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Whether it’s a birthday, a wedding, or just a day when you want to enjoy a sweet treat… can you have your cake and have SIBO too?
With this amazing cake recipe, you can!!
SIBO expert (and patient, too!) Dr. Allison Siebecker shared this recipe with me from her personal files.
I’ve even had the pleasure of eating this cake, prepared by Dr. Siebecker.. And let me tell you, it doesn’t disappoint!
I hope you enjoy this cake recipe as much as I have for your upcoming special occasions.
Information and Substitutions
This recipe uses coconut flour. I know what you’re thinking… “But coconut flour is HIGH FODMAP!”
Remember that the serving size is the most important factor when it comes to what foods are and aren’t tolerated on a SIBO diet.
According to Dr. Siebecker’s SIBO-specific food guide, a ¼ cup serving of coconut flour is low-FODMAP and a “green food.”
This recipe calls for a total of ½ cup coconut flour… which means as long as you don’t eat the entire cake in one sitting, it will be low-FODMAP.
For most people with SIBO, coconut flour is tolerated in servings of ¼ cup or less at a time.
Because it is highly absorbent, you can’t easily substitute other flours – like almond or gluten-free flour blends – for the coconut flour in this recipe. If you don’t tolerate coconut flour, this recipe might not be right for you.
One last thing… flax eggs or other egg substitutions haven’t been tested. If you try out an egg substitute, let us know how your cake turns out in the comments!
SIBO-Friendly Vanilla Cake (Low-FODMAP, Gluten Free)
Shared by Dr. Allison Siebecker, adapted from Elana’s Pantry
½ cup coconut flour, sifted
½ teaspoon celtic sea salt
¼ teaspoon baking soda
6 large eggs
½ cup grapeseed oil
½ cup clover honey or maple syrup
1 tablespoon vanilla extract
In a medium bowl, combine coconut flour, salt and baking soda.
In a small bowl, blend together eggs, grapeseed oil, honey or maple syrup, and vanilla.
Mix wet ingredients into dry and blend with a mixer or hand blender until smooth.
Pour batter into lined or well-oiled muffin pan or 8-inch cake pan.
Bake at 350°F for 20 minutes or until a toothpick inserted comes out clean.
Cool completely before topping with chocolate frosting (recipe to follow).
SIBO-Friendly Rich and Creamy Chocolate Frosting
Shared by Dr. Allison Siebecker
- 1 oz Baker’s unsweetened chocolate (previously 1 square, now 4 squares)
- ½ cup butter
- ½ cup clover honey
- ½ cup unsweetened cocoa powder (such as Ghirardelli or Droste)
- 1 tablespoon vanilla
Melt unsweetened chocolate square and butter in a double boiler or in the microwave on low
Allow to cool for 15 minutes, then transfer to a mixing bowl. Add the honey, cocoa and vanilla and beat until fluffy (using an electric beater or mixer).
Notes: cooling chocolate and butter before proceeding prevents honey from dropping to bottom.
I know how frustrating it can be to feel like all “fun foods” are off the table because of SIBO. I hope this recipe helps bring some joy to your day.
For more of my favorite SIBO-friendly recipes, be sure to download my free cookbook HERE.
As the days pass, I’ve been thinking more and more about how to make the most of the situation we are in.
For the first time in YEARS, I have no plans on the calendar for the next month.
No dinners, no weddings, no work functions. It’s just me, my husband, and the cats for the foreseeable future.
Which means I have NO excuse to not start the Elemental Diet.
What does that mean? Why would I be trying a diet right now? (It isn’t about weight loss)… and why do I think it might be the perfect time for you, too? Let me explain…
What Is An Elemental Diet?
The Elemental Diet is the only diet that can actually resolve SIBO completely, and it’s one of the most effective treatments we have available. Elemental diets starve bacterial and fungal overgrowths. They’re easy to digest, giving your gut a chance to rest and repair. And they reduce exposure to irritants.⠀
The Elemental diet is an all-liquid diet that can help repair the gut, kill bacterial overgrowth, and reduce inflammation. On the Elemental diet, you’ll drink a specially formulated blend of nutrients to get your daily calorie needs met.
This isn’t a regular protein powder, though: the proteins in the Elemental diet are broken down into the most elemental form – amino acids. The carbohydrates in the Elemental diet are fully digested, and so it essentially contains no fiber which can be very helpful for sensitive guts.
I think of it as eating all your nutrients “pre-digested” to both completely eradicate bacteria (which feast on undigested carbs) and give your gut a much-needed break.
3 Ways To Use The Elemental Diet
There are 3 ways to use the Elemental Diet:
#1 Gut Friendly Meal Replacement
You can use the Elemental Diet to replace any meal with highly digestible nutrients and give the gut a break. If you’ve been looking for SIBO-friendly protein powder or meal replacement shake, this is it!
