Last Updated on November 25, 2020
Ultimate SIBO Diet Guide – Low Fermentation Foods to Eat and Avoid
Diet can help in overcoming symptoms and improve your gut health.
Whether you use diet alone or diet with other treatments, what you eat can play a role in resolving digestive symptoms.
But, with all the different advice out there, it can be confusing.
So, what is the best diet for SIBO?
In this guide, we will discuss the basics of dietary treatment for SIBO including a comparison of the different treatment diets, which foods to avoid, which foods may be best to eat, the best beverages, and a handy SIBO diet food list which can simplify your grocery shopping.
Table of Contents
- 1 SIBO Diet Food List
- 2 What is the SIBO Diet and How Does Dietary Treatment Work?
- 3 What Are the Main Goals of the SIBO Diet?
- 4 3 Main Sibo Diets Compared
- 5 Low FODMAP Diet
- 6 Specific Carbohydrate Diet – SCD Diet
- 7 Cedars Sinai-Low Fermentation Diet
- 8 Which Beverages Are Ok?
- 9 SIBO Diet Frequently Asked Questions
- 9.0.0.1 How long do you stay on a SIBO Diet?
- 9.0.0.2 Which foods should you avoid with SIBO?
- 9.0.0.3 Which foods are the best to eat with SIBO?
- 9.0.0.4 Is snacking ok?
- 9.0.0.5 What's the best way to eat when your gut is flaring up?
- 9.0.0.6 Can You Eat Gluten Containing Foods on SIBO Diet?
- 9.0.0.7 Can the Low FODMAP Diet cure SIBO?
- 9.0.0.8 Do Probiotics Make SIBO Worse?
- 9.0.0.9 Is Rice Bad for SIBO?
- 9.0.0.10 Can You Eat Eggs on SIBO Diet?
- 9.0.0.11 Can You Drink Alcohol With SIBO?
- 9.0.0.12 Is Garlic Good For SIBO?
- 9.0.0.13 Can Celery Cure SIBO?
- 9.0.0.14 Is Turmeric Good for SIBO?
- 9.0.0.15 What Can You Eat For Breakfast With SIBO?
- 10 Conclusion
SIBO Diet Food List
Just looking for a food list you can download and print out?
We put together a simple list to stick to when eating with IBS, SIBO, or any other digestive issues such as leaky gut.
A lot of SIBO food lists can be overwhelming and too restrictive. It has been shown in research that it’s best to stick to the basics of a Low FODMAP diet for a short period of time, then slowly diversify your diet to include a wide range of healthy foods you can tolerate.
We’ve created a simple and effective guide that lists the foods to eat and foods to avoid to get your gut on track.
What is the SIBO Diet and How Does Dietary Treatment Work?
Small intestine bacterial overgrowth occurs when too much bacteria accumulate in the small intestine. This bacterial overgrowth may cause various different digestive symptoms such as gas, bloating, constipation, diarrhea, and more.
It’s important to remember that SIBO is usually caused by one of the following:
- Small intestine dysmotility (slow movement of the intestines)
- Structural issues in the bowel such as adhesions
- Malnutrition or malabsorption disorders
- Immune system dysfunction
- Medications that impair motility of normal GI function
Treatment usually involves one or a few of the following:
- Fixing underlying issues causing slow motility
- Antibiotics
- Prokinetics (help increase gut motility & function)
- Elemental Diet
- Probiotics
- Dietary changes
Keep in mind that the only way to resolve bacterial overgrowth is to address the underlying cause.
For a more in-depth overview of SIBO, the causes, and symptoms associated see our guide here.
How the Sibo Diet May Help
Now that you understand what SIBO is, we can discuss how the Sibo diet plan may help.
All effective diets used for bacterial overgrowth reduce food sources for bacteria in the gut. Bacteria mainly feed on carbohydrates so each diet limits the number of fermentable carbohydrates. This helps reduce the number of bacteria by limiting their food supply which then reduces digestive symptoms.
