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eating with sibo

Eating with SIBO

From Low FODMAP to Carnivore, everything you need to know about popular gut health diets

These days it seems like there’s a diet for everything. Advertisements, articles, and stories about various diets have dominated social media, magazines, and every news outlet for decades. With so many people and companies touting the health benefits of an almost endless stream of new nutritional guides and eating plans, it’s become very difficult to sift through the maze of information and claims to discern which food choices are better for you.

 

This is made even more difficult for those who have been diagnosed with, or suspect they may have, a gastrointestinal condition like SIBO (Small Intestinal Bacterial Overgrowth), IMO (Intestinal Methanogen Overgrowth) or ISO (Intestinal Sulfide Overproduction). For people who are struggling with these diagnoses or who experience gut symptoms like diarrhea, constipation, bloating, and changes in bowel habits, researching and trying different diets often becomes a fundamental, but extremely frustrating, part of their journey.

 

The goal of this article is to explore the most common dietary approaches people try when managing microbial overgrowths like SIBO, IMO, and ISO, explain what each one is designed to do, and place them in the larger context of your gut health. Rather than recommending a single “best” diet, we’ll highlight how different eating patterns can influence your symptoms and their underlying causes within your digestive system.

 

But before we begin, a quick disclaimer: As is usually the case when addressing medical conditions, there is no “one size fits all” solution that can be universally applied to all patients in a population. It is vital for you to consult with your healthcare provider(s) to assess your condition, investigate possible causes, and explore which approaches to treatment and management will be most effective for you.

The Relationship Between Food and Microbial Overgrowths

Food doesn’t just nourish you. It also feeds the trillions of microbes living in your digestive tract. In a healthy gut, these microbes (little single-celled organisms like bacteria and archaea) exist in appropriate quantities and they help your system break down fiber and carbohydrates into useful nutrients. But, under certain conditions, these microbes can become overabundant, disrupting the gut microbiome (the community of microbes that live in the gut and help support digestion, immunity, and overall health) and potentially causing a host of difficult gastrointestinal symptoms.

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What we eat changes the amount and type of fuel that’s available to these microbes, affecting their population growth and sometimes leading to dysbiosis–a harmful imbalance in our gut microbiome. Those imbalances can create or aggravate the types of symptoms that millions of Americans struggle with each year: bloating, diarrhea, constipation, abdominal discomfort, and disruptive changes in bowel habits. So, of course, it makes sense that most strategies for managing patients with known or suspected gastrointestinal conditions include at least some element of dietary awareness or modification.

 

With that in mind, let’s dive right in and explore some of the most well-known diets, with a special focus on how they could affect someone with SIBO, IMO or ISO. Please note that food lists are provided as common examples and are not meant to be authoritative or exhaustive. They may change over time as emerging research studies and refines these diets.

Low FODMAP Diet

What is it? The Low FODMAP diet, developed by researchers at Monash University, is probably the most famous diet on this list. It’s often tried by patients with SIBO, IBS (Irritable Bowel Syndrome), and other related conditions. FODMAP stands for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols.​

​Each of these is a fancy term for a different group of carbohydrates (“carbs”) that all have one thing in common: they are more difficult for the small intestine to absorb, so they often end up feeding the microbes in your gut, leading to excessive gas production, bloating, and other uncomfortable symptoms.

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​How does it work? The idea behind the Low FODMAP diet is straightforward: if you eliminate your intake of FODMAP carbs, you will reduce the amount of fermentation and gas production happening in your intestines, making symptoms more manageable.

low fodmap diet

The Low-FODMAP diet is usually recommended in conjunction with other treatments like antibiotics, and it is not generally intended to be a permanent solution. Long-term restriction of FODMAPs can negatively impact the gut microbiome, limiting its diversity and effectiveness, while also leading to a potential for nutrient deficiencies. Instead, the Low FODMAP diet is typically followed for two to six weeks (or the length of time your doctor recommends based on your personalized treatment plan), after which foods are systematically reintroduced to identify individual triggers.

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Pros: Strong evidence for IBS and IBS-type symptom relief, structured approach, helps identify specific triggers as you reintroduce foods

 

Cons: Can feel restrictive during elimination phase, not designed specifically for SIBO, not generally recommended for long-term use

 

Foods to Avoid (High-FODMAP):​

  • Garlic and onions

  • Wheat, rye, and barley (in large amounts)

  • Milk, yogurt, and soft cheeses (lactose)

  • Apples, pears, watermelon, and stone fruits

  • Beans, lentils, and chickpeas

  • Sweeteners like sorbitol, mannitol, and xylitol

 

Foods to Choose (Low-FODMAP):​

  • Carrots, spinach, zucchini, and bell peppers

  • Bananas (unripe), blueberries (in small quantities), grapes, and oranges

  • Lactose-free milk, hard cheeses, and many plant-based milks (like almond)

  • Gluten-free grains (rice, oats, quinoa)

  • Chicken, eggs, tofu (not silken), and most fish

  • Olive oil and small amounts of maple syrup

Low Fermentation Eating

What is it? Due to the limitations and nutritional concerns associated with indefinite adherence to the Low-FODMAP Diet, renowned gastroenterologist Dr. Mark Pimentel and his team at Cedars-Sinai developed a more sustainable dietary approach: Low-Fermentation Eating (LFE). LFE focuses on reducing fermentable foods while emphasizing consistent meal timing and limiting problematic foods to minimize bacterial overgrowth.