Use as a gut-healing meal replacement shake. Elemental Heal can be safely used long term to replace 1-2 meals per day. It’s a complete meal replacement but also predigested, giving your gut a chance to rest and heal.
#2 Gut Reset: 2-4 Days
This is an easy way to stop a flare of gut symptoms and give your gut a rest. Suggested use is to replace all meals and snacks with Elemental Diet for 2-4 days.
#3 SIBO Healing: 1-3 Weeks
When used for 1-3 weeks, the Elemental Diet can resolve even stubborn SIBO cases. Suggested use is 1-3 weeks of replacing all meals and snacks with Elemental Diet.
Why Now Is A Great Time For The Elemental Diet
If you decide to use the Elemental Diet as a SIBO treatment, the hardest thing about following it for most people is fitting it into a busy schedule.
Right now, many of us have clear schedules… which can make 1-3 weeks on the Elemental Diet perhaps feasible for the first time ever.
Even if you don’t want to commit to a full Elemental Diet, having it on hand right now makes sense. It’s a simple meal replacement that won’t flare up symptoms and make you feel worse.
I’ve seen several people posting in the facebook group about struggling to find SIBO-friendly foods right now… having the Elemental Diet on hand means you always have something SIBO safe ready to eat.
Choosing The Right Formula For You
Until recently, there were two options for the Elemental Diet:
- Prescription mixes (require a doctor’s order and many taste disgusting)
- Homemade recipes (require specific ingredients and a lot of prep work)
Luckily, SIBO expert Dr. Michael Ruscio has now developed a third option for all of us: Elemental Heal.
Elemental Heal is by far the best tasting and easiest elemental diet option… it’s a powder (in chocolate or vanilla) that you mix with a small amount of oil and water.
It’s available without a prescription, so you can keep it on hand for meal replacements and “gut resets.”
And no matter your needs, there’s an option for you:
- Traditional, which comes in Chocolate and Vanilla
- Whey-free, for those who don’t tolerate whey protein
- Low-Carb, which has just 20 grams of carbohydrates per serving
These new formulations have been in the works for months, and are finally ready to ship. I’ve been looking forward to sharing this new resource with you, and the timing couldn’t be better.
How To Learn More & Get 15% Off
I’m taking this time to focus on my health, and there has never been a better time for the Elemental Diet than right now.
If you’re interested in joining me on the Elemental Diet, I asked Dr. Ruscio for an exclusive discount for you. Right now, the SIBO SOS® Community can get 15% OFF all Elemental Heal (including low-carb and whey free!).
Want to learn more? Watch this Q&A with Dr. Ruscio
Judging by posts in the SIBO SOS® Facebook Community, many of us who struggle with Small Intestine Bacterial Overgrowth are VERY confused about garlic!
Here are some screenshots of posts we’ve had in the group:
Let me start by saying – I totally understand the confusion! I used to be confused myself.
You may have heard that you shouldn’t eat garlic if you have SIBO… but that garlic is also a popular treatment…. How can that be?
But it’s actually simple once someone explains it to you. I was lucky enough to have Dr. Allison Siebecker explain the difference to me, and today I want to pass that knowledge on to you!
Is Garlic a “Forbidden Food” For SIBO Patients?
This is where all the confusion begins!
Garlic is a high-FODMAP food. FODMAP stands for fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These are short chain carbohydrates and for people with issues like SIBO or IBS (irritable bowel syndrome), foods that are high in FODMAPs can increase symptoms like bloating and discomfort.
Many diets for SIBO and IBS recommend limiting high-FODMAP foods and sticking to a low-FODMAP diet.
But defining what foods are “high” and “low” in FODMAPs is a little tricky. There’s no universal standard for high and low, and quantity matters a lot, as well. Even a food that is very high in FODMAPs might be well-tolerated by people with IBS and SIBO in smaller quantities.
To make it even MORE confusing, not all people with SIBO or IBS react to all high-FODMAP foods. Some people might only struggle with oligosaccharides and be fine with polyols, for example. And some people might be able to tolerate one food that is high in monosaccharides but not another.
That means that there is no such thing as forbidden foods for SIBO and IBS. The best diets for SIBO and IBS are “frameworks” for finding the foods that work for you – not black and white guidelines.
The only way to know what foods you can and can’t tolerate it to test them! (To learn more about this, I recommend Dr. Siebecker’s Diet Masterclass).
Garlic is a high-FODMAP food that contains fructo-oligosaccharides that some people with SIBO don’t tolerate – but for others, it is just fine (or maybe only tolerated in small quantities).
What About Garlic Infused Foods?
Some people who develop symptoms after eating whole garlic (like a clove of garlic in tomato sauce) are able to tolerate garlic infused foods (like olive oil).
That’s simply because the short chain carbohydrates that can cause a problem are in the fiber of the garlic.
That being said, some people say that even low-FODMAP garlic infused items cause symptoms for them.