A few things to keep in mind are:
- The combination of bacterial species is unique in each individual so food tolerance will be different for each person
- Changes in diet may change the fecal microbial footprint rapidly
- There is no sound evidence-based dietary treatment for SIBO although some diets have more research than others
- Each diet modifies specific carbohydrates
- Fermentable carbohydrates are important for overall health so restrictive diets should only be used the short term until you figure out what combination of carbohydrates you can tolerate
What Are the Main Goals of the SIBO Diet?
1. To decrease bacterial fermentation and increase nutrient absorption
- We want our bodies to get as much nutrition from our food as possible and not the bacteria in the small bowel
- Some fermentation by bacteria is normal and healthy but excessive fermentation is not normal in the small intestine
2. To allow time between eating to give your migrating motor complex a chance to clean
- Research has shown that a large majority of people with small intestine bacterial overgrowth have a decrease in cleansing waves which may be an underlying cause of the bacterial overgrowth
- With weak migrating motor complex waves, it is important to try and allow at least 4-5 hours between meals
- Nighttime is when you have the longest period of fasting so it may help not eating late
3. To eat a balanced whole food diet with as much diversity as you can tolerate
- It is healthiest to eat a balanced diet so that your body may get all essential nutrients
- Stick to the least restrictive diet that helps manage symptoms effectively
- In general, eat less processed foods which may exacerbate symptoms
If you keep these goals in mind you will be able to figure out a custom dietary treatment plan that allows for digestive symptom reduction as well as overall health maintenance.
3 Main Sibo Diets Compared
Low FODMAP Diet
(Fermentable Oligo-Di-Monosaccharides and Polyols)
A Low-FODMAP diet is a dietary approach developed by Sue Shepard, Peter Gibson, & colleagues at Monash University (Australia) to manage IBS and other functional gastrointestinal disorders.
FODMAPs are osmotic carbohydrates that are found in foods. They may not be digested or absorbed well allowing for bacteria to ferment them when eaten in excess causing symptoms like gas and bloating.
When beginning the diet, high FODMAP food sources are limited to 2 weeks to 2 months then re-introduced depending on your tolerance. FODMAPs stands for fermentable oligosaccharides (fructans/GOS), disaccharides (lactose, milk sugar), monosaccharides (excess fructose), and polyols (sugar alcohols like mannitol and sorbitol).
There is scientific evidence showing the effectiveness of this diet for treating IBS and SIBO.
See the Low FODMAP diet article to learn more.
Low FODMAP Foods to Eat on the Diet
| FOOD TYPE | LOW FODMAP FOODS |
| Meat, Poultry, Eggs, Fish | Chicken, fish, eggs, pork, shellfish, turkey, beef, lamb, cold cuts |
| Dairy (low lactose) | Lactose-free dairy, half and half, lactose-free cream cheese, lactose-free cottage, cheddar, colby, parmesan, swiss, sorbet, lactose-free yogurt, coconut yogurt |
| Non-Dairy Alternatives | Almond milk, rice milk, nuts, nut butters, seeds, hemp milk |
| Grains (wheat free) | Wheat-free grains and flours without a ton of fiber: bagels, breads, noodles, pasta, pretzels, waffles, tortillas, pancakes, quinoa, rice, cream of rice, cheerios, grits, oats, sourdough bread, soba noodles |
| Vegetables | Cucumbers, carrots, celery, eggplant, lettuce, leafy greens, pumpkin, potatoes, squash, yams, tomatoes, zucchini, bamboo shoots, bell peppers, bok choy, bean sprouts, collards, spaghetti squash, olives, green beans, rutabaga, spinach, ginger root, radish, turnips, corn, mushrooms, kale |
| Fruits (limit to one serving) | Bananas, berries, cantaloupe, grapes, honeydew, grapefruit, kiwi, lemon, lime, orange, pineapple, rhubarb, passion fruit, kiwifruit, dragon fruit, papaya, clementine |
| Beverages | Water, small amounts of low FODMAP juice, coffee, tea, gin, vodka, wine, whiskey |
