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SIBO
SIBO

What Foods to Avoid with SIBO?

Christa Brown, MS, RDN, LD
Author: 
Medical Reviewer: 
Christa Brown, MS, RDN, LD
|
Author: 
Heather Smith, RN, BSN
Published:
March 12, 2024
Updated on
#
min read
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Table of Contents

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SIBO

Key Takeaways

  • If you have SIBO, avoiding certain foods may help you manage your symptoms, such as FODMAPS, sugary foods, high-fiber foods, and dairy. 
  • Foods that trigger SIBO symptoms may differ from person to person. It’s advisable to seek the guidance of a registered dietitian to help determine your trigger foods.  
  • Dietitians are experts in nutrition and may help you improve SIBO symptoms through diet and lifestyle changes.

Having bacteria and other microorganisms in your intestines is natural and even beneficial.

Experts call these beneficial microbes your gut microbiome.

However, sometimes, the volume and type of bacteria can become unbalanced and lead to digestion problems.

Small intestinal bacterial overgrowth (SIBO) is a condition in which the small intestines have an overgrowth of bacteria, leading to symptoms such as bloating, gas, and changes in bowel movements. 

Avoiding certain foods can help people manage their SIBO symptoms while undergoing treatment for bacterial overgrowth.

However, food triggers vary per person, and a dietitian can help you determine if any of your food choices are affecting your symptoms.  

Discover why avoiding certain foods may help you manage your symptoms.

Also, learn which foods are generally safe to eat if you have SIBO and some alternative treatment options.

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What Is The SIBO Diet?

The SIBO diet is a nutritional approach designed to manage symptoms related to the overgrowth of bacteria in the small intestines. 

While there’s no specialized SIBO diet, certain dietary changes may help you reduce the intensity of your symptoms.

However, each person’s journey with SIBO is different, and foods that may trigger one person’s symptoms may not trigger yours. 

To discover the link between diet and SIBO symptoms, many people will go on a short-term elimination diet, then, with the guidance of a dietitian, slowly reintroduce foods back in. 

A dietitian is an expert on the connection between digestive health and nutrition and can guide you on how to safely and effectively complete an elimination diet to help you get maximum results.

According to the American Journal of Gastroenterology, the most common recommendations are reducing or eliminating:

  • High-fiber foods.
  • Alcohol sugars (xylitol, erythritol, maltitol, sorbitol).
  • Sucralose (Splenda).
  • Inulin and other prebiotic foods (foods that feed the bacteria).

An elemental diet, a liquid diet that contains easy-to-digest nutrients, is another route some experts recommend.

Sometimes, this diet can help the digestive system reduce inflammation and heal.

However, the elemental diet requires detailed calculations to ensure you get enough nutrition, and always needs to be done under medical supervision.

How Diet Affects Bacterial Overgrowth 

Just like you need nutrition to survive, bacteria also need nutrition to flourish and grow. 

Some foods you eat may actually be fueling your bacteria more than they are fueling you.

When you eat these foods, the bacteria digest them and create gas in the process, giving you uncomfortable symptoms. 

Eating these types of foods on a regular basis may increase your SIBO symptoms.

‍Common SIBO symptoms include:

  • Abdominal pain.
  • Gas.
  • Bloating.
  • Nausea.
  • Feeling Full.
  • Distended abdomen.
  • Diarrhea.
  • Sometimes constipation.

Cutting down on foods that feed your bacteria may help decrease your SIBO symptoms.  

However, it’s important to note that some research says diet changes alone do not get rid of SIBO.

While symptoms may decrease sometimes, other treatments, such as antibiotics, are required to reverse SIBO. 

Foods To Avoid For Managing SIBO 

Dealing with SIBO can be complicated because your gut microbiome is constantly evolving.

It’s advisable to work with a dietitian to determine which foods may be triggering your SIBO symptoms. 

They will suggest which foods to cut and help monitor your symptoms.

They will also offer guidance on how and when to introduce foods back into your diet. 

High-FODMAP Foods

FODMAP is an acronym for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.

These foods contain short-chain carbohydrates that are difficult for some people to digest (especially if you have irritable bowel syndrome). 

However, the bacteria in your intestines may love them.

The process of the bacteria digesting these foods causes increased fermentation in your intestines, which may exacerbate your SIBO symptoms. 

Nevertheless, research on how FODMAPs affect SIBO is still limited.

You may feel better after cutting these foods out or feel at peace knowing that these foods don’t affect your symptoms at all.

Examples of high FODMAP foods you may want to avoid include:

  • Foods with glucose, fructose, maltose, and sucrose.
  • Garlic.
  • Onions.
  • Beans.
  • Broccoli.
  • Brussels sprouts.
  • Honey and high fructose corn syrup.
  • Some fruits.
  • Milk and dairy products.
  • Wheat.