But remember: for all foods, the “dose makes the poison” when it comes to FODMAPs. You might be fine with a hint of garlic but can’t handle a lot. Or perhaps you’re very sensitive to garlic and have to temporarily avoid it altogether.
Or maybe you don’t react to garlic at all… but find you can’t tolerate apples or oatmeal or some other food. We’re all unique and there’s no one-size-fits-all protocol.
But one last thing: just because a food is high-FODMAP or causes symptoms for you doesn’t mean that the food is bad, unhealthy, or has to be avoided for life.
Comparison isn’t helpful in SIBO – just because one person can tolerate garlic and you can’t doesn’t mean you’ll never eat Italian again or are doing something wrong!
Using Garlic To Treat SIBO
Garlic isn’t just a sometimes-problematic food… it’s also one of the most effective natural treatment options for SIBO.
But if many people with SIBO don’t tolerate garlic, how can that be?
According to Dr. Siebecker, garlic is one of the 4 main herbs used to treat SIBO – but it’s not just regular garlic cloves you can buy at the grocery store.
Instead, it’s an extract of garlic called allicin.
“The four main herbs that we use typically to treat SIBO are berberine containing herbs, which are things like goldenseal root, Oregon grape, barberry Coptis. Neem is a traditional ayurvedic and a microbial. We use oregano, like the kitchen herb spice, oregano oil. And then lastly is an extract that comes from garlic called allicin, like my name but it’s spelled different.
And in that one we like to use stabilized allicin extract because garlic is a very fermentable food and triggers a lot of people’s SIBO symptoms. We don’t want to use whole garlic per se like the actual clove taking it down, unless somebody did tolerate that, but it’s pretty common for SIBO people not to. And we don’t want to use like garlic crushed or garlic oil. We prefer the antibacterial extract allicin that’s been extracted out.”
Even if you can’t tolerate garlic whatsoever, you will likely be able to tolerate allicin extract as part of a SIBO treatment because it doesn’t contain the problematic fructo-oligosaccharides.
Why Garlic Is A Key Player In Treating SIBO
There are three main types of SIBO: hydrogen dominant, methane dominant, and hydrogen sulfide.
(Although as research continues to advance, more types and more specifications within each type are likely to be discovered!)
According to Dr. Siebecker, “The special thing about allicin is that this is what treats the methane, methanogenic archaea (which, for ease, we’ll just say bacteria). They are tough to kill. And they need different antimicrobials to kill them. And the extract from garlic does it, allicin. It works against them. We see it clinically. We see it with our before and after breath tests. It’s for real.”
If you have methane, garlic is a must-have for herbal antibiotic treatments.
The Garlic Dr. Siebecker Recommends
If you’re considering taking garlic as part of an herbal protocol for SIBO, here’s what Dr. Siebecker has shared with me in the past:
“Berberine and Allimed is my go-to combination. I think of berberine kind of like Rifaximin, and Allimed like the neomycin or metronidazole, because this is what works on the methane, this is what works on the hydrogen—and you need to do them both.”
Here’s why a two-part treatment is so important:
“The reason you need to do them both is because methane archaea turn hydrogen into methane. So there are already bacteria making hydrogen there, and then there are other bacteria that are turning that hydrogen into methane. You have both there, so you need to address them both.”
And what about choosing the right allicin supplement?
“My go-to is Allimed. And we use the “-med” because it just gives the strongest potency in the least amount of pills. And the dose on this is six a day. And usually, when you’re taking a bunch of pills, we split that into three doses. You can do it as two, three times a day, or you can do it as three, two times a day.”
Help! I’ve Already Tried Allimed (Without Results)
Remember that SIBO is a tricky condition to treat – and typically requires trial and error (if you’re one of the lucky ones who’s very first treatment eradicate SIBO – good for you!).
Dr. Siebecker recommend trying Allimed paired with another herb – if you tried Allimed and berberine, for instance, try Allimed and neem next.
How often can you keep repeating this?
“Keep going until we don’t think it’s working anymore or we see on the test it’s not working anymore,” said Dr. Siebecker.
My Allimed Experience
As a person with methane SIBO, I’ve used Allimed several times.
I have a very fond feeling toward it, as it definitely made a huge improvement in my symptoms!
My pro tip? Keep it in the fridge or freezer. It does have a noticeable “garlic-y” and keeping it frozen helps reduce the odor!
Want to try it yourself?
I know how expensive trying different treatments can be – so I’m excited to be able to share a special discount with you today!
Use code “LOVEMYBODY” for 20% off your order from Allimed!
Have you tried Allimed? Are you going to? Leave a comment and let us know!
If you have Small Intestine Bacterial Overgrowth (SIBO) or IBS (Irritable Bowel Syndrome) you may have heard of the Low-FODMAP diet.
It’s a controversial diet plan, and for every practitioner who recommends it, there’s another who doesn’t.
Today, my goal is to share some of these opinions with you so you can make your own decision.