| Seasonings, condiments, spices | Basil, cilantro, coriander, lemongrass, parsley, mint, sage, thyme, homemade broth, chives, flaxseed, margarine, mayonnaise, olive oil, pepper, salt, sugar, mustard, vinegar, balsamic vinegar, pure maple syrup, vanilla, dark chocolate |
| Desserts | Any made from allowed foods |
High FODMAP Foods to Limit on the Diet
| FOOD TYPE | HIGH FODMAP FOODS |
| Meats, Poultry, Eggs, Fish | Anything made with HFCS or high FODMAP ingredients such as sausage |
| Dairy | Cottage cheese, ice cream, creamy sauce, milk, soft cheeses, sour cream, whipped cream, evaporated milk, yogurt, custard, buttermilk, kefir, gelato |
| Non-Dairy Alternatives | Coconut cream, beans, hummus, pistachios, soy products, coconut milk, black eyed peas, fava beans, kidney beans |
| Grains | Inulin, wheat, wheat flours, flour tortillas, rye, chicory root, barley, bran cereals, granola bars,wheat germ, semolina, spelt flour |
| Vegetables | Artichokes, garlic, onion, onion and garlic powder, asparagus, beets, broccoli, brussel sprouts, cabbage, cauliflower, fennel, okra, snow peas, sun-dried tomatoes, mushrooms, dried beans, butter beans |
| Fruits | Large amounts avocado, apples, apricots, dates, canned fruit, cherries, dried fruit, figs, guava, mango, nectarines, pears, peaches, persimmon, watermelon, plums, prunes, figs, grapefruit |
| Beverages | High FODMAP fruit and vegetable juices, rum, anything with HFCS, milk |
| Seasonings | HFCS, garlic, jams and jellies, onions, pickle, relish, artificial sweeteners like sorbitol, mannitol, isomalt, xylitol, agave, coconut |
| Desserts | Any made with High FODMAP |
Specific Carbohydrate Diet – SCD Diet
The SCD diet was developed by Elaine Gottschall & Dr. Sidney Haas. This diet has helped many people with various forms of bowel disease to improve their quality of life. The diet is mainly intended for people with Crohn’s disease, ulcerative colitis, celiac disease, diverticulitis, cystic fibrosis, and chronic diarrhea. Practitioners also use this diet for IBS and bacterial overgrowth, but it may be too restrictive for some people.
The foods that are allowed on this diet are based on their carbohydrate structure. The main difference is that the SCD diet does not allow starches and grains which are complex carbohydrates. There is some evidence for the SCD diet in inflammatory bowel disease but it has not been studied in IBS or SIBO.
See the SCD Diet article to learn more.
| FOOD TYPE | ALLOWED | NOT ALLOWED |
| Protein | Beef, pork, chicken, fish, eggs, bacon, shellfish, lamb | Any meats that are processed, canned, breaded or made with added starch |
| Dairy | 24-hour fermented yogurt, natural cheeses like cheddar, Colby, gruyere, Havarti, dry curd cottage cheese, swiss, | Milk, cottage cheese, chocolate, ice cream, cream, feta, mozzarella, ricotta, primost, gjetost, Neufchatel |
| Vegetables | Any fresh or frozen non-starchy vegetables | Potatoes, yams, parsnips, okra, chickpeas, bean sprouts, soybeans, mung beans, fava beans, garbanzo beans, barley, chicory root, pinto beans, yucca root, seaweed |
| Fruits | Any fresh fruit | Plantains, any that are dried with added starch or sugar |
| Grains | No grains allowed | All grains and flours are avoided on the SCD |
| Nuts | All nuts, nut butters and nut flours are allowed | |
| Beverages | Fresh squeezed juices without added sugars, weak tea or coffee, almond milk, gin, scotch, whisky, vodka, dry wines, club soda | Milk, sugary drinks, soymilk, instant coffee, concentrate juices, beer, brandy, port wines, sake, sherry |
| Condiments | All spices and condiments without starch or sugar such as honey | Spices and condiments with starch and sugars added |
| Desserts | Desserts made with nut flour, honey, and acceptable fruits | Desserts made with any starch that isn’t allowed or sugar besides honey |
Cedars Sinai-Low Fermentation Diet
This diet was developed by Dr. Pimentel at Cedars Sinai in Los Angeles. It emphasizes meal spacing and lower fermentation foods. It allows easily digested starches and sugars and is not super restrictive.