How does it work? LFE reduces fermentable substrates for gut microbes, while also focusing on maximizing healthy spacing between meals. Spacing meals four to five hours apart allows your Migrating Motor Complex (MMC) to more thoroughly and rhythmically sweep bacteria out of the small intestine between meals. This is particularly important for preventing the recurrence of SIBO and IMO, as poor motility (movement of food through your digestive system) is a major contributing factor in bacterial overgrowth.

low fermentation diet

​Pros: Created specifically for SIBO/IMO patients, can be easier to follow for some people, focuses on both food choice and meal timing


Cons: Still somewhat restrictive, may be easier to follow with professional guidance

 

Foods to Avoid:​

  • Beans and legumes (lentils, chickpeas, black beans)

  • Certain vegetables (cabbage, Brussels sprouts, broccoli, cauliflower, asparagus)

  • Whole grains (whole wheat breads, multigrain breads, oats)

  • Dairy products with lactose (milk, yogurt, soft cheeses)

  • Certain fruits (apples, ripe bananas, dates, dried fruits, figs, pears, prunes, raisins)

  • Sweeteners (sucralose/Splenda™, sugar alcohols like sorbitol, xylitol)

  • Gums and thickeners (gum Arabic, xanthan gum, carrageenan)

 

Foods to Choose:​

  • Refined carbohydrates: White bread (sourdough, French, potato bread), white rice

  • Proteins: Beef, chicken, fish, pork, eggs

  • Non-cruciferous vegetables: Peppers, tomatoes, carrots, cucumbers, zucchini, squash, eggplant, potatoes

  • Fruits: Strawberries, blueberries, raspberries, oranges, grapefruit, lemons, limes, cantaloupe, honeydew, grapes, kiwi, pineapple, papaya

  • Dairy: Lactose-free milk, hard cheeses (cheddar, Parmesan)

  • Nuts and seeds: Almonds (small servings), walnuts, pecans, macadamia nuts, sunflower seeds, pumpkin seeds

  • Oils and fats: Olive oil, coconut oil, butter (in moderation)

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Meal Timing Recommendations:​

  • Structured meals without frequent snacking

  • At least 4-hour gaps between meals

  • Avoid late-night eating to support gut motility

Elemental Diet

What is it? The Elemental Diet isn’t a typical “diet”. Think of it as more of a medical nutrition therapy–a powerful gut reset–which can be especially useful for those with severe or recurrent SIBO, IMO, or ISO. Since it aims to bring your gut back in balance using a heavily nutrition-focused approach, doctors sometimes recommend the Elemental Diet in cases where antibiotics aren’t effective or well-tolerated.

How does it work? With the Elemental Diet, patients consume a liquid-only formula that provides fully broken-down nutrients (such as amino acids, simple carbs, and fats) in forms that are easily absorbed in the gut without requiring fermentation. By depriving bacteria of their food source, the diet essentially starves out your bacterial overgrowth while still providing essential nutrition. Studies show that the elemental diet has a high success rate, with some reports indicating that up to 80% of individuals experience a significant reduction in bacterial overgrowth after following the diet for two to three weeks.​

elemental diet

However, because it requires strict adherence to a specific liquid diet, it can be challenging for some people due to issues like taste, cost, lifestyle challenges, and calorie restrictions. Additionally, the Elemental Diet is generally not recommended without the supervision and guidance of an appropriate healthcare provider.

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Pros: High success rate under appropriate conditions, potential to provide fast symptom relief, useful when other treatments aren’t an option


Cons: Can be expensive or unpalatable for some patients, not sustainable long-term, generally requires close medical oversight

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Foods to Avoid: All whole foods during the active treatment phase

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Foods to Choose: The Elemental Diet formula

SIBO Biphasic Diet

What is it? The SIBO Biphasic Diet is a structured eating plan developed by Dr. Nirala Jacobi, ND, focused specifically on people diagnosed with SIBO. It’s a phased dietary protocol designed to limit foods that are more likely to ferment in the small intestine, such as certain fibers, legumes, and high-FODMAP fruits.

The “Biphasic” part of the name refers to the diet being structured into two phases. In the first phase, restricted foods are reduced or eliminated to help minimize bloating, gas, and abdominal discomfort. The second phase focuses on carefully reintroducing previously restricted foods to restore dietary diversity and reduce the risk of nutrient deficiencies.

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How does it work? The phased design is intended to both address the symptoms in the short term and make the diet more sustainable over time. By removing fermentable carbohydrates during phase 1, the diet reduces the fuel needed for bacterial overgrowth. Then, phase 2 aims to expand the diet, helping patients regain nutritional balance and restore their gut microbiome.

sibo biphasic diet

Pros: Structured specifically for aiding in SIBO management, may reduce common symptoms during the restriction phase, reintroduction phase helps restore diversity and balance

 

Cons: Limited clinical research compared to other diets, heightened restrictions in phase 1 may be difficult for some people, requires close medical oversight

 

Foods to Avoid (Phase 1):​

  • High-FODMAP fruits (such as apples, pears, mangoes)

  • Legumes and beans

  • Wheat, rye, and barley products

  • Certain dairy products containing lactose (like most soft cheeses, milk and yogurt)

  • Onions, garlic, and other high-fermentable vegetables

 

Foods to Choose (Phase 1):​

  • Lean proteins (like poultry, fish, eggs)

  • Non-starchy vegetables that are lower in FODMAPs (like zucchini, carrots, spinach)

  • Gluten-free grains such as rice or quinoa (in moderation)

  • Lactose-free dairy or alternatives (like hard cheeses, lactose-free milk, almond milk)

  • Healthy fats (like olive oil, avocado, small portions of nuts/seeds as tolerated)

 

Phase 2 then broadens the Foods to Choose categories by gradually reintroducing foods, with adjustments dependent on individual tolerance and symptom response. Because of the complex nature of the SIBO Biphasic Diet, it is generally not recommended without the supervision and guidance of an appropriate healthcare provider.

Carnivore Diet

What is it? The Carnivore Diet is an extreme elimination diet that removes all plant-based foods and focuses exclusively on animal-based products such as meat, fish, eggs, and some dairy. Although not created for people with SIBO or IBS, it has gained some popularity among people experimenting with ways to reduce bloating, gas, or other gut symptoms.

How does it work? The idea is simple: if fermentable carbohydrates are the main fuel for gut microbes, removing them entirely should reduce fermentation and gas. With only animal proteins and fats on the menu, there’s less fuel left for bacteria or archaea to break down. Some anecdotal reports indicate symptom relief when adopting this approach. However, the diet also removes many sources of fiber, antioxidants, and plant-based nutrients that support overall health, and there is very little clinical research showing it manages or treats SIBO.

carnivore diet

Pros: May provide fast symptom relief by eliminating fermentable carbs, comparatively straightforward food list

 

Cons: Extremely restrictive list of foods, high risk of nutrient deficiencies over time, not yet supported by formal studies with IBS or SIBO patients, not appropriate for people who don’t eat meat for personal, cultural, or religious reasons

 

Foods to Avoid:​

  • All vegetables

  • All fruits

  • All grains and legumes

  • Nuts and seeds

  • All sugars and sweeteners

 

Foods to Choose:​

  • Beef, chicken, pork

  • Fish, shellfish

  • Eggs

  • Butter, ghee (amounts of dairy allowed may vary)

  • Some dairy, such as hard cheese may be allowed

Anti-Inflammatory Diet

What is it? An Anti-Inflammatory Diet isn’t a single, rigid plan, but rather a way of eating that emphasizes foods believed to calm inflammation in the body. It sometimes resembles the Mediterranean diet, which highlights fruits, vegetables, olive oil, fish, legumes, and whole grains. Some people also try variations which remove gluten or dairy from their diets as well, since these have also been linked to inflammation and gut distress in some people.

How does it work? The theory here is that reducing chronic inflammation can help soothe the gut environment and improve overall health. While these diets don’t target microbial overgrowth directly, they may decrease gut irritation, improve nutrient intake, and support a broader approach to digestive wellness. Anti-inflammatory diets are also more sustainable than other more extreme diets, making them a more appealing complement to specific therapeutic approaches for SIBO, IMO, and ISO.

anti-inflamatory diet

Pros: Balanced and more sustainable over time, anti-inflammatory foods may provide potential benefits beyond just digestive health, flexible and adaptable to some personal preferences

 

Cons: Not designed to treat microbial overgrowths, may not provide similar symptom relief to other, more targeted diets, lack of standardized protocols make it harder to follow

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While anti-inflammatory diets have some similarities, their variations make it more difficult to make a definitive list of foods to avoid or choose, but some of the more common examples are provided below for reference. It should be noted that some of the foods encouraged for anti-inflammatory diets may be at odds with the more focused list of foods you would follow when adhering to a SIBO-specific diet like Low Fermentation Eating. So, medical guidance is strongly recommended when making nutritional choices.