Here are some of the pearls I’ve gathered from deep-dive sessions with SIBO experts over the past 12 months.
Dr.Sheila Dean, DSc, RDN: This Is The Low-FODMAP Diet
Dr. Sheila Dean: “First, let me say that there’s a lot of different approaches to gut health. The FODMAP approach, or the low FODMAP diet approach is a very popular approach just because there’s so much empirical data. There’s so many testimonials to the fact that it works. There’s just so many people that testify to the fact that they do well with fairly limited research.
FODMAP is an acronym. It’s not food map, it is really FODMAP. An acronym that stands for—get ready—fermentable O for oligosaccharides, D for disaccharides…
Disaccharides are basically two sugars—the word di-, the prefix di-, and then the saccharide refers to sugar. When you stick two sugars together, we call that a disaccharides. You might see that in things like milk sugar. Milk sugar is a disaccharide like lactose.
We’ve got, let’s see, fermentable oligasaccharides, disaccharides, M for monosaccharide (which is just “one sugar”), and then P for polyols.
Polyols will be things like sorbitol or manitol (which more people might be a little bit familiar with—you know, you see these things in like sugar-free gum or sugar-free mints and even in some medications where they’re trying to avoid the use of regular sugar or even corn syrup).
When you put that together, F-O-D-M-A-P, FODMAP, that’s how you get the acronym.
A low FODMAP is a 2 to 6 weeks elimination diet, the goal is to remove foods that are considered high FODMAP to assess whether these foods are actually problematic for the person with this altered gut problem like IBS.”
Angela Pifer, Nutritionist: Eating FODMAPs Doesn’t Make SIBO Worse
Angela Pifer: “I think the problem is that, anytime people eat FODMAPs and see a reaction, especially with SIBO, they think SIBO is getting worse. “
Shivan Sarna: “It’s a reasonable assumption.”
Angela Pifer: “It is… but the symptoms are affected, SIBO is not getting worse. On the studies that we look at, three weeks or four weeks, six weeks on a high FODMAP diet, methane does not get worse and hydrogen doesn’t go up. So it’s just the symptoms [that get worse].
The fear is that SIBO is getting worse. They’re going to keep restricting and restricting.
At the SIBO Symposium this year, they had a lovely nutrition track . Half that track was around anxiety around food, fear around food, and eating disorders. I’m not saying that everyone that’s on a FODMAP diet has an eating disorder by any means. When you put somebody on that restrictive of a diet, and they get on that for a long period of time, there’s going to be food fear. It’s going to be disordered eating to a degree because of all of the anxiety being bred.”
Dr. Mark Pimentel, MD: “The Low-FODMAP Diet is Unhealthy”
Dr. Mark Pimentel: “The low FODMAP diet is unhealthy. Now, some of your viewers may not like me saying that. But even those who purport the low FODMAP diet or discover the low FODMAP diet recognize that you have to have a reintroduction phase because it’s going to hurt people over time potentially.
This was presented at the American College of Gastroenterology about a month and a half ago where they showed the people who were sustained on a low FODMAP diet for more than three months started to have measurable nutritional deficiencies.
You can’t stay on low FODMAP forever, period.”
Dr. Michael Ruscio, DC: Don’t Be Scared of Low-FODMAP
Dr. Michael Ruscio: “We learn about how gut bacteria are important, how important it is to feed your gut bacteria and have high levels of diversity.
While all that is true, sometimes, what ends up happening is people hear about the low FODMAP diet and how the low FODMAP diet can starve bacteria, and then they get scared that I shouldn’t go on a low FODMAP diet because it’s going to starve my gut bacteria or cause me to lose gut bacteria and they’re supposed to be so healthy. People are very confused about what to do.
To say it very simply, I would not be concerned at all—no, I shouldn’t say “at all.” I would not be very concerned about a low FODMAP diet impact on your gut microbiota. Let me outline a few reasons why that is.
One, there’s been a few studies [that] essentially found that a low FODMAP diet has the ability to help the serotonin cell density—so the number of serotonin cells that you have in the gut—become more like that of healthy controls.
They took IBS patients, put them on a low FODMAP diet, compared them to patients who were healthy, and they found that patients with IBS had lower levels of serotonin cells in the gut compared to healthy controls. The low FODMAP diet allow those numbers of serotonin cells to become more normal over time. And this is found not only in the large intestine, but also in the small intestine.
Repair Your Intestines with a Low-FODMAP Diet
You may be able to, in part, repair your intestines with a low FODMAP diet through helping to facilitate serotonin cells in your guts—serotonin cells are important for motility, which I’m sure you’ve talked a lot about in the summit—and also for nociception or for pain reception.
Quickly on motility, one of the mechanisms that may cause SIBO is your motility (or the ability of food to move through the intestines) is slowed down. If you don’t have adequate movement, food kind of sticks around, bacteria can grow (just like bacteria can grow in stagnant water, but doesn’t tend to grow in flowing water. Then, you can have SIBO.
One of the things that we see on the low FODMAP diet is a restoration of serotonin cell density which may be helpful.
Now, we don’t have any studies yet that have studied the motility effects of the low FODMAP diet. We can’t fully say that this is translated all the way through to a clinical endpoint. However, at least the initial mechanism data that we have is promising that there is reparative utility to the low FODMAP diet.
But not only that, there’s been at least one study that has shown that leaky gut decreases on a low FODMAP diet, and as I mentioned, before another study showing a decrease in histamine on a low FODMAP diet.”
Rebecca Coomes, SIBO Chef: It’s Not Just About The Food
Rebecca Coomes: “The first mistake or challenge that I see people make and experience is thinking it’s all about food—and only about food. So rather than seeing that your diet and your nutrition is one of many components of recovering your gut health, they just focus on food because it’s one thing we can control as a SIBO patient.
What I see commonly is people get fixated on what they’re eating, or what they’re not eating, a lot of fear creeps in, trepidation around reintroduction of foods.
I myself experienced that. Scared to come off the very restrictive SIBO diet I was on and to start eating other foods. I was terrified of things like bananas. You know, a banana isn’t a bad thing. It’s just perhaps the quantity you ate or the time that you ate it. I didn’t appreciate how what we’re eating and our tolerance to it changes as we go through the SIBO diet. What you can tolerate today doesn’t mean that’s all you will ever, ever tolerate.
And we know that food can be delicious. It’s our life force. It’s our nourishment. If we’re stuck eating the same 5 to 10 foods for years, how can we expect our microbiome to recover and be healthy and diverse? It’s not all about the food.”
Make The Choice That’s Right For You!
As you can see, the experts don’t all agree about low-FODMAP diets
No two cases of SIBO are the same – which means we all need a customized treatment plan.
There’s no one protocol or diet that works for everyone: healing SIBO is a different path for each of us.
I believe the answer to finding the right path for YOU lies in getting as much information from the experts as we can. Then, we can lean into our own innate wisdom to find what works for us and what doesn’t.
I created the SIBO SOS® Masterclass Summit Series to help bring you ALL the latest information on SIBO – right to your home.
It starts innocently enough: you decide to try an elimination or other specific diet for Small Intestine Bacterial Overgrowth like:
- SIBO Specific SCD
- GAPS or AIP
At first, taking certain foods out of your diet really helps!
But then there is a fork in the road for almost everyone:
You either get better and are able to reintroduce foods…
Or, your symptoms don’t resolve, and you continue eliminating more and more foods.
It can get to a point where you’re only eating a handful of “safe” foods – and you’re feeling worse and worse every day. You’re scared to eat more foods – but also scared to continue on the path you’re on.
What do you do then?
In this post, I’m talking about the good – and the bad – of using elimination diets for SIBO with Dr. Michael Ruscio, DC.
Dr. Ruscio is often my “voice of reason.” He has a very straightforward, commonsense approach to treating SIBO and IBS – even the very tough cases.
I hope this information is helpful to you!
How Elimination Diets Can Be Useful
Dr. Ruscio uses elimination diets like Low-FODMAP as part of his treatment for patients. He also is an expert of the Elemental Diet, which is probably the most restrictive diet of them all!
Here’s how he describes his treatment approach:
“I start with diet and lifestyle. Step #2 would essentially be things like probiotics and enzymes. They’re inexpensive. They’re generally helpful. You don’t need lab testing to apply those.
And then, Step #3 would be considering some kind of antimicrobial therapy—antifungal, antibacterial, anti-biofilm, antiprotozoal.
And then, one of the final things within the realm of the microbial step, we’ll be potentially considering the Elemental Diet as a different method of antimicrobial. It does more than just antimicrobial, but that’s kind of where I classify it.
And after that, we broaden the diet and try to support the gut with things like fiber and some probiotics—if they’re tolerated.”
The Importance of Reintroduction
Dr. Ruscio views restricted diets as a temporary intervention, not a long-term approach to staying healthy:
“We don’t want to have anyone on a restrictive diet longer than they have to be. This is a general principle. We should be working to use these diets to gain awareness, figure out what foods work, and what foods don’t work, and then, ultimately, be trying to broaden to the widest diet possible. That’s very important.
And for some people, the main thing that’s making them feel sick is the fact that they haven’t tried to push to a broader diet, and they keep going more narrow, more narrow, more narrow. And they haven’t pushed back outwards. Sometimes, that simple change of just trying to loosen up your grip or your rules on the diet can actually be very healing and helpful for people.”
Don’t Let Fear Be Your Motivator
Dr. Ruscio says that those who are MOST successful with elimination or restricted diets are those who approach it with a mindset of curiosity rather than fear.