- The diet is designed to allow you to be able to find food anywhere
- It was created by a top IBS researcher
- It emphasizes meal spacing to allow cleansing waves to function (no snacking)
- Simple sugars which are easily digested are ok
| FOOD TYPE | ALLOWED | NOT ALLOWED |
| Protein | All proteins are good | |
| Dairy | Lactose-free dairy | Anything with lactose |
| Carbohydrates | Simple easy to digest carbs like rice, potatoes, white, French, or sourdough bread | Whole wheat bread, high fiber bread or carbs |
| Vegetables | Anything that grows underground like potatoes, yams, carrots, turnips, rutabaga, peppers, tomatoes, cucumber, zucchini, squash, eggplant, peas, mushrooms | Beans, legumes, cabbage, broccoli, Brussels sprouts, cauliflower, leafy vegetables, hummus |
| Fruits | Small amounts of fruit | Large amounts of fruit. Limit apples, pears and bananas |
| Beverages | Water, tea, coffee | Sodas with sucralose or Splenda, milk |
| Desserts | Lactose-free ice cream, cheap cakes made without dairy | Dairy products |
Which Beverages Are Ok?
So what’s best to drink to avoid digestive issues?
It’s pretty simple. Stick to water, light teas, lactose-free milk, and the occasional glass of dry wine if you like to have a drink.
You’re best to avoid sugary drinks, too much alcohol, dairy with lactose, too much caffeine in coffee, sodas with Splenda, and too much fructose in fruit juices. Some drinks like herbal teas can even be helpful for some people.
For example, peppermint, ginger, and fennel tea may help ease gas and bloating. You can see our gut-friendly tea guide for more information on helpful teas.
SIBO Diet Frequently Asked Questions
How long do you stay on a SIBO Diet?
If following the Low FODMAP diet, there is a restrictive phase for 2 to 6 weeks, a reintroduction phase, and then an expansion phase. So, it’s best to only stay on a restrictive diet for a month or 2 before allowing more diversity in your diet. The restrictive phase of any of the lower fermentation diets is meant to determine which foods you really have problems with and should avoid.
The SIBO diet is not meant to be a long term diet unless it incorporates a healthy diversity of foods allowing your body to get its nutritional requirements.
Which foods should you avoid with SIBO?
The foods that usually cause the most symptoms are milk, cheese, beans, large amounts of raw vegetables, cabbage, cauliflower, garlic, onions, broccoli, large amounts of fruit, wheat, anything with added fiber, hummus, beer, Brussels sprouts, artificial sugars.
Which foods are the best to eat with SIBO?
The best foods to eat with SIBO are the lower fermentation foods like rice, potatoes, cooked low FODMAP vegetables, meats, lactose-free dairy, nuts, nut milks, herbal teas, cream of rice, sourdough and french breads, olive oil, ginger, salt, pepper, condiments without added sugar, natural spices, dry wine, low FODMAP fruits, gluten-free foods without additives.
Is snacking ok?
It’s best to limit snacking. If someone has blood sugar issues then that obviously takes precedence but it’s generally best to allow between 3-5 hours between meals for the migrating motor complex cleansing waves to function.
In most people with SIBO, they have weaker migrating motor complexes so they need to give those cleanup waves a chance to work during fasting.
What's the best way to eat when your gut is flaring up?
