Many different diets are recommended when you are dealing with SIBO (Small Intestinal Bacterial Overgrowth). Knowing the difference and choosing one diet could already be a challenging step. There is no right or wrong type of diet; each individual has various needs, metabolism, underlying reasons, and sometimes it may take a trial and error process to find the best fitting one. But I am here today to give you more information about these SIBO diets.
In my previous blog post, I wrote about the roles the diet plays in the treatment process and >> the most popular SIBO diets, specifically about the pros and cons of the low-FODMAP diet, the Elemental diet, and the SCD diet.
In this post, I am going to cover the other commonly used SIBO diets:
- The SIBO Specific Food Guide (SSFG),
- Bi-phasic diet,
- Cedars-Sinai low fermentation diet,
- Fast Tract Diet.
SIBO diet#4: The SIBO Specific Food Guide (SSFG)
The SSFG diet was created by Dr. Allison Siebecker ND, who is passionately teaching about SIBO and participating in summits.
Dr. Siebecker combined the Specific Carbohydrate Diet (SCD) and the Low-FODMAP diet and classified foods into different categories between "SCD legal"/low-fodmap and SCD "illegal." It contains several modifications to the original diets based on her clinical expertise in SIBO treatment. The diet aims to reduce a variety of fermentable carbohydrates to achieve symptom relief. It restricts foods and also defines the allowed quantities for certain foods.
You can >>download the SSFG diet from Dr. Siebecker's website to learn more about the allowed and not recommended foods.
What are the Pros?
- It can help reduce digestive symptoms such as bloating efficiently
- It was created explicitly for SIBO treatment
- It can be a great choice in case of severe symptoms
What are the Cons?
- It is considered to be a very restrictive diet
- Possible nutrient deficiencies or weight loss if the diet is not designed well
- It can be challenging to follow the guidelines
- It may trigger food fears contributing to disordered eating
- There is no guideline for reintroducing foods, so many people may get stuck in the strict phase
- No clinical trials have been done yet
SIBO diet#5: The Bi-Phasic Diet
The Bi-Phasic Diet was created by Dr. Nirala Jacobi, a SIBO Specialist. She further developed Dr. Siebecker's SIBO Specific Food Guide and split it into two phases. This diet protocol contains a particular gut healing phase and a phase for treating SIBO with antimicrobials.
The first phase is the most restrictive one because it removes all grains, dairy, sugar, legumes, and many vegetables as well as fermented, processed foods. Some of the foods can be reintroduced in Phase 2.
According to the plan, the first phase is typically recommended to follow for 4-6 weeks to reduce the bacterial overgrowth by removing fermentable carbohydrates and giving a chance for the gut lining to heal. Besides, practitioners can prescribe gut-healing nutrients, specific probiotics to boost the process. Phase 1 is divided into two sub-phases to manage the strictness of the diet, which are the "Phase 1 restricted diet" and "Phase 1 semi-restricted diet". This phase can efficiently help reduce symptoms such as bloating.
In the second phase, which is also recommended for 4-6 weeks, the focus is on further reducing overgrowth using antimicrobials. In this phase, the diet is a bit more permissive to feed the bacteria to avoid them going dormant. It also gives a great emphasis on avoiding relapse by using prokinetics to restore motility.
Based on clients' request, Dr. Nirala Jacobi and nutritionist Anne Criner created the Vegetarian version of the SIBO Bi-Phasic Diet, allowing more soaked/sprouted grains and soy products as the original version was quite heavily meat-based.
She has also developed another version of the diet with dietician Heidi Turner, the Histamine SIBO Bi-Phasic Diet for people suffering from histamine intolerance besides SIBO. The diet aims to remove not just fermentable carbohydrates but also high-histamine-containing (histamine liberating) foods. The diet is recommended for short-term use. Read more about the >>SIBO and histamine connection.
>> Download the Bi-phasic Diet here
>> Download the Vegetarian SIBO Bi-Phasic Diet here
>> Download the Histamine SIBO Bi-Phasic Diet here
What are the Pros?
