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“What should I eat with SIBO?”

It’s the question I get asked more than any other.

I tried them all. Low FODMAP. SCD. GAPS. Elimination diets. Some of them more than once.

And here’s what 5 relapses taught me: more restriction never made me heal faster.

The right SIBO diet calms your symptoms, supports your treatment, and gets you back to eating as many foods as possible.

SIBO Diet: What to Eat, What to Avoid + How Long to Follow It

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Does diet treat SIBO?

On its own, usually no.

Cleveland Clinic calls diet one of many things your provider may suggest, alongside antibiotics or other therapies.¹

Food helps with 2 things:

1. Symptoms. Fewer fermentable carbs means less fuel for the bacteria, and usually less gas and bloating.
2. Support. The right food choices during and after treatment can make the whole process easier.

The one exception is the elemental diet, which works as a treatment in its own right. More on that below.

Which SIBO diet is best?

There isn’t one perfect SIBO diet. There are 4 you’ll hear about most.

1. Low FODMAP diet

FODMAPs are fermentable carbohydrates: Fermentable Oligosaccharides, Disaccharides, Monosaccharides, And Polyols.

They’re food classifications, not food groups. Lactose in milk is a FODMAP, for example, which is why lactose-free milk is usually fine.

Bacteria feed on FODMAPs. Cut them back, and there’s less to ferment.

Cleveland Clinic describes an elimination phase of about 3 to 4 weeks during treatment, then bringing high-FODMAP foods back one group at a time.²

Make note: Cleveland Clinic says plainly that staying low FODMAP long term isn’t recommended, because these foods feed your healthy gut bacteria too.

In one trial in people with IBS, 4 weeks of low FODMAP eating lowered levels of Bifidobacterium, one of the good guys.²

Low FODMAP is a short-term tool.

Grab my Printable FODMAP Food List to make it easier.

2. Elemental diet

An elemental diet is a liquid formula where the nutrients are already broken down, so they absorb high up in the small intestine. That leaves very little for bacteria to eat.

In one study, 80% of people with an abnormal breath test had a normal test after 14 days on an elemental diet.³

Cleveland Clinic notes it typically lasts 2 to 3 weeks and “only works if you stay with it.”

It’s hard. Liquid only, for weeks. But for some people, especially those who can’t or won’t take antibiotics, it’s a real option.

Here’s how to do a DIY Elemental Diet for SIBO.

3. Specific Carbohydrate Diet (SCD)

SCD removes grains, most sugars, and starchy foods, and keeps meat, fish, eggs, most vegetables, some fruits, and some aged cheeses.

Some practitioners combine it with low FODMAP for SIBO.

Make note: I couldn’t find controlled trials testing SCD for SIBO specifically. It’s a clinical approach, so try it with a practitioner if you go this route.

4. Bi-phasic diet

The bi-phasic diet was created by Dr. Nirala Jacobi, a SIBO-focused naturopathic doctor. It combines low FODMAP and SCD in 2 phases that line up with treatment.

I talked with Dr. Jacobi about SIBO on the podcast. Listen to SIBO vs IBS with Dr. Nirala Jacobi.

Like SCD, it’s practitioner-built and hasn’t been tested in large trials.

What to eat with SIBO (and what to avoid)

This list follows a low FODMAP approach, the one with the most practical support for SIBO symptoms. These examples come from Cleveland Clinic.¹

Your list will look a little different. Some “safe” foods will bother you, and some “avoid” foods won’t.

And watch the dose. Many foods are fine in small amounts and a problem in big ones.

Hungry for ideas? My SIBO Diet Recipes are all built around these foods.

What to eat during SIBO treatment

This surprised me.

During antibiotics or herbals, don’t go more restrictive than you need to.

In one trial, people who took rifaximin with a fiber called partially hydrolyzed guar gum cleared SIBO 85% of the time. Rifaximin alone cleared it 62% of the time.⁴

That’s one study. Still, it’s a good reason not to over-restrict during treatment.

Ask your doctor what they want you eating during your specific protocol.

You can see what I ate during my final 28-day rifaximin + neomycin round.

How long should you follow a SIBO diet?

Shorter than you think.

• Low FODMAP: about 3 to 4 weeks of elimination, then reintroduce¹
• Elemental: about 2 to 3 weeks¹
• After treatment: start bringing foods back as soon as your symptoms settle

The goal is the widest diet your gut can handle.

How to reintroduce foods after SIBO

1. Go one food group at a time. Cleveland Clinic recommends bringing high-FODMAP groups back one by one.
2. Start small. A few bites, not a full serving.
3. Give it 2 to 3 days before adding the next one.
4. Track everything. Food, symptoms, sleep, stress. Patterns show up fast on paper.
5. Retry later. A food that bothers you in week 1 may be fine in month 3.

Track with an app and/or physical journal.

For at-home breath testing during reintroduction, the FoodMarble AIRE 2 device is incredible!

Don’t forget meal spacing

What you eat matters. When you eat matters too.

Your small intestine runs a cleanup wave between meals called the migrating motor complex. It only runs while you’re fasting, and eating stops it. Research links a missing cleanup wave to SIBO.⁵

Constant grazing means that wave rarely gets a chance to run.

For me personally, spacing my meals was one of the biggest changes I made. Read more in Fasting to Cure SIBO.

What I learned beyond the diet

In July 2018, right after my final round of antibiotics, I wrote the first version of this post.

Most of it was about movement. My symptom journal showed that running and intense workouts lined up with my bloating.

So I changed more than my plate:

• I stopped running and high-intensity workouts and switched to lighter strength training with a focus on my core.
• I walked, 20 to 60 minutes most days, no intensity.
• I ate lower carb and lower FODMAP, in small amounts, and planned to bring foods back over time.
• I got regular massages for the tension I carried in my core.
• I worked on stress, with breathing and calming techniques.

I haven’t relapsed since July 2018.

Diet was one piece. Movement, stress, and meal spacing were the rest.

Read the full story in How I Healed SIBO Long Term, and if SIBO keeps coming back for you, read When SIBO Keeps Relapsing.

SIBO diet FAQ

What is the best diet for SIBO?

There’s no single best SIBO diet. Low FODMAP is the most common choice for symptoms, and the elemental diet is the only one with research showing it can normalize a breath test on its own. The best one is the least restrictive diet that controls your symptoms.

Can you cure SIBO with diet alone?

Usually not. Diet helps manage symptoms and supports treatment. The exception is the elemental diet, which normalized breath tests in 80% of people in one study.

How long should I stay on a low FODMAP diet for SIBO?

About 3 to 4 weeks of elimination, then reintroduce foods one group at a time. Long-term low FODMAP eating isn’t recommended.

What should I eat during SIBO antibiotics?

Ask your doctor about your specific protocol. In one study, adding a fiber to rifaximin raised the clearance rate from 62% to 85%, so very strict restriction during treatment may not help.

You might also enjoy:

1. The 3 Types of SIBO: Hydrogen, Methane (IMO), and Hydrogen Sulfide Explained
2. How to Heal SIBO: 5 Steps to Start (From Someone Who Did)
3. GLP-1 Medications and SIBO: Can Ozempic, Wegovy, Mounjaro, or Zepbound Trigger Bacterial Overgrowth?

This post may contain affiliate links. I only share products I use and trust.

This content is for education only and isn’t medical advice. Please work with your doctor before starting or changing any treatment.

Xox,

SKH

1. https://health.clevelandclinic.org/sibo-diet ↩︎
2. https://pubmed.ncbi.nlm.nih.gov/28625832/ ↩︎
3. https://pubmed.ncbi.nlm.nih.gov/14992438/ ↩︎
4. https://pubmed.ncbi.nlm.nih.gov/20937045/ ↩︎
5. https://pubmed.ncbi.nlm.nih.gov/22450306/ ↩︎