When your symptoms are acting up it’s best to lower your fermentable carbohydrate intake, get adequate rest and relaxation, drink soothing teas, allow fasting time, and avoid excess sugar. Even supplementing with a semi-elemental diet can be helpful to allow bowel rest.
Can You Eat Gluten Containing Foods on SIBO Diet?
Yes, you can consume gluten containing foods on a SIBO Diet although some people with gluten sensitivities or celiac disease may need to limit gluten.
Gluten is a protein found in grains like wheat, barley, and rye. These grains are also high in FODMAPs. Remember, fermentable carbohydrates which are not absorbed well will feed bacteria. In most SIBO and IBS cases the carbohydrates which are found in gluten-containing grains are causing the issues, not the gluten specifically. This is why people with SIBO and IBS can tolerate some amount of gluten-containing products.
On the other hand, people with Celiac Disease have to avoid all gluten because it causes damage to their intestinal tract. In summary, for the majority of people with SIBO the reason reducing gluten helps symptoms is because it reduces the number of fermentable carbohydrates.
Can the Low FODMAP Diet cure SIBO?
Usually the Low FODMAP diet does not work as a cure but as a management tool for people with IBS and SIBO. The only way to cure SIBO is to fix the underlying cause.
Diet can certainly be an effective treatment strategy for reducing symptoms and improving quality of life though.
Do Probiotics Make SIBO Worse?
This is a tricky topic. On one hand, there has been some research and patient evidence that shows probiotics can be helpful in some people with SIBO. On the other hand, a lot of people with SIBO cannot tolerate any probiotics because they don’t clear bacteria from their small intestine effectively. It’s important to remember that all bacteria ferment, so if someone with SIBO cannot clear the bacteria in the small bowel which is already out of balance it may make their symptoms worse.
It depends on the individual. If you’re going to experiment with probiotics, it’s best to start really small and slow to see what kind of a reaction you notice. For more information, you can check out the probiotics for SIBO article.
Is Rice Bad for SIBO?
No, rice is not bad for SIBO.
Rice is actually a naturally gluten-free and lower fermentation food which is often tolerated well in SIBO patients. White and brown rice are excellent. With all starches and grains it makes sense to monitor how much you eat and how much your digestive system can tolerate since some people do have a little harder time digesting these types of carbohydrates. You can include rice in your Sibo Diet.
Can You Eat Eggs on SIBO Diet?
Yes, eating eggs on a SIBO diet is usually fine unless you are someone who deals with an egg allergy or reacts negatively to them.
Can You Drink Alcohol With SIBO?
Yes, you can drink alcohol with SIBO although it is recommended to keep consumption to a small amount or limit it completely.
Usually if consuming alcohol it’s best to stick to a little bit of dry wine, vodka, gin, or whiskey without added sugars.
Is Garlic Good For SIBO?
Generally garlic is not tolerated as well in SIBO patients due to the fermentable substrates it contains.
That being said some people can tolerate garlic just fine and others can tolerate small amounts of garlic in their diet. Garlic is a healthy food and if tolerated well it can be included. If not tolerated well, trying in small amounts or eliminating from the diet for a period of time can be useful.
Can Celery Cure SIBO?
No, celery has not been shown to cure SIBO.
To cure SIBO you need to fix the underlying cause which is causing slow intestinal movement or impaired bowel function.
Is Turmeric Good for SIBO?
Turmeric can be good for SIBO due to it’s anti-inflammatory properties.
It’s best to try turmeric in small amounts as a spice in tea, cooking, or taken as a herbal supplement to see if it helps inflammation and bowel function. If it helps including it in your Sibo diet can be helpful, if not don’t worry about eating turmeric.
What Can You Eat For Breakfast With SIBO?
You can eat Low FODMAP or fermentation food options for breakfast if you have SIBO.
Some examples include: cream of rice, rice cereals, oatmeal, fruit, nuts, lactose free or dairy yogurt, buckwheat pancakes, and more.