“We want to motivate patients to buy books or undergo programs or watch documentaries—which is good on the one hand. But we don’t want to “fear factor” them into being compliant or motivated to get them there. I think [fear is] a short-term motivator. I don’t think people are motivated in the long-term.
And that’s why when people say to me, “But we need these labs to motivate patients,” my experience has been if someone is not motivated, and you tell them, “If you eat this food, you’re going to cause all these inflammation for months on end, blah-blah-blah,” they’ll follow that advice for a little while. But very quickly, they’re going to go back to what they feel to be how they want to live their life.
And so, what I would rather do, rather than extrinsically motivating someone with fear, is coach them through, “Okay, let’s tighten up your diet for a little while to see how good you feel. And then, because you’re going to probably want to do this anyway, let’s have you re-introduce… and you’ll probably notice a lot of these foods are okay. Even a lot of these foods the Internet says are bad are okay. But there’s a couple, ‘Ugh, I really didn’t feel well when I eat those.’
And then, they’re going to be intrinsically motivated to avoid those foods. And they’re going to be intrinsically motivated to avoid these foods to the degree to which they have a reaction.”
Remember This If You’re On A Restricted Diet…
When you’re stuck eating a small number of foods, you can feel hopeless – uncertain what to try next or how to progress. Dr. Ruscio has some words of wisdom for you:
“Realize that there is a whole world of therapeutic options. I was just talking with a friend’s girlfriend and she was telling me how she’s had IBS for three years. And she’s tried everything.
“I’ve tried everything!”
I said, “Oh, so the low-FODMAP diet didn’t work?”
Now, you probably have heard of the low-FODMAP. But the point I’m trying to articulate is there’s a lot of options out there for you.
So if you’re feeling defeated, don’t go to despair too quickly because there’s a wide array of therapeutic options available to you. And if you can utilize those in the right way, then there’s a very high probability that you’ll be able to feel a lot better.”
A New Treatment for Tough Cases?
If you’re “stuck” in SIBO limbo and not making any progress toward healing – especially if you’ve tried a LOT of different treatment – I have something to share with you.
It’s a NEW treatment for SIBO developed by Dr. Michael Ruscio: Intestinal Repair Formula.
Intestinal Repair Formula is a blend of immunoglobulins that help restore a healthy immune system. (We get so many questions about immunoglobulin treatments and why I was so excited to learn about this new supplement!)
Here’s a video Dr. Ruscio shared that explains the science behind this therapy.
If you’ve already tried other treatments like changing your diet and probiotics, but you’re not seeing complete resolution of symptoms – watch this video NOW!
Here’s what Dr. Ruscio has to say about Intestinal Repair Formula:
“IRF has been shown to help patients who did not respond to treatments like diet, probiotics, antimicrobials and soothing agents. IRF binds to irritants like bacteria and toxins. IRF allows healing to begin. Due to its healing effect, Intestinal Repair Formula may even improve nutrient absorption.”
I’m so excited about the possibility with this treatment!
(And if you decide to buy, use code SIBO-SOS for $5 off!)
P.S. Do you have any questions about this product or for Dr. Ruscio? Leave them in the comments below!
P.P.S. I want you to know that I take making recommendations very seriously! For this particular product, I was impressed with the amount of time and research that Dr. Ruscio put into to – and with some of the preliminary results. I’ve worked with Dr. Ruscio extensively on past Masterclasses and Summits, and I trust him and find him to be very genuine. While I obviously can’t guarantee that this product will or won’t work for anyone, I can tell you that I think it’s worth considering. My goal is simply to share the information and let you make the decision. And – you should know, I don’t make any profit of the sale of this product.
There are literally HUNDREDS of different diets recommended for Small Intestine Bacterial Overgrowth (SIBO)
– which means it can be really overwhelming and confusing to get started.
Should you try low-FODMAP or Elemental? Gluten-free or low-fermentation? Vegan or all meat? Should we eating to feed the gut bugs or starve them? Are apples allowed or are they forbidden?!? HELP!
People ask me about this all the time, so today I want to help cut through all the clutter and talk about the “Big 6” diets for SIBO – these are the diets that I hear recommended from the top practitioners most often.
(There are definitely more than 6 effective SIBO diets – and you may have found one that works for you that isn’t on this list! That doesn’t mean you’re doing anything wrong. We all have to find our own path in SIBO treatment.)
Here are the diets I’m going to cover:
- The Low-FODMAP Diet
- Cedars-Sinai Low Fermentation
- The SIBO Specific Food Guide
- The Bi-Phasic Diet
- The Fast Tract Diet™
- The Elemental Diet
Before I dig into the diets themselves, I’ll briefly talk about what diet can and can’t do, and why diet is used in SIBO treatment.
Why Use Diet for SIBO?
There are several reasons to use diet in SIBO treatment:
- Diet is used in conjunction with antibiotic or herbal antibiotic treatment for SIBO. These treatments take time to work, and changing your diet can provide symptom relief during treatment. Some diets can also increase the effectiveness of antibiotic or herbal treatments. Some doctors prescribe diets before drug treatments to help manage die-off, too. In these cases, diet is usually a temporary change, and then patients return to their normal way of eating (or close to it).
- Diet provides relief for those with chronic SIBO. Some people have an underlying cause that causes SIBO to recur or never be completely resolved. They’ve tried drug or supplement treatment without results (or with frequent relapses). For those people, diet is a powerful tool to treat symptoms so that they don’t have to suffer! These people will follow the diet (typically modified to their exact needs) long-term.
- Diet can be the only treatment some people are willing to do. There are lots of reasons why someone may not want to treat SIBO with drugs or supplements – from financial to personal beliefs. Diet can’t “cure” SIBO, but it can resolve your SIBO symptoms, so some people choose to use diet alone to manage SIBO. Diet usually has to be followed long-term to provide ongoing symptom relief. (The only exception to this might be the Elemental Diet – more on that to come!)
- Diet can help prevent relapses. After treatment, following a modified diet (usually along with a prokinetic) can help prevent SIBO from recurring.
What All SIBO Diets Have In Common
All SIBO diets have one thing in common: they work by addressing carbohydrate malabsorption.
Most (but not all) symptoms in SIBO are caused by carbohydrate malabsorption.Carbohydrate malabsorption is when carbohydrates in particular bypass absorption in the small intestine and get left in the lumen, aka the inside tube of the large or small intestine. Because they haven’t been digested, they ferment (get eaten by bacteria) and create gas. The gas causes symptoms like bloating, flatulence, and diarrhea.
All SIBO diets work by restricting carbohydrates in one way or another – usually by avoiding a specific type of carbohydrates.
Want to learn more about how SIBO causes carbohydrate malabsorption and the underlying causes of SIBO? Go here.
What Makes Each SIBO Diet Unique
We now know all SIBO diets work be restricting carbohydrates – but they all take a slightly different approach to how, which, and why carbs are restricted. And one diet goes a totally different direction.
Let’s get to it!
The Low-FODMAP Diet
The Low-FODMAP diet was created by Dr. Sue Shepherd and Dr. Gibson from Monash University in Australia as a treatment for Irritable Bowel Syndrome. It works by restricting certain types of carbohydrates: fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs).
Common high-FODMAP foods include things like milk, asparagus, broccoli, apples, wheat, and beans. You can find lots of lists of high and low-FODMAP foods online or use apps like the Monash University Low FODMAP Diet app.
Some people need to restrict all kinds of FODMAPs, while others might find they only have problems with one or two kinds, like polyols or oligosaccharides.
SIBO expert Dr. Allison Siebecker suggests The Low-FODMAP diet for those with mild SIBO who can tolerate more foods and for those are struggling to gain weight, as the low-FODMAP diet allows more carbohydrates than most other SIBO diets. She also uses it after treatment alongside prokinetics to help prevent relapse.
Low-FODMAP is one of the best options for vegetarians and vegans with SIBO because it includes some less-fermentable beans and legumes that can be used a protein source.
But what makes The Low-FODMAP diet a good choice for some means it doesn’t work well for others. Because it is less-restrictive than other diets, it doesn’t provide symptom relief for all people. It allows foods like fiber, starch, and resistant starch which can cause symptoms for some people with SIBO.
The Cedars-Sinai Low Fermentation Diet
The Cedars-Sinai Low-Fermentation Diet was created by Dr. Mark Pimentel to treat IBS and to help prevent SIBO relapse after treatment. According to Dr. Siebecker, this diet can cause an average of 60-80% reduction in symptoms.
The Low-Fermentation focuses on reducing complex carbs and carbs that are likely to ferment in the stomach – things like whole grains, brown rice, and artificial sweeteners. Instead, you’ll eat carbs that digest more quickly – like white bread, white rice, and potatoes.
Like the Low-FODMAP diet, the Low-Fermentation diet is good for those with mild SIBO or who have other food restrictions, like vegetarianism. Some people perceive the Low-Fermentation diet as the easiest diet to follow – so if you hate being on a restricted diet, this one might be the one for you!
If your SIBO is severe, the Low-Fermentation diet might not be restrictive enough to help manage your symptoms.
Learn more about the Low-Fermentation diet here.
The SIBO Specific Food Guide
The SIBO Specific Food Guide was created by SIBO expert Dr. Allison Siebecker. Combining principles of the Specific Carbohydrate Diet (one of the oldest diets used for gut disorders) with the Low-FODMAP diet.
Created specifically to help treat SIBO and is one of the most successful diets for treating SIBO symptoms and restricts both food AND quantities of allowed foods (for instance, 20 almonds at a time instead of unlimited quantities).
Why does it work so well? Probably because it restricts the most carbohydrates of any of the diets we’ve talked about so far!
