SIBO (Small Intestinal Bacterial Overgrowth) treatment diet

Small Intestinal Bacterial Overgrowth or SIBO, as it is more commonly known, denotes the presence of excess bacteria in the small intestine. This happens when bacteria which are normally present in the large intestine, start growing in the small intestine. This could be due to the changes in the pH or acidity level of the small intestine. Sometimes these bacteria can be the real bad variety causing issues.

Many of these bacteria and other single cell organisms called archaea ferment sugars to produce gases, like hydrogen and methane that can cause an array of symptoms like chronic diarrhoea and malabsorption. People with SIBO are also likely to suffer from nutritional deficiencies and osteoporosis.

It is difficult to pinpoint the exact cause of SIBO as the symptoms can be difficult to differentiate from other common gastrointestinal problems. It could be caused by an underlying condition like Crohn’s disease, Celiac disease, Inflammatory Bowel Disease (IBD) or even Hypothyroidism. According to studies, more than one-third of the people suffering from SIBO also have IBD.

The bile acids which are responsible for breaking down and absorbing fats are deficient when you have SIBO. The result is pale coloured and unpleasant smelling stools.

Some Common Symptoms of SIBO

• Pain in abdomen
• Nausea
• Bloating
• Excessive belching
• Reflux
• Flatulence
• Diarrhoea/constipation
• Loss of appetite
• Weight loss
• Malnutrition
• Smelly stools

Treatment and outcomes of SIBO

Though SIBO is quite prevalent and its symptoms vary from mild to chronic cases of diarrhoea, there is no one optimum line of treatment available for it. Antibiotics remain the primary method for treating SIBO. Which is a catch-22 situation, as medication wipes off good colonies of bacteria, affecting you even more.

If left untreated, SIBO could lead to complications like malnutrition, dehydration and nutrient deficiencies. Even when treated, there is always a chance of it recurring.

SIBO can affect anyone at any age but it is more like to create problems for adults. There are studies which further suggest that more women than men suffer from this disease.

What happens with SIBO is that it can interfere with the absorption of nutrients from the food we eat leading to malnutrition. The effects of this could range from fatigue, weight loss, depression and other serious health concerns like osteoporosis and anemia.

Excess bacteria in the small intestine can interfere with the absorption of carbohydrates and proteins leading to weight loss, low energy and decreased immunity. SIBO could also impact the absorption of fat soluble vitamins like A, D, E, K and B12.

Once you are diagnosed with SIBO, diet plays a major role in your treatment. You will have to understand the foods that are likely to aggravate your condition and those that are safe for you to eat. Hence a dietary plan makes sense. But do consult an expert to help you plan a diet which will help you to manage and eliminate the symptoms of SIBO.

Since the disease is all about the presence of excess bacteria in your small intestine, your diet needs to be such that it starves your gut bacteria, thus bringing down their population. When bacteria feed on carbohydrate food in your digestive tract, they produce gases in a process known as fermentation. So you need to keep fermentation levels low by consuming less fermentable carbs.

According to studies, there are four kinds of diets which can be helpful for gut conditions like SIBO. They are -

1. Low FODMAP diet
2. The Keto diet
3. Elemental diet
4. Macrobiotic diet

All four of these diets work on the elimination method. They basically work by eliminating fermentable foods from your diet that may trigger or aggravate your symptoms. Of these, the Elemental diet is the most restrictive as it eliminates all solid food and replaces with a liquid meal diet. They are only recommended for a few weeks and can only be a first step towards treating SIBO. The Keto diet severely restricts your carbohydrate intake. The low FODMAP diet is the least restrictive of the three.

Elimination in the first three diets could be extreme and restrictive for example: A FODMAP is an acronym for these categories of food called, fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These foods have a high content of fermentable carbs and are most likely to cause symptoms.

Some examples of such food includes, lentils, beans, wheat, rye, dairy products like cottage cheese; natural and artificial sweeteners; vegetables like onions, garlic, cauliflowers and cabbage; fruits like apples, pears, peaches, plums and apricots; dried fruits and fruit juices.

List of low FODMAP foods

• Meat
• Fish
• Eggs
• Oatmeal
• Unsweetened cereal
• Rice, gluten-free noodles
• Olives
• Peanuts
• Quinoa
• Seeds

Vegetables like green beans, zucchini, tomatoes, lettuce, cucumbers, potatoes, yams, parsnip, taro root, broccoli (heads only), leafy greens, carrots and pumpkin

Fruits like blueberries, strawberries, grapes, cantaloupe and oranges

Lactose-free dairy products

The emphasis should be on eating fresh, whole foods. Portion sizes can also make a difference and transform a low FODMAP diet to a high FODMAP one.

Although SIBO treatment diet plays an important role in the overall procedure, please remember that the first 3 elimination diets cannot be a permanent feature of your life. In the long term, a restrictive diet could actually prove to be harmful for your gut health.

A Macrobiotic diet and SIBO

I have seen a great recovery in my SIBO clients, when on the Macrobiotic approach; as it’s a more fuller approach that makes sure you not only cleanse the gut, but re-inoculate it with good bacteria using foods, hence strengthen the gut and also not deprive the body of nutrients from food by eliminating almost everything. SIBO in my clients takes an average of 8 months to show some remission.

The Macrobiotic approach is a more comprehensive approach which seeks to eliminate foods that cause issues: dairy, sugar, processed, refined, simple sugars, keep you more plant-based (unless you are non-vegetarian: work with a balanced approach), antibiotics, pain medication if not needed. Include a whole foods diet, Ayurvedic plant-based medication, cut back grains and keep you more on vegetables, protein (plant-based or lean protein in case of non-vegetarians), nutrient supplements, probiotics and digestive enzyme supplements which can help manage and keep the uncomfortable symptoms of SIBO at bay.