Conclusion
Dietary changes for SIBO can be an important part of your treatment protocol to reduce symptoms, but it’s important to understand that diet is just one of the treatment strategies alongside antibiotics, prokinetics, and fixing underyling causes. It’s necessary that you still meet all of your nutritional requirements and do not cause nutritional deficiencies by restricting too many foods.
In summary, the Low FODMAP or low fermentation diet has shown the best research results for helping people with SIBO, so trying this dietary approach may be helpful to identify the combination of carbohydrates your body tolerates best.
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I would like a suggestion of how to treat a 10 year old girl with SIBO?
Is the low fodmap diet appropriate for kids?
Andrea,
While I am not a doctor I can tell you my opinion. In adults, the Low FODMAP diet has not shown any negative consequences. In children there have not been any studies conducted. My guess would be that the diet is ok if followed properly where you go from elimination phase back to a more diverse diet. I think the issues occur when you stay on a restricted diet for a long period of time and this probably isn’t healthy for kids.
I have SIBO and frequent uti can I take cranberry & D-mannose?
Dana,
This is a question to ask your doctor.
Kefir that is fermented for at least 24 hours is low-fodmap. This should be mentioned.
Thanks for the suggestion! Probiotic foods can be tricky for people with SIBO and IBS because some people can’t tolerate a lot of extra bacteria. Fermented foods with live bacteria cause a lot of fermentation on their own without FODMAPs. It may be great for some people but for others they may have to be careful.
How do I get enough fiber on a low fermentation diet?
Good question. A low fermentation diet should contain vegetables and grains that are lower in FODMAPs but also contain some fiber. Foods like carrots, rutabaga, squash, brown rice, quinoa, and leafy greens are all good sources of fiber that you can eat in smaller amounts on a low fermentation diet. You should be able to get enough fiber in on the low fermentation diet as long as you are including a little bit of these types of foods. The key is just to avoid high FODMAP foods that are causing excess fermentation which are often time foods like garlic, onions, broccoli, kale, cauliflower, ect.
If you eat a lot of Low FODMAP fruits and veggies, (bananas, raw spinach, carrots, strawberries, etc) could you be eating too much fiber?
Yes, that is possible. That’s why on the FODMAP diet they talk about portion sizes of different foods. For a regular healthy diet, fiber is great and you don’t need to worry about too much but if you’re dealing with SIBO then yes fiber can aggravate symptoms.
When they say there are 35 carbohydrates in a serving size of 1/4c of rice cereal is that 1/4c of uncooked or cooked rice?
Hello – long time IBS sufferer, recently unofficially diagnosed with SIBO.
I’m trapped in a world full of conflicting information!!!!
Been following LOW FODMAP diet for over 8 weeks, with very little results. I’ve been taking digestive enzymes (at her recommendation) but the constipation was so bad, I had to seek outside help. I found some LOW FODMAP all organic/natural fibre supplement MONASH approved. The fibre definitely eased the constipation BUT since the entire 8 weeks I saw little to no improvement I’m now wondering if I’m consuming TOO MUCH fibre?
This past week my naturopath put me on herbal supplements to treat the SIBO (Iberogast and St Francis Herb Farm Goldenseal)
I WOULD LOVE any comments/suggestions anyone has on how to help. I’ve only been on the SIBO treatment for 4 days but naturopath said SOME people see immediate results, I unfortunately have seen no change.
ANY ideas, suggestions, comments and related stories of experiences are welcomed!
PLEASE HELP! Thank you!
Hi Katie – please don’t worry 🙂 I’ve used a few things that have helped, and it can take time. But you will get better
* Drink loads of water
* Sauna at least x3 a week for 20 min to sweat out toxins
* Epsom salt baths help too
* Milk thistle to facilitate detoxification
* I also use antibacterial herb such as clove, black walnut and wormwood on an empty stomach in the morning
And a few other things
It can take a while, but rest assured you’re not alone and like others, there is light at the end of the tunnel.
Hello, I have been diagnosed with SIBO. My naturopath prescriped garlic pills, but I read that Garlic
should be avoided. I am confused.