 

Foods Often Limited or Avoided:​

  • Processed foods (like chips or frozen meals high in additives)

  • Refined and processed carbs (like sugary cereals, candy, and soda)

  • Fried foods

  • Foods with excess added sugars

  • Processed meats (like some bacon, hot dogs, and deli meats)

  • Dairy or gluten, if not well-tolerated

 

Foods Often Emphasized:​

  • Fruits (berries, citrus, apples in moderation)

  • Vegetables (leafy greens, zucchini, carrots)

  • Healthy fats (olive oil, nuts, seeds, avocado)

  • Fish and lean meats

  • Whole grains (rice, quinoa, oats, gluten free grains if needed)

Dr. Pimentel

"Diet alone won’t cure SIBO."  —Dr. Mark Pimentel

Final Thoughts

We hope you’ve found this article useful. If you haven’t already, go ahead and take a look at the other articles in our SIBO Resources section. Diet is an important piece of the puzzle, but it is only one piece. As Dr. Pimentel notes in his landmark book The Microbiome Connection, “diet alone won’t cure SIBO.” Testing, medications, lifestyle changes, and other therapies often play an important role, as well.

 

Finding answers on your gut health journey can be a difficult and painstaking process. But don’t give up! If you’ve received a diagnosis of SIBO, IMO, ISO, or IBS, or if you’re struggling with symptoms like bloating, diarrhea, constipation, excessive gas, or abdominal discomfort, you deserve to find support and relief.

FAQ

What is the SIBO diet?

There is no singular diet referred to definitively as “The SIBO Diet”. Instead, there are sets of dietary approaches, like the Low FODMAP Diet or Low Fermentation Eating that are aimed at reducing foods that feed bacteria in the small intestine. These diets often help manage your symptoms but do not cure SIBO on their own.

Can you eat potatoes on a SIBO diet?

Generally, yes. But it can depend on the type of potato and how it’s prepared. White potatoes are generally considered low in FODMAPs when eaten in moderation and are often well-tolerated. Sweet potatoes contain more fermentable carbohydrates and may cause symptoms in some people. Fried potatoes in any form are usually discouraged. Because tolerance varies, experimentation with portion size and types of potatoes may be necessary to determine if they are appropriate for you.

Is a Carnivore Diet good for SIBO?

The Carnivore Diet eliminates all plant foods, which may reduce fermentable carbs that bacteria feed on. However, it lacks fiber and key nutrients, and it’s generally not recommended as a first-line SIBO therapy. Medical guidance is strongly recommended when considering your nutritional choices, especially one that may adversely impact your overall health.

What can you eat on a SIBO diet?

This is a complex question, which is dependent on many factors, including which diet you are adhering to and the personal nutritional needs that are best suited for your case. In general, many common proteins (meat, fish, eggs), vegetables (zucchini, carrots, spinach), lactose-free dairy, and lower-fermenting fruits (berries, oranges, grapes) are better suited for people with microbial overgrowths. Take a look at the lists of foods provided above for reference, and also consult with your healthcare provider(s) about which choices are right for you.

Can I eat popcorn on a SIBO diet?

Popcorn is usually avoided because it is high in insoluble fiber and can be difficult to digest, potentially worsening symptoms.

Can you cure SIBO with diet alone?

No, diet alone is generally not considered sufficient to cure SIBO. Dietary changes can ease symptoms, support recovery, and possibly help you to avoid a SIBO recurrence, but antibiotics or other medical treatments are usually needed to eradicate bacterial overgrowth.

Can you eat chia seeds on a SIBO diet?

Chia seeds are usually avoided because their soluble fiber can ferment in the small intestine and worsen bloating or gas.

Can you eat corn on a SIBO diet?

Corn is generally avoided because it contains fermentable carbs and fiber that can trigger symptoms in SIBO patients.

Can you eat eggs on a SIBO diet?

Yes, eggs are usually a well-tolerated protein source on nearly all SIBO diets and do not contribute significantly to fermentation.

Does the Elemental Diet cure SIBO?

Research shows that a properly administered elemental diet can potentially resolve SIBO in some cases, but it should be medically supervised due to its restrictive nature. Since the elemental diet process can be difficult for some patients, it is generally not utilized as a first-line treatment for SIBO, and is more often reserved for patients for whom antibiotics and other therapies are not tolerated or have proven ineffective.

Is Diet Coke Low FODMAP?

Yes, Diet Coke is considered Low FODMAP because it contains no fermentable carbs. However, it still may not be suitable for those struggling with SIBO or other digestive conditions, since carbonation and artificial sweeteners have been found to trigger gut symptoms in some people.

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