If your SIBO symptoms are very severe, the SIBO Specific Food Guide is the option for you. It averages between 75 and 90% reduction in symptoms.
The drawbacks? The guide can be difficult to follow if you’re vegetarian and can cause weight loss because it is so restricted. Some people find it too difficult to stick to.
Learn more about the SIBO Specific Food Guide here.
The Bi-Phasic Diet
The Bi-Phasic Diet was created by Dr. Nirala Jacobi and is based on the SIBO Specific Food Guide. It’s split into two phases: one for before treating SIBO with antimicrobials and one for during and after treatment.
The goal with the first phase is to reduce the amount of overgrowth so that die-off symptoms are less severe. The second phase is done alongside antibiotic or herbal treatments.
Like the SIBO Specific Food Guide, the Bi-Phasic diet is very restricted – so it tends to have very good results – again 75-90% reduction in symptoms.
The Bi-Phasic diet is very structured – so if you’re someone who likes to know exactly what to eat and avoid, this may be a good choice for you. If you prefer a more flexible diet, this protocol might not be a good fit for you.
You can learn more about the Bi-Phasic Diet here.
The Fast-Tract Diet™
The Fast Tract Diet™ was developed by microbiologist Dr. Norm Robillard using a mathematical equation paired with the Glycemic Index to assign foods a “Fermentation Potential” value.
Depending on your symptoms you’ll set a goal number to stay under per day, and then count the “FP” in everything you eat.
The Fast Tract Diet™ reminds me of Weight Watchers – you choose a goal number and count the points in everything you eat. And just like Weight Watchers, there’s an app you can download to help you find and track the FP points of everything you eat.
If your symptoms are still severe, you can reduce the number of FPs you eat per day – and as you improve, you can increase the number of FPs you eat each day.
One of the easiest diets to follow if you eat out or travel a lot. And many people love the simplicity and structure of this diet. Following it is straightforward!
Learn more about The Fast Tract Diet™ at the upcoming Masterclass and Q&A Session with Dr. Norm Robillard. More information on the Masterclass here!
The Elemental Diet
The Elemental Diet is very different from the 5 other diets we’ve discussed so far. Unlike the other SIBO diets, the Elemental Diet is a therapy in itself. It shouldn’t be the first diet you try – in fact, it should only be considered for tough cases who have already failed other SIBO treatments.
A liquid diet that can be both antibacterial and anti-inflammatory while also helping repair the gut. (There is also a Semi-Elemental Diet, but according to Dr. Michael Ruscio the effectiveness of both the full elemental and semi-elemental diets are the same.) It is followed for 2-3 weeks at a time.
This is not the same as fasting (or modified fasting) – on the Elemental Diet, you’ll drink a specially formulated blend of nutrients to get your daily calorie needs met.
The proteins in the Elemental Diet are broken down into the most elemental form – amino acids.
The carbohydrate contained in the element is fully digested, and so it essentially contains no fiber which can be very helpful for sensitive guts.
You can purchase a pre-made Elemental Diet or create your own at home using store-bought ingredients.
For some severe SIBO cases, the Elemental Diet is a lifesaver. It is the only diet that cure SIBO.
But for other people, it’s way too restrictive and can cause weight loss.
You can learn more about the Elemental Diet here.
Is There A Perfect Diet For SIBO?
NO! There is no one perfect diet for everyone with SIBO. We all have different symptoms AND different personalities. What works for me might make you feel worse. It’s highly individual.
Finding the right diet for you is a learning and trying process. I hope this breakdown has helped you better understand the options available!
To your health,
P.S. We’ve heard many good things about the Fast Tract Diet™ from our community – but it’s the diet I know the least about personally – That’s why I’m very excited to welcome Dr. Robillard for a special masterclass and Q&A where Dr. Robillard is teaching more about the Fast Tract Diet™. Join the Masterclass by clicking here.
Should you commit to a gluten-free diet if you have SIBO?
It’s one of the most common questions we hear from the SIBO SOS™ community.
Some practitioners think only those with Celiac Disease need to be gluten-free.
Others think gluten is evil and should be avoided by everyone – especially those with gut issues like Irritable Bowel Syndrome (IBS) or Small Intestine Bacterial Overgrowth (SIBO).
So what is the truth about gluten and SIBO?
Today, I’m going to explain Celiac Disease, non-Celiac gluten sensitivity, their connection to SIBO, and (hopefully!) empower you to make the right decision for you about gluten. This blog post is based on information I have learned from interviewing Dr. Lisa Shaver, ND.
What Is Gluten?
Gluten is a protein found in grains like wheat, rye, barley, and spelt. It also is a common contaminant in grains that don’t naturally contain gluten, like oats. Gluten is a large molecule with two sub-molecules: gliadin and glutenin.
Many foods are naturally gluten-free – even some grains like rice, corn, and quinoa. Other foods, like oats, can be gluten-free if they are properly handled. But gluten can’t be removed from gluten-containing grