If you ask ten people what a SIBO diet involves, you’ll likely get ten different answers. Small intestinal bacterial overgrowth (SIBO) is a major culprit behind bloating, gas, and digestive distress—but there’s no one-size-fits-all solution when it comes to diet.
So, what should you actually eat for SIBO relief? While different SIBO diets exist, they all share a common goal: restoring gut balance and reducing uncomfortable symptoms. Unlike traditional diets focused on weight loss, a SIBO diet is designed to heal your gut and support long-term digestive health.
In this guide, we’ll break down the most effective SIBO diet strategies, explore the science behind them, and help you discover which approach may work best for you.
What is SIBO?
Amy Burkhart MD RD
Amy Burkhart MD RD
Diets used for SIBO
Choosing the Right SIBO Diet
There isn’t a one-size-fits-all approach to managing SIBO through diet. The best plan depends on factors like your lifestyle, personal preferences, and any other health conditions you may have.
Your healthcare provider will help determine which diet suits you best. While most SIBO diets are designed for short-term use to reduce symptoms, some can be followed long-term for continued gut health.
Let’s take a closer look at the different diet options and how they can help manage SIBO effectively.
Low FODMAP diet
Probably the best-known dietary intervention for SIBO is the Low-FODMAP diet.
FODMAPs is a term used to describe a group of specific carbohydrates that can cause symptoms in people with IBS, SIBO, or both.
The Low-FODMAP Diet for SIBO
The Low-FODMAP diet is one of the most well-known dietary approaches for SIBO. It targets fermentable carbohydrates (FODMAPs), which can trigger digestive symptoms in people with IBS and SIBO.
FODMAPs are found in foods like onions, garlic, apples, wheat, beans, and asparagus. While research mainly focuses on IBS, many experts believe the diet may also help SIBO, as the two conditions often overlap. Studies show that 60–70% of IBS sufferers experience symptom relief on a Low-FODMAP diet, though research on its direct impact on SIBO is still limited.
This diet is meant to be short-term, followed by a structured food reintroduction phase. Since it can be restrictive, working with a dietitian familiar with Low-FODMAP protocols is recommended.
Amy Burkhart MD RD
Prolon Fasting Mimicking Diet
How Fasting and the ProLon Diet Support Gut Health
Fasting is known to benefit gut health and the microbiome, but sticking to a strict fast can be difficult.
The ProLon Fasting-Mimicking Diet is a 5-day program designed to provide the benefits of fasting while still supplying nutrients and calories. Unlike a full water fast, it helps reduce common side effects like fatigue and headaches. This may sound impossible, but the diet is based on years of scientific research receiving millions of dollars in NIH funding and is currently the subject of over 50 ongoing clinical trials. Currently, ProLon is the only fasting-mimicking diet program available.
While there are no specific studies on ProLon and SIBO, research shows that ProLon can lower inflammation, and fasting in general supports a healthier gut microbiome. I’ve also seen positive results in my own patients.
👉 Learn more in my article on the ProLon diet.
The Specific Carbohydrate Diet (SCD)
The Specific Carbohydrate Diet (SCD) for SIBO
The Specific Carbohydrate Diet (SCD) was created over 100 years ago to treat conditions like ulcerative colitis, Crohn’s disease, and celiac disease. It gained popularity in the 1980s after Elaine Gottschall’s book, Breaking the Vicious Cycle.
The premise behind the SCD is that certain types of carbohydrates increase inflammation and feed the growth of harmful gut bacteria, which in turn interferes with nutrient absorption. This is similar to what happens in SIBO, which is why some use the SCD to manage it.
The SCD works by eliminating most carbohydrates, starving the harmful bacteria in the small intestine. Foods like rice, potatoes, quinoa, legumes, processed meats, and added sugars are excluded, while fruits, vegetables, eggs, fermented dairy, and meats are recommended. The diet follows a strict protocol with little flexibility.
In a recent study comparing the Low-FODMAP diet to the SCD for IBS, participants on the Low-FODMAP diet saw greater symptom relief. However, there are no studies yet specifically on the SCD for SIBO.
While the SCD may help some people, it’s restrictive, time-consuming, and challenging to follow. In my experience, I don’t typically recommend it as a starting point, and if used, it should be done with guidance to ensure nutritional balance.
👉 Learn more about the Specific Carbohydrate Diet and its role in SIBO treatment.
Low Fermentation/Cedars Sinai Diet
The low fermentation diet limits carbohydrates that are not well digested by humans and can be “leftovers” for the gut bacteria to eat.
The Cedars Sinai Diet / Low Fermentation Diet was developed by researcher and SIBO expert Dr. Mark Pimentel. If they eat these “leftovers,” they produce gas and other symptoms. There is some overlap between the low-FODMAP diet and the low-fermentation diet.
Timing is also important in the low-fermentation diet. Eating specific meals and limiting snacks are suggested to allow for “cleansing waves” in the digestive system. These are described as “housecleaning” for the gut. In reality, most, if not all of these diets are often used in conjunction with this type of meal spacing> The low-fermentation diet simply emphasizes the importance of meal spacing. This diet can be followed long-term and focuses on achieving some sense of normalcy while still limiting the odds of SIBO recurrence.
Elemental Diet
An elemental diet is the only diet listed here to treat SIBO; the others are used for long-term management.