Sugars And Sweeteners 

Bacteria thrive on sugars and several types of sweeteners. 

Numerous human and animal studies show that diets high in sugar throw off the balance of good gut bacteria versus harmful bacteria and increase inflammation. 

Because it’s important to maintain a balance of gut bacteria, experts recommend cutting out alcohol sugars and other fermentable sweeteners.

These can include:

  • Jams and jello (regular and sugar-free).
  • Honey.
  • Agave.
  • Karo syrup.
  • Molasses.
  • Brown rice syrup.
  • Granulated (white) sugar.
  • Brown Sugar.
  • Maple syrup.
  • Pancake syrup (including sugar-free and fruit-flavored).
  • High fructose corn syrup.
  • Crystalline fructose.
  • Evaporated cane juice.
  • Sugar alcohol (sorbitol isomalt, lactitol, maltitol, mannitol, xylitol, erythritol, lactitol).

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High-Fiber Foods

Research is conflicting on whether people with SIBO should avoid high-fiber foods.

Some experts recommend cutting out fiber as it may increase fermentation in the small intestine.

On the other hand, other research suggests that vegan and vegetarian diets high in fiber have been beneficial in decreasing SIBO symptoms. 

Because of the conflicting information, it’s best to work with a dietitian and discover if high-fiber foods affect your SIBO symptoms with their expert guidance.

Examples of foods high in fiber include:

  • Lettuce and other leafy greens.
  • Asparagus.
  • Broccoli.
  • Artichokes.
  • Squash.
  • String beans.
  • Lentils and beans.
  • Nuts and seeds.
  • Peaches.
  • Apples.
  • Figs.
  • Whole grains.
  • Brown rice.
  • Quinoa.
  • Bran.

Dairy Products 

Some people with SIBO may not be able to digest lactose, the carbohydrate found in milk and dairy products (yogurt, cheese, sour cream). 

However, research still needs to clarify if this a true lactose intolerance or a by-product of unbalanced microbes.

Some experts believe the onset of lactose intolerance may be related to the bacteria not tolerating lactose rather than the person missing lactate—the enzyme needed to digest lactose.

This distinction could change long-term treatment approaches, and hopefully researchers will have more insight soon. 

For now, know that some people with SIBO may feel better cutting out dairy, while others may have no change in symptoms. 

Work with a dietitian to determine if cutting out dairy is right for you. 

Safe SIBO Foods to Eat Instead

Here is a list of safe foods to eat for SIBO taken from the University of West Virginia Digestive Health Center. 

Proteins

  • Beef, pork, lamb, chicken, turkey, duck, fish, shellfish, eggs, milk

Plant proteins

  • Tofu, tempeh, unsweetened peanut butter, unsweetened almond butter, nuts and seeds (1 oz or less per serving)

Grains

  • Breads: sandwich, pita, rolls, biscuits, naan, bagels, English muffins, cornbread, tortillas, bread sticks
  • Starches: pasta, noodles, rice, bread stuffing  
  • Unsweetened breakfast cereals: Cheerios, Corn Flakes, Total, Rice Krispies, Chex, Special K, Kix  
  • Hot unsweetened cereals: oatmeal, Cream of Wheat/farina, cream of rice, grits  
  • Breakfast breads: pancakes and waffles (without syrup—both regular and sugar free), plain, corn, and English muffins, rice cakes  
  • Snack foods: crackers (saltines, club, soda, matzo), cheese nips, goldfish, potato chips

Fruits

  • No more than ½ cup applesauce daily OR 1 small piece of fresh fruit daily.  
  • Talk to your Registered Dietitian about whether you should cut fruit out altogether when starting this diet.

Vegetables

  • Starchy vegetables (no more than ½ cup at a meal): white potato, butternut squash  
  • Non-starchy vegetables (no more than ½ cup at a meal): green beans, carrots, spinach, kale & other greens, tomato

Dairy

  • Plain milk, plain yogurt, plain kefir, cottage cheese, hard cheeses, soft cheeses

Beverages

  • Water  
  • Herbal teas  
  • Unsweetened tea

Condiments and sweeteners

  • Oil, vinegar, mayonnaise, mustard, salad dressings free of banned ingredients (see sugars to avoid above)
  • Splenda, Equal, Sweet N Low, Stevia

Other Tips for Managing SIBO

Because SIBO is a complicated condition and more research is needed to understand it better, you may need to incorporate several treatments to find what works best for you. 

Antibiotics are typically the first line of treatment for SIBO, and sometimes several rounds of treatment are needed.

