Small Intestinal Bacterial Overgrowth (SIBO) can make even nutritious meals feel uncomfortable. Bloating, gas, and abdominal pain often stem from excessive bacteria in the small intestine. These bacteria ferment certain foods, leading to gastrointestinal distress and malabsorption. While medication can help reduce bacterial overgrowth, long-term symptom management often begins with food choices.
That’s where the SIBO diet comes in. Adjusting what and how you eat helps limit fermentation, reduce bloating, and support digestive recovery. Many people find it easier to make these changes with guidance from registered nutritionists who can tailor meal plans based on their specific symptoms, SIBO subtype, and tolerance levels.
What is SIBO and why diet matters
SIBO occurs when bacteria that typically live in the large intestine migrate into the small intestine, disrupting digestion and nutrient absorption. This imbalance can cause gas, bloating, diarrhea, constipation, fatigue, and even nutrient deficiencies over time.
Diet plays a critical role because certain foods, especially those rich in fermentable carbohydrates, act as fuel for bacterial overgrowth. When bacteria ferment these carbohydrates, they release gases such as hydrogen, methane, or hydrogen sulfide, each linked to different symptom patterns. Reducing these bacterial food sources can make a noticeable difference in how you feel – it is like taking away the ingredients so the bacteria cannot keep “cooking up” gas.
It’s important to remember that the SIBO diet is not a cure and is meant to be a short-term intervention. It’s a therapeutic approach that helps manage symptoms and works best when combined with medical treatment. Collaborating with healthcare professionals and qualified nutritionists ensures your plan is balanced, sustainable, and suited to your body’s needs.
Core principles of a SIBO diet
The main goal of a SIBO diet is to minimize foods that feed unwanted bacteria while maintaining adequate nutrition. Several dietary frameworks are commonly used to guide this process.
Low-FODMAP framework
The FODMAP for SIBO approach limits specific types of fermentable carbohydrates — oligosaccharides, disaccharides, monosaccharides, and polyols — found in foods like wheat, onions, garlic, and certain fruits. These carbohydrates ferment easily and can worsen gas and bloating.
A low-FODMAP diet often brings significant short-term relief, but this is a short-term elimination diet (typically 2-6 weeks). It is crucial that this phase is followed by gradual reintroduction to identify personal triggers and to prevent negative long-term effects on the essential colon bacteria.
Low sulfur diet for SIBO
For those with hydrogen-sulfide–dominant SIBO, a low sulfur diet for SIBO can be beneficial. Sulfur-rich foods such as eggs, garlic, and cruciferous vegetables (like broccoli and cauliflower) may worsen odor or discomfort in some individuals. Reducing these temporarily can help manage symptoms, but sulfur-containing foods shouldn’t be eliminated long term without professional supervision.
While the low-FODMAP diet is the most common starting point, your nutritionist may recommend other structured diets, such as the Specific Carbohydrate Diet (SCD) or the Cedars-Sinai Diet, depending on your SIBO subtype and response to initial treatment.
Identifying SIBO friendly foods
Generally, SIBO friendly foods are those that:
- Contain minimal fermentable carbohydrates
- Are gentle on digestion
- Don’t feed bacterial overgrowth
Each person’s tolerance differs. Some may handle small amounts of fiber or starch well, while others may react even to moderate portions. Personalized nutrition counseling helps identify what works for you and ensures variety in your diet.
Foods to include: Best choices
When planning meals, focus on simple, whole foods that are easy on your digestive system and promote steady energy. Below are food groups that often work well in an SIBO diet:
- Lean animal proteins: Chicken, turkey, fish, and eggs are typically well tolerated and provide essential amino acids without fermentable carbohydrates. (Note that eggs are high in sulfur, so individuals with confirmed hydrogen-sulfide SIBO should limit them temporarily).
- Low-fermentable vegetables: Zucchini, spinach, carrots, bell peppers, and green beans are gentle options. Steam or sauté them in olive oil for easy digestion.
- Whole grains and pseudo-grains: When considering quinoa and SIBO, quinoa is often a mild, gluten-free grain that can serve as a gentle carbohydrate source. Start with small portions and note how your body responds. Rice and gluten-free oats are also often well-tolerated when introduced cautiously.
