first week, 1–2 days/week in the second week, and then by the third week you may be ready! If you have a hunch that you’re reacting to red wine, but you only have it once a week, the low frequency might make it easier to temporarily cut out. Make a conscious effort to monitor your symptoms and consider how your digestion is feeling as you alter your diet. Whatever gets measured gets managed!
I also believe many of us are capable of knowing how much elimination is too much for us, i.e., if you eat fast food everyday, switching directly to AIP probably isn’t practical. Likewise, if you’re currently doing a standard paleo diet and still having symptoms, switching to AIP or low FODMAP makes more sense. And like I mentioned earlier, if you want to re-frame the diet and think of it as a “what foods can I eat?” diet, put that list of foods on your refrigerator.
Helpful hint: If you’re going to eliminate something you really enjoy, say the glass of wine, replace it with something, say a cup of tea or a non-alcoholic, non-added sugar wine. Fill one habit with another.
This approach requires a heavy dose of self-awareness, but just by reading this, I know you have the right mindset to improve your health. However, there is a certain level at which you may require the assistance of an experienced clinician or nutritionist. Especially with the reintroduction phase of the diets. At that point you’ve done the most difficult part of eliminating the foods, now you should want to test your microbiome and see if it’s ready to tolerate those foods again.
As impactful as dietary measures are, sometimes, diet alone cannot fix your SIBO. Diet can be great for symptom management, reductions in bloating, abdominal pain, etc, but you still need to address the root cause of your SIBO. Whether that be from IBS itself, autoimmunity to the nerves in the small intestine, or post-abdominal surgery, you need a clinician who understands root cause healthcare. At The HIVE Natural Health Center, our clinicians have extensive training in root cause analysis, and a way to deliver gut-specific care that is practical and cost-effective.
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As always, Trust in Your Gut.
Disclaimer: The contents of this article are for educational purposes only, and are not intended to diagnose or treat any condition. Do not apply any of the information in this article without first speaking with your doctor.
References
- Marsh A, Eslick EM, Eslick GD. Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta-analysis. Eur J Nutr. 2016;55(3):897–906.doi:10.1007/s00394–015–0922–1
- Dionne J, Ford AC, Yuan Y, et al. A Systematic Review and Meta-Analysis Evaluating the Efficacy of a Gluten-Free Diet and a Low FODMAPs Diet in Treating Symptoms of Irritable Bowel Syndrome. Am J Gastroenterol. 2018;113(9):1290–1300. doi:10.1038/s41395–018–0195–4
- Abbott RD, Sadowski A, Alt AG. Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis. Cureus. 2019;11(4):e4556. Published 2019 Apr 27. doi:10.7759/cureus.4556