However, due to the increase of antibiotic-resistant bacteria strains, medical professionals are looking for other methods of treating SIBO. 

Several natural treatments for SIBO may include:

  • Taking a probiotic and prebiotic
  • Taking digestive enzymes before eating.
  • Using herbal antimicrobial agents.
  • Finding ways to reduce stress.
  • Trying intermittent fasting.
  • Oil of oregano.

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Takeaway

SIBO is a condition in which the small intestines have an overgrowth of bacteria, leading to uncomfortable symptoms such as bloating, gas, nausea, diarrhea, or constipation. 

While research is still limited on this topic, some studies recommend cutting out certain foods such as high FODMAPs, sugars, high-fiber, and dairy to decrease fermentation in the intestines and help manage symptoms. 

Which foods to avoid can vary from person to person, and working with a dietitian can be helpful while you work through this complicated condition.

How a Dietitian Can Help

A dietitian is specially trained in the nutritional management of digestive conditions, including SIBO.

They have intricate knowledge of how foods and beverages affect the digestive system and can offer evidence-based suggestions to help you discover your food triggers. 

Talk with a SIBO dietitian today for expert and personalized advice on managing your SIBO symptoms and learn ways to resolve bacterial overgrowth. 

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Frequently Asked Questions

What foods make SIBO worse?

Certain foods may cause SIBO symptoms to be worse, but the types of foods that exacerbate symptoms may differ from person to person.

Some common triggers are FODMAPs, sugars, high-fiber foods, and dairy products.

What naturally kills SIBO?

Natural approaches for managing SIBO can include taking probiotics, herbal antimicrobials, reducing stress, intermittent fasting, and oil of oregano.

However, managing SIBO is complicated, and working with a dietitian for personalized advice is advised.

‍

Can I eat potatoes if I have SIBO?

Potatoes are generally considered low in FODMAPs and may be a good option for people with SIBO.

However, foods that trigger SIBO symptoms can vary, and it’s advisable to seek personalized guidance from a dietitian.

‍

References

View all references

Microbiome. (2023). National Institute of Environmental Health Sciences. 

‍

Pimentel, M., et al. (2020). ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. The American Journal of Gastroenterology.

‍

Sorathia, E., et al. (2023). Small Intestinal Bacterial Overgrowth. StatPearls.

‍

Pimentel, M., et al. (2004). A 14-day elemental diet is highly effective in normalizing the lactulose breath test. Digestive diseases and sciences.

‍

Diet for Those with Symptomatic Small Bowel Bacterial Overgrowth. (2016). University of Virginia Digestive Health Center. 

‍

Souza, C., et al. (2022). Diet and intestinal bacterial overgrowth: Is there evidence? World Journal of Clinical Cases. 

‍

O Achufusi, T. G., et al. (2020). Small Intestinal Bacterial Overgrowth: Comprehensive Review of Diagnosis, Prevention, and Treatment Methods. Cureus. 

‍

Low FODMAP diet. (2023). MedlinePlus.

‍

Satokari, R. (2020). High Intake of Sugar and the Balance between Pro- and Anti-Inflammatory Gut Bacteria. Nutrients. 

‍

High-Fiber Foods. (2022). MedlinePlus.

Nourish has strict sourcing policies and prioritizes primary sources, including medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about our medical review process and editorial guidelines.