It is also the only diet that has been specifically studied as a treatment for SIBO. An elemental diet is a premade liquid drink or powder that is mixed with water. The nutritional components of the formula are broken down already so that your body does not have to do any work. The mixture contains proteins in the form of amino acids and carbohydrates, fat, vitamins, and minerals that are broken down. Some products require you to add MCT oil to the mix. MCT is a form of fat that is already broken down and ready for absorption by the body.
The elemental diet formula is absorbed by the body so quickly that the gut bacteria don’t have time to eat it. Effectively it starves the bacteria to death. Clinical trials show an 80-84% success rate in getting rid of SIBO. The elemental diet is safe( under guidance), effective, and is well-tolerated.
With that success rate, which is great, why not do this with everyone? There are a few reasons; an elemental diet is not appropriate for some people nor desirable for most. It is a two-week, liquid-only, no solid food diet. Most people do not want to “drink” their food for two weeks. It is also expensive, costing upwards of $1500 per treatment, and not typically covered by insurance.
Low Sugar/No concentrated sweets
This is not a specified diet plan but more of a long-term lifestyle change.
After SIBO treatment, the recommendations are to avoid or severely limit processed sugars such as cookies, cakes, candy, soda. Alcohol is also eliminated or drunk in minimal amounts. Complex carbohydrates are preferred over simple carbohydrates. The total amount of daily carbohydrate may be decreased compared to before treatment but not as severely as a Paleo or ketogenic diet. There are no specific research studies on this plan, but recent studies are looking at determining optimal diet diversity for SIBO management. This diet can be useful for someone who is not interested in following the other restrictive diets in hopes that it will limit SIBO recurrence. Unfortunately, it is not uncommon to have to do one of the other dietary interventions temporarily before liberalizing the diet to this plan.
Amy Burkhart MD RD
Paleo Diet
The specific criteria of what “counts” as paleo varies.
The paleo diet is less well-defined than low-FODMAP or SCD diets. In general, the paleo diet eliminates grains, dairy, and processed foods. It also limits sugars. There are no studies looking at the paleo diet as a SIBO intervention. But, it does limit carbohydrate intake significantly and many patients with SIBO say they feel better on a paleo diet.
Amy Burkhart MD RD
Sibo Specific Diet
The guide for this diet has a color-coded guide of permitted foods.
The SIBO specific food guide diet was crafted by Dr. Allison Siebecker and combines the low FODMAP and SCD diets. Like a stoplight, green-coded foods are “legal,” whereas yellow-coded foods are to be eaten with caution in lower amounts. Red-coded foods are “illegal.” The guide gives recommended portion sizes for each food. There are no studies on this diet being used to manage SIBO. It is, however, widely used and anecdotally improves symptoms. It is restrictive and not meant to be followed long term. I have also used it in a “partial” fashion with patients and seen improvement in symptoms. This means patients may follow the guidelines loosely, choosing foods primarily from the list but allowing for some deviation and increased normalcy.
Amy Burkhart MD RD
Biphasic Diet Plan
Amy Burkhart MD RD
Low Histamine Diet
SIBO is considered to be an underlying cause of histamine overproduction, hence the rationale for using this diet.
A low histamine diet may be used in SIBO management if someone is showing signs of histamine intolerance.
And while there has not been research investigating the low-histamine diet and SIBO, it is possible that the low histamine diet will help SIBO symptoms. By report, people are using it to do so. This diet may be used in a variety of ways from minimal to extensive restrictions. It is not meant to be used long-term. Histamine overload symptoms often improve after SIBO treatment and the diet can be expanded. This is an emerging area of interest.
Amy Burkhart MD RD
GAPS Diet
It eliminates sugar and artificial sweeteners, alcohol, processed foods, grains, starchy vegetables, and beans.
GAPS stands for Gut and Psychology Syndrome, a term coined by the diet’s founder Dr. Natasha Campbell-McBride.
The GAPS diet is a strict elimination diet aimed at decreasing gut permeability, otherwise known as a leaky gut. It’s promoted as a natural treatment for people with conditions such as autism, ADHD, Dyslexia, and other neurologic or mental health disorders (8). No published research studies are using the GAPs diet for SIBO management. It does significantly reduce total carbohydrate intake, which may be why SIBO sufferers claim improvement.
No Diet- Antibiotics Only
If there are too many bacteria, why not just treat them with antibiotics? Why address diet at all?
Antibiotics alone are the treatment used by most traditional doctors. Unfortunately, with this option, SIBO often recurs.
Antibiotics (herbal or traditional) will temporarily help SIBO symptoms and are a cornerstone of treatment. But, SIBO relapse rates with antibiotics alone are high. There are several reasons this may happen, but they are beyond the scope of this article.
Because of this high recurrence rate, patients (and practitioners) seek out alternative therapies for SIBO.
In my clinical experience, incorporating diet as a component of long-term management is vital to decreasing the odds of symptoms returning. I am glad to see more research focusing on diet and SIBO. If studies find benefits, more medical doctors will use diet as a component of SIBO management in the future.
Amy Burkhart MD RD
Key Takeaways
Recent Research: The SIBO Diet
- Alternative treatment approaches to SIBO-Review article
- An alternative approach to SIBO-case study
- The role of dietary diversity in the formation of SIBO
- Diet patterns in SIBO
- Diet features of SIBO and IBS-D
- Effects of a Low FODMAP Diet and Specific Carbohydrate Diet on Symptoms and Nutritional Adequacy of Patients with Irritable Bowel Syndrome: Preliminary Results of a Single-blinded Randomized Trial
- Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus