The following is intended to give a simple background for the reasons behind the diets on this website as well as to give some insight as to the ingredients that may or may not be included in the recipes on Posh Belly’s Kitchen. This should not be construed as medical advice. If you are experiencing GI symptoms, please contact your doctor’s office and schedule an appointment for review of symptoms and referrals to the proper specialists and testing facilities.
My down and dirty answer to the question, “What is SIBO?” is the following: SIBO is an acronym for Small Intestinal Bacterial Overgrowth (also known as SBBO or Small Bowel Bacterial Overgrowth). SIBO occurs when the good, healthy bacteria that is supposed to live within the colon with intermittent visits to the small bowel gets naughty and throws an ongoing rager in the small bowel. In the case of methane producing SIBO, methanogenic archaea known as Methanobrevibacter smithii (aka M. smithii) form a bloom in the large intestine. As with any out of control party, mayhem and destruction may ensue and the aftermath can be devastating. SIBO is now known to be one of the leading causes of previously unexplained cases of IBS. Symptoms and repercussions of SIBO may include bloating, GI distress, changes in bowel habit, malabsorption, nausea, loss of appetite, weight gain or loss, exhaustion, muscle pain, and more. These symptoms are not in your head and can be alleviated or cured with proper treatment.
Recommended reading for more information on SIBO, its causes, proper testing, and advisable treatments:
**These resources are some of the most accessible and reliable sources of information on the topic. There are many technical medical journal articles available as well. Please be careful, as there are an ever-increasing number of people promoting unscientific testing methods and treatments that do not follow the research.
The diet that has helped me finally have great success in my SIBO treatment after nearly a decade of actively struggling for improvement is the Low Fermentation Diet, formerly known as the Cedars Sinai Diet, recommended by Dr. Pimentel.
(With the permission of Dr. Pimentel, I have summarized the diet below. Please DO NOT reprint or publish in any form without prior permission. Please do share this page by linking to it as often as your heart delights!)
Allowable food categories: Fats, proteins, and simple/easily digestible carbohydrates such as sucrose and glucose or dextrose (aka D:glucose) are allowed. Digestive enzymes may be helpful.
SIBO safe Fats: Olive oil, ghee, coconut oil, avocado oil, etc.
SIBO safe Proteins: Eggs, seafood, poultry, beef, pork, isolated protein powders, lactose free or very low lactose dairy products such as hard aged cheeses and lactose free milk or cottage cheese, and fermented soy proteins such as tofu or tempeh. Caution: Be careful of any seasonings or other additives that would fall into the disallowed category.
SIBO safe Carbohydrates: White rice, potatoes, sweet potatoes, white/sourdough breads, nuts, lactose free chocolate, etc.
SIBO safe Fruits and Vegetables: Any fruit "vegetables" such as eggplant, pepper, tomatoes, zucchini, peas, squash, etc. Any roots or bulbs such as beets, carrots, alliums, etc. Fungus. (Yay mushrooms!!) Salad greens must be limited to a side portion and not be the main meal. Any fruit not included in the disallowed list is allowed but keep in mind that fructose should be limited. Hint: It is easier for the human body to digest cooked fruits and vegetables than it is to digest raw.
SIBO Safe Drinks: Lactose free milk. Soy milk made from protein only - not whole bean. Nut milks. Water. Herbal tea.
Disallowed food categories: Anything that is not easily digestible by the human body will provide fodder for the bacteria. Foods high in fibre and fermentable carbohydrates or sugar alcohols such as Sucralose (Splenda), Sorbitol, Xylitol, Lactulose, etc, cannot be digested by the human body and must be avoided. Fructose and lactose are difficult to digest and should be limited. Most SIBO patients should also avoid probiotics and probiotic foods such as yoghurt or fermented vegetables as they will contribute to the bacterial load.
DISALLOWED Carbohydrates/Fiber: Supplements such as Metamucil, Citrucel, etc. “Healthy” foods with added fiber. Whole grains such as whole wheat, brown rice, etc. Sugar alcohols or products containing them.
DISALLOWED Fruits and Vegetables: Legumes or any non-fermented products made from them such as soy, chickpeas, beans, etc. Cruciferous vegetables and dark leafy greens such as broccoli, cauliflower, brussels sprouts, cabbage, etc. Potentially constipating fruits such as apples, pears, bananas.
Meal spacing is also a very important factor in the treatment and prevention of recurrence of SIBO. Snacking and grazing are to be avoided. This includes avoiding even some non-caloric things such as chewing gum which would stimulate peristalsis and not allow the Migratory Motor Complex (MMC) to function. Meals should be spaced at a minimum of 4-5 hours apart in order to allow for ample time for the natural cleansing waves of the Migratory Motor Complex (MMC) to sweep the digestive tract clean. Drinking water between meals is acceptable. It is encouraged to drink ample (5-8 glasses) water daily.