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, 
CA
California
33.875670, -117.568840
Madison
, 
WI
Wisconsin
43.073051, -89.401230
Huntsville
, 
AL
Alabama
34.7014286, -86.6597495
Kansas City
, 
MO
Missouri
39.099728, -94.578568
Irvine
, 
CA
California
33.684566, -117.826508
Chula Vista
, 
CA
California
32.640072, -117.084038
Denton
, 
TX
Texas
33.215530, -97.132446
Aurora
, 
IL
Illinois
41.7571701, -88.3147539
Baton Rouge
, 
LA
Louisiana
30.4494155, -91.1869659
Columbus
, 
OH
Ohio
39.961178, -82.998795
Baltimore
, 
MD
Maryland
39.2908816, -76.610759
Detroit
, 
MI
Michigan
42.331429, -83.045753
Chesapeake
, 
VA
Virginia
36.7183708, -76.2466798
Birmingham
, 
AL
Alabama
33.5206824, -86.8024326
Scottsdale
, 
AZ
Arizona
33.501324, -111.925278
Cincinnati
, 
OH
Ohio
39.103700, -84.513610
North Las Vegas
, 
NV
Nevada
36.201946, -115.120216
Riverside
, 
CA
California
33.980602, -117.375496
Plano
, 
TX
Texas
33.019844, -96.698883
Minneapolis
, 
MN
Minnesota
44.977753, -93.265015
Salinas
, 
CA
California
,
Anaheim
, 
CA
California
33.836594, -117.914299
Springfield
, 
MO
Missouri
37.208958, -93.292297
Fort Wayne
, 
IN
Indiana
41.077469, -85.137489
Phoenix
, 
AZ
Arizona
33.448376, -112.074036
Bakersfield
, 
CA
California
35.3738712, -119.0194639
Garden Grove
, 
CA
California
33.774269, -117.937996
Anchorage
, 
AK
Alaska
61.2163129, -149.894852
Indianapolis
, 
IN
Indiana
39.768402, -86.158066
Nashville
, 
TN
Tennessee
36.162663, -86.781601
Tempe
, 
AZ
Arizona
33.425522, -111.941254
Mobile
, 
AL
Alabama
30.695366, -88.039894
New Orleans
, 
LA
Louisiana
29.951065, -90.071533
Knoxville
, 
TN
Tennessee
35.960636, -83.920738
Grand Rapids
, 
MI
Michigan
42.963360, -85.668083
Fontana
, 
CA
California
34.102890, -117.435760
Elk Grove
, 
CA
California
38.418129, -121.393257
Miami
, 
FL
Florida
25.7825389, -80.3118603
Grand Prairie
, 
TX
Texas
32.745499, -97.003532
Fort Collins
, 
CO
Colorado
40.588970, -105.082458
Killeen
, 
TX
Texas
31.117119, -97.727798
Modesto
, 
CA
California
37.639095, -120.996880
Oklahoma City
, 
OK
Oklahoma
35.468491, -97.521263
Santa Ana
, 
CA
California
33.745571, -117.867836
Ontario
, 
CA
California
34.063343, -117.650887
Brownsville
, 
TX
Texas
25.9015688, -97.4984005
Montgomery
, 
AL
Alabama
32.379223, -86.307739
Hialeah
, 
FL
Florida
25.857595, -80.278107
Springfield
, 
MA
Massachusetts
42.102051, -72.585762
Toledo
, 
OH
Ohio
41.652805, -83.537865
Pembroke Pines
, 
FL
Florida
26.007765, -80.296257
Overland Park
, 
KS
Kansas
38.974819, -94.683601
Little Rock
, 
AR
Arkansas
34.746483, -92.289597
Glendale
, 
CA
California
34.142509, -118.255074
Roseville
, 
CA
California
38.752125, -121.288010
Rancho Cucamonga
, 
CA
California
,
Wichita
, 
KS
Kansas
37.687176, -97.330055
Huntington Beach
, 
CA
California
33.659485, -117.998802
Augusta
, 
GA
Georgia
33.4709714, -81.9748429
Worcester
, 
MA
Massachusetts
42.271389, -71.798889
Virginia Beach
, 
VA
Virginia
36.852924, -75.977982
Oceanside
, 
CA
California
33.1958696, -117.3794834
Santa Clarita
, 
CA
California
34.456043, -118.571335
Philadelphia
, 
PA
Pennsylvania
39.952583, -75.165222
Corpus Christi
, 
TX
Texas
27.800583, -97.396378
Portland
, 
OR
Oregon
45.512230, -122.658722
Denver
, 
CO
Colorado
39.739235, -104.990250
Boston
, 
MA
Massachusetts
42.3554334, -71.060511
Atlanta
, 
GA
Georgia
33.7489924, -84.3902644
Chicago
, 
IL
Illinois
41.8755616, -87.6244212
Orlando
, 
FL
Florida
28.538336, -81.379234
Jacksonville
, 
FL
Florida
30.332184, -81.655647
Tampa
, 
FL
Florida
27.950575, -82.457176
Long Island
, 
NY
New York
40.757801, -73.940033
Queens
, 
NY
New York
40.728226, -73.794853
Bronx
, 
NY
New York
40.8466508, -73.8785937
Staten Island
, 
NY
New York
40.643501, -74.076202
Brooklyn
, 
NY
New York
40.6526006, -73.9497211
New York
, 
NY
New York
40.712776, -74.005974
San Jose
, 
CA
California
37.342205, -121.851990
San Francisco
, 
CA
California
37.774929, -122.419418
San Diego
, 
CA
California
32.834686, -117.130775
Los Angeles
, 
CA
California
34.052235, -118.243683
El Paso
, 
TX
Texas
31.761877, -106.485023
San Antonio
, 
TX
Texas
29.387428, -98.496574
Dallas
, 
TX
Texas
32.776665, -96.796989
Fort Worth
, 
TX
Texas
32.755489, -97.330765
Houston
, 
TX
Texas
29.760427, -95.369804
Austin
, 
TX
Texas
30.2711286, -97.7436995
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