Do you have SIBO? Have you heard about it? I set out to write a simple guide about which diet would help SIBO the most. Once I got started in the science, something entirely different emerged. Please take a deep breath and sit down – you’re in for a wild ride.
Here’s how this story started.
One of my long-term patients was upset. Recently her doctor diagnosed her with small intestinal bacterial overgrowth (SIBO.) He gave her the antibiotic Rifaximin to treat it and a list with foods to eat and foods to avoid. All of these steps were reasonable ones that many doctors would have taken.
When she first heard the news, she was encouraged that she had finally found the hidden cause behind her Hashimoto’s disease and Irritable Bowel Syndrome (IBS.)
She felt better after taking the medicine, but the benefits seemed to go away within a week of finishing it. Why didn’t the benefits last? She was afraid that maybe she didn’t do the diet correctly and did a Google search for ‘best diet for SIBO.’
At first, she saw that some of the SIBO diets were much more restrictive than the one she was following. After reading about a few more she also realized that the diets contradicted one another. Some diets said that foods like walnuts, onions, broccoli, rice were safe, others said they were not.
I got involved when she sent me a note to explain her situation and to ask me what was the best diet for her.
I knew that SIBO experts often recommended diets like the low–Fermentable Oligo-, Di-, and Monosaccharide And Polyol (Fodmaps), Specific Carbohydrate Diet (SCD), and Gut and Psychology Syndrome (GAPS). Before I gave her any input, I wanted to be clear on which had the most compelling evidence, if any, so I decided to look at the medical research.
Before I get into the findings, let me start by saying that I am open minded. I will believe absolutely anything – as long as there is evidence. I’m also cautious. Between following my health and that of my patients, I’ve had about 38 years of seeing health fads come and go. I’m not proud to say that I’ve fallen for some myself, but I am better than I was at avoiding them.
Before I started reading the literature on SIBO, I assumed: SIBO was real, it caused symptoms, it could be accurately tested for, and there were effective treatments for it. When I found inconsistent research, I dug deeper and read everything I could find.
What I found shocked me and I’m not the first to see it. We may learn more in the future that changes things, but at this point, the story about SIBO it is pretty clear.