- It can help reduce digestive symptoms such as bloating efficiently
- It was created explicitly for SIBO treatment
- It can reduce the side effects of bacterial/fungal "die-off"
- It has a very structured format – more straightforward to see what is allowed and should be avoided
- It has more versions (Vegetarian, Histamine)
What are the Cons?
- It is considered to be a restrictive diet
- Possible nutrient deficiencies or weight loss if the diet is not designed well or followed too long
- It can be challenging to follow the guidelines due to the different phases
- It may require a Practitioner for a better outcome
- It may trigger food fears contributing to disordered eating
- No clinical trials have been done yet
SIBO diet#6: Cedars-Sinai Low Fermentation Diet
The Cedars-Sinai Low-Fermentation Diet was created by Dr. Mark Pimentel from Cedars Sinai Hospital to help people with IBS and SIBO manage symptoms and prevent relapse with SIBO.
The diet primarily focuses on removing complex carbohydrates that bacteria might ferment and more difficult to digest, therefore creating gas, bloating, etc. It allows simple carbohydrates that are quickly digested. It also emphasizes that meal spacing is crucial to allow the clearing wave of the gut (Migrating Motor Complex) to kick in and sweep the remaining food particles and bacteria towards the colon. So giving up snacking and sticking to the 3 main meals can be essential to prevent relapse.
What are the Pros?
- It is less restrictive than other diets
- A leading IBS researcher created it
- Recommendation on the eating habits (such as avoiding snacking) is beneficial
- It may help reduce symptoms
- It allows simple carbohydrates
What are the Cons?
- In case of severe symptoms, the diet might not work
- No instructions on how or when to reintroduce foods back to the diet
- Being long-term on a low fermentation diet may have a negative effect on the gut microbiome (long term avoidance of prebiotic foods can lead to the decrease of beneficial bacteria in the colon)
- Some of the allowed foods might be high-FODMAPs and may trigger symptoms in specific individuals (mushrooms, sweet potato)
- No clinical trials have been done yet
Download the Low Fermentation diet handout to get more information about this diet.
SIBO diet#7: Fast Tract Diet
After looking for a solution for his reflux symptoms, the Fast Tract Diet was created by Dr. Norm Robillard, a microbiologist, founder of the Digestive Health Institute. The diet aims to help reduce symptoms for IBS, SIBO, reflux, and other digestive conditions.
He developed a flexible point system, and a particular point value ("Fermentation Potential" (FP)) is assigned to each food based on their symptom potential (Low, Moderate, High). It means if you eat food with a low(er) "FP," then it is less likely to cause any symptoms.
You can find more information in Dr. Robillard's book: Fast Tract Digestion or on his website.
He has also developed an app for Fast Tract Diet to help you achieve your health goals more easily.
What are the Pros?
- It can help resolve SIBO and other digestive symptoms
- Very structured
- There is an app that can help with the implementation
What are the Cons?
- Possible nutrient deficiencies or weight loss if the diet is not designed well or followed too long
- It may trigger food fears contributing to disordered eating
- No clinical trials have been done yet for SIBO
Which SIBO diet should you choose?
I wish I could give a simple answer to that question, but unfortunately, it is very individual. There is no one-size-fits-all solution when it comes to SIBO. Each of us has various symptoms, metabolism, underlying causes, genes, etc. What might work for one person might not work for you. We also have different mindsets and personalities – some people like eating more intuitively, while others like a structured system.
Finding the best diet could be a trial and error process. I have also tried at least 5 different types of diet until I landed the one I preferred the best.
This post is only for informational purposes and is not meant to diagnose, treat or cure any disease. I recommend consulting with your healthcare practitioner always before trying any treatment or dietary changes.
Alexandra is a Functional Medicine Certified Health Coach & Holistic Nutritionist specializing in IBS, SIBO, and Gut Health. She helps her clients identify the root causes of their chronic gut issues with functional testing, supporting their bodies holistically and implementing the necessary lifestyle changes long-term to regain control of their bodies and enjoy food freedom. Book your FREE SIBO Assessment call now >>>