- Healthy fats: Olive oil, avocado oil, and small amounts of coconut oil can provide energy and help absorb fat-soluble vitamins without feeding bacterial growth.
- Low-sulfur vegetables: If sulfur sensitivity is suspected, limit high-sulfur options like garlic, cauliflower, and asparagus.
- Moderate fiber sources: Once symptoms improve, you might tolerate small servings of oats, psyllium husk, or low-FODMAP fiber supplements to support gut motility. Exercise caution with foods high in resistant starch (like green bananas), as these are highly fermentable and can cause an immediate flare-up for many individuals with SIBO.
Simple meal ideas:
- Grilled salmon with zucchini and carrots
- Scrambled eggs with spinach and olive oil
- Quinoa bowl with chicken, green beans, and herbs
A nutritionist can help fine-tune meal combinations and serving sizes to match your individual tolerance while ensuring you meet your daily nutrient needs.
Foods and ingredients to limit or avoid
Knowing what foods to avoid with SIBO is key to symptom management. These foods tend to ferment quickly or irritate the digestive lining, worsening bloating and discomfort.
Avoid or limit:
- High-FODMAP foods: Garlic, onions, legumes, apples, pears, and wheat-based foods.
- Sugar alcohols: Found in sugar-free gum and low-calorie snacks; they ferment rapidly.
- Refined carbs and sugary foods: White bread, pastries, and soft drinks can feed bacterial overgrowth.
- High-sulfur foods: Eggs, garlic, and cruciferous vegetables may worsen gas in hydrogen-sulfide SIBO.
Highly processed foods, carbonated beverages, and alcohol may also exacerbate discomfort. If uncertain, keep a food and symptom journal to identify patterns and avoid unnecessary restrictions.
Meal planning and practical tips
Managing your SIBO diet becomes easier with a structured, mindful approach. Here are strategies to help you stay consistent and comfortable:
- Start simple. Choose three to five core protein-and-vegetable combinations to rotate each week.
- Eat smaller meals. Large portions can slow digestion and increase fermentation.
- Chew thoroughly. Proper chewing helps reduce bloating and improves nutrient absorption.
- Space meals evenly. Leave three to four hours between meals to allow the migrating motor complex (MMC) to clear bacteria from the small intestine.
- Stay hydrated. Water aids digestion and helps move waste efficiently.
- Plan for social settings. When eating out, choose grilled proteins, cooked vegetables, and avoid sauces that may contain high-FODMAP ingredients.
If you have hydrogen-sulfide SIBO, work with a professional to integrate elements of a low sulfur diet for SIBO safely. A registered nutritionist can help you create a flexible plan that supports symptom relief without compromising nutrition.
When diet alone isn’t enough
While dietary changes often bring significant relief, diet alone rarely eradicates SIBO. Medical treatments, such as antibiotics or herbal antimicrobials, may be necessary to reduce bacterial overgrowth effectively.
Addressing underlying factors — such as gut motility issues, structural abnormalities, or chronic medication use — is crucial for preventing recurrence. Overly restrictive eating patterns can also lead to nutrient gaps, especially in fiber, vitamin B12, and iron.
This is why ongoing nutrition counseling is so valuable. Working closely with a qualified SIBO nutritionist helps you maintain balance, monitor symptoms, and adjust your plan as your gut health improves.
Take the next step toward relief with Health Loft
The right SIBO diet can transform how you feel — reducing bloating, easing discomfort, and helping your gut regain balance. But because every case of SIBO is unique, a one-size-fits-all approach rarely works. Your symptoms, triggers, and lifestyle all shape what’s best for your digestive health.
When using the FODMAP for SIBO strategy, remember it’s designed for short-term use. Prolonged restriction without professional guidance can lead to nutrient deficiencies or reduced microbial diversity. A gut health nutritionist can help plan reintroductions safely once your symptoms stabilize.
If you’re ready to move beyond guesswork, connect with a registered nutritionist at Health Loft. Our team can help you identify food triggers, build a personalized plan, and guide you step by step toward lasting symptom relief and better digestion.
This article was reviewed by Solveig Adalsteinsdottir, MS, RDN, LDN. It is intended for informational purposes only and does not replace personalized nutritional advice.
