August 17, 2017 by Amy Hollenkamp
There was nothing that made me want to pull my own hair out more than trying to decide on what diet to follow during SIBO treatment. It seemed like many of the popular SIBO diets contradicted each other.
I latched on to the popular notion that the more I could starve the bacteria the faster I would beat the SIBO. So, I religiously followed a low carb SCD/FODMAP combo for 4 months. It seemed like my whole life revolved around avoiding fiber! But the more energy I spent making my diet as “SIBO friendly” as possible, the worse I seemed to feel.
When I spent all of my time and energy restricting my diet, I was setting myself up for failure in a number of ways. First, SIBO can’t be starved! (Unless you are doing an elemental diet, which I view as more of a treatment rather than a diet)
Second, SIBO is primarily a motility problem not a diet problem. You won’t have SIBO success until you start treating the root causes that are disturbing movement of food through the GI tract.
Overly restrictive diets don’t just set you up to fail, they can make you feel like a failure too! You start to measure your ability to beat SIBO by the amount of foods you can avoid. When I didn’t feel much better on SCD/Low FODMAP combo, I assumed it was a problem with my diet. I concluded that I must be eating too many carbs, so I restricted even further! Boy was I wrong!
It can be easy to fall into this downward spiral of increased restriction to control symptoms. But, looking back, I should have viewed these symptoms as an indication that I wasn’t addressing the underlying root causes of my issues. My symptoms were a result of hormone dysfunction, brain-gut axis issues and large intestine imbalances not a problem with my diet.
Restricting would not correct these underlying issues and it actually exacerbated them. When I started focusing on treating my root causes, I started to make progress.
In my opinion, we need to retire this idea that the more restrictive the SIBO diet is the better. I would even argue that being too restrictive can be harmful.
Too much restricting can lead to nutrient deficiencies, large intestine imbalances, undesirable weight loss, social isolation, chronic stress from the restrictions and hormone imbalances. These risks need to be weighed against the benefits when deciding how restrictive you want your SIBO diet to be.
I do want to be clear that some people may do well or even require a highly restrictive diet for a short period of time to heal or to manage symptoms. But the overall goal should be to broaden your diet as soon as possible to avoid developing any of the problems associated with restrictive diets.
In these cases, it becomes crucial to work with a functional medicine practitioner to make sure you play some defense to prevent any of the potential problems to develop while you are restricting. This may involve:
- Nutritional supplementation to ensure you are meeting your needs
- Probiotics and other gut support to preserve integrity of colonic bacteria
- Hormonal support (especially if you are restricting carbs)
- Stress management exercises (meditation, breath work, yoga, etc..)
- Controlling your weight by making sure you are eating enough calories
- Support through restriction and reintroduction process
But can your diet not be restrictive enough?
While being too restrictive can hinder recovery, not restricting enough can also cause problems. You can’t beat SIBO eating a Standard American Diet.
Beating SIBO and repairing the breakdowns in your GI tract will require some dietary changes. A diet high in processed and refined foods will generate inflammation that disrupts gut function. When your gut is on fire, you won’t make any progress to heal. Even if you do clear the bacteria, relapse is inevitable.
Breaking dietary patterns can be very hard. I think it becomes even harder when all the SIBO diets seem to contradict each other. You may be discouraged from embarking on dietary changes when you see people not making progress on the popular restrictive diets. Or maybe your doctor said dietary changes won’t make a difference and why would you bother changing your diet when apparently it doesn’t matter!
You also may be on a restrictive diet and still may be eating foods that you are reacting to simply because they fall into the “yes” food column of the diet you are following. Just because a food is allowed on the FODMAP diet, doesn’t necessarily mean it is right for your body! (On the contrary, you may tolerate many of the “no” foods just fine!)
You are going to have a unique list of foods that you need to avoid based on varying genetics, level of immune dysfunction and the root causes of your SIBO. Sometimes that requires trusting your body and bravely eating outside of the confines of any of the SIBO diets.
You might react poorly to sweet potatoes while someone else thrives on a starchy diet. You may thrive on an AIP style diet versus any of the SIBO diets! We are all unique!
Finding Your SIBO diet Sweet Spot
There seems to be a fine line when it comes to the appropriate restriction level during SIBO recovery and remission. Too much or too little restriction will cause issues!
The goal of diet restriction should not be to starve bacteria, but rather to minimize symptoms and reduce GI inflammation. In my experience, trying to starve the bacteria was a fruitless goal.
Reducing symptoms while only restricting foods that you need to will lead to what I refer to as the “sweet spot”. As a former analyst, I tend to visualize this concept in my head as a U-shaped curve. So, I decided to make an actual U-shaped curve!
The graph demonstrates the consequences of falling on either end of the restrictive spectrum and how the “sweet spot” falls somewhere in the middle.
This “sweet spot” is going to be different for each person and should change as you move through treatment. While you may have periods that your diet is more restrictive, I believe the goal should always be to keep your diet as broad as possible without exacerbating symptoms.
Instead of jumping straight into a very restrictive diet right out of the gate, I wish I would have started broad and then moved narrower if I needed to. I was so scared to feed the beast, I avoided foods that I didn’t need to.
If I could do it all over again, I would try this broad to narrow template to figure out what worked for me:
As I mentioned earlier, if your symptoms are forcing you into a very restrictive diet for a long period of time, it may be an indication that your SIBO isn’t cleared or that you have other problems that need to be addressed (large intestine imbalances, hormone issues, brain-gut axis problems). In either of these cases, more restricting is most likely not the answer.
Don’t focus solely on diet to beat SIBO!
It can be easy to neglect other important aspects of treatment when you are spending all your time and energy restricting your diet. Diet should only be one part of your SIBO treatment. A multifaceted treatment approach is required to clear the overgrowth and address the root causes for you to make progress.
When I was very restrictive, I had no energy to address the stress, hormone issues, brain-gut axis problems and large intestine imbalances that were at the root of my SIBO. It was kind of like I was putting all my eggs in the SIBO diet basket. But when I only invested my energy and resources in perfecting my diet to treat SIBO, there was no payoff.
My payoff skyrocketed when I started to diversify my treatment strategy. Allowing some slack in my SIBO diet freed up energy and resources to address my root causes!
While some restrictions are crucial for healing, too many restrictions can become detrimental. Finding your sweet spot can help you reduce symptoms and inflammation so that you can address the root causes of your SIBO.
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Until next time!!