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Alyssa Simpson RD, CDE, CLT
Alyssa Simpson

RD, CDE, CLT​

I’m So Confused. What Do I Eat on the SIBO Diet?

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registered dietitian weight loss tips

Do any of these symptoms sound familiar?
✔ Gas
✔ Bloating
✔ Abdominal pain
✔ Diarrhea
✔ Constipation

These symptoms are an indication that you might have SIBO, small intestine bacterial overgrowth. Your small intestine should be a relatively bacteria-free environment. But sometimes bacteria find their way into your small intestine. And if the conditions there are favorable, they’ll set up house and start multiplying.

When this happens, you get SIBO.

The symptoms for SIBO also show up in many different conditions. So you can’t really diagnose SIBO just based on symptoms.

The best way to know FOR SURE if you have SIBO is to get tested. In my practice, I use the SIBO Breath Test. This non-invasive test can tell us not only if you have bacterial overgrowth, but also how severe it is and where it’s located.

With my clients, I use these test results to personalize a treatment and diet plan that will get them feeling better as soon as possible.

For more info about SIBO and how to find out if it’s what’s causing your digestive issues, check out this blog post.

My mission is to help clients who struggle with these symptoms. And whether they are diagnosed with Irritable Bowel Syndrome (IBS), SIBO, or both — there’s a lot of crossover — we dig into dietary changes right away. This way you start feeling better while we work together to uncover the root cause of your issues.

The goal of diet change with SIBO (or IBS) is twofold. I want you to feel more comfortable, so we focus on a diet that will likely reduce your symptoms. AND I want to eliminate the problem that caused your symptoms in the first place.

One diet I often recommend to my SIBO and IBS clients is the Low FODMAP diet. This diet, combined with therapies, can help you feel better fast.

This diet can get complicated. Some foods need to be avoided completely. And some foods you limit to specific quantities. If you need help sorting it all out, check out this guide.

Let’s take a look at what to eat on the SIBO diet — and what FODMAP foods to avoid when you have SIBO.

What are FODMAPS Anyway?

FODMAPs are carbohydrates that can be difficult to digest, especially if your digestive system is compromised. And if these unprocessed carbohydrates hang out in your small intestine, they feed the bacteria growing there.

FODMAPs have three things in common that make them problematic for SIBO:

  1. The small intestine doesn’t absorb them effectively so they sit there for too long.
  2. They draw water into the intestine and create a better environment for bacteria to thrive.
  3. They are quickly fermented by the bacteria, causing unpleasant symptoms.

Often the reduction of FODMAPs can help start the process of starving the bacteria so they stop bothering you.

Sounds easy enough, right? It would be. But FODMAPs are EVERYWHERE. So completely eliminating them isn’t really feasible. That’s why it’s a low FODMAP diet, and not a no FODMAP diet. But, let’s dive in and navigate how to start cutting the bulk of these troublesome carbs out of your diet.

What FODMAP Foods Should I Avoid?

FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. It’s a mouthful. But let’s break it down one at a time so you know which foods to start avoiding!

F is for Fermentable

Fermentable foods are not inherently bad. In fact, they are great for the healthy bacteria in your large intestine. But food has to pass through the small intestine before it can reach the bacteria you want to feed. So avoiding fermentable foods while you are on your low FODMAP diet helps starve the small intestinal bacteria you are trying to get rid of.

O is for Oligosaccharides

Oligosaccharides contain two types of problematic carbohydrates:

  1. Fructans

Fructan is a type of sugar compound present in wheat and other gluten products, fruits, and certain vegetables.

To avoid fructans, you’ll need to cut out wheat products like pasta and bread, along with anything containing barley. Fructans are also present in onions, shallots, and garlic, as well as vegetables like cabbage, broccoli, artichoke, and asparagus.

  1. Galactans

Galactans are found in some legumes, including chickpeas, lentils, beans, broccoli, Brussels sprouts, and products with soy.

D is for Disaccharides

The most common disaccharide is lactose.

Lactose

Lactose is a type of sugar found in dairy products. That’s why people who are lactose-intolerant can’t have dairy, or need dairy that is free of lactose.

A little known fact is that not all dairy foods contain lactose. As a general rule of thumb, the more liquidy a dairy product is at room temperature, the more lactose it contains. And the more solid it is at room temperature, the less lactose it contains. A glass of milk, for example, contains 12g of lactose. Yogurt is about 1/2 of that, and cottage cheese has just a little over 2g per serving. Cheddar cheese has only 0.2g, and butter 0!

So products like milk and really soft cheeses like ricotta and cottage cheese are very high FODMAP and need to be avoided.

M is for Monosaccharides

The most common monosaccharide is fructose.

Fructose

Fructose is a simple sugar found in fruits, some veggies, and in certain sweeteners.

Foods high in fructose include: honey, table sugar, agave nectar, fruit juices, and high fructose corn syrup — check your labels for this one. You’ll find it in many processed and sweetened foods.

High FODMAP foods in the fructose category are not necessarily high in fructose — take asparagus, for example.  What makes them high FODMAP is when a food has EXCESS FRUCTOSE — i.e. more fructose than glucose. When fructose and glucose are present in equal quantities, the fructose hitches a ride with glucose and is absorbed readily.  It’s the excess fructose is slow to absorb and hangs out in the gut too long.

P is for Polyols

Polyols are sugar alcohols used as sweeteners. They are found in fruits that contain pits (like peaches and cherries), as well as apples and pears. Mushrooms and cauliflower also contain polyols.

With the keto craze, polyols are showing up as low-carb sweeteners. So you’ll want to avoid products sweetened with xylitol or sorbitol.

The Good News

I know what you’re probably thinking….

That’s a pretty depressing list. No ice cream? No bread or pasta?

Yes, the low FODMAP Diet is restrictive. But, it works quickly. And you don’t stay on it for long.

The low FODMAP diet serves as an elimination diet. You eliminate or limit these foods for a period of about 6 – 8 weeks to get your SIBO under control. Then you add back in foods in a controlled manner so that you can pinpoint what you tolerate and what you don’t.

Some people feel so much better on the low FODMAP diet that they want to stay on it. But be careful. Going on a diet this restrictive for a long period of time can have health consequences.

You can develop deficiencies in nutrients like calcium, vitamins A, C, and D, and more. So it’s important to use the low FODMAP diet in a controlled setting under the guidance of an experienced practitioner.

A Registered Dietitian (such as myself) will guide you through the low FODMAP diet so that you can reduce your symptoms safely.

But changing your diet is only part of the solution. You need to get to the root of what caused your SIBO (or IBS) in the first place. Typically getting rid of SIBO (not just the symptoms) requires some herbal support or antibiotic therapy in order to kill the bacteria.

That’s where I come in. I’ve worked with over 1,000 patients to overcome their digestive problems and help them get their lives back. I use the latest and greatest techniques and testing, along with time-tested methods to find and correct the underlying problem. Then once we get your symptoms under control, the likelihood of recurrence is greatly reduced.

If you’re ready to get to the bottom of your issues and find sustainable solutions, click the link below to book a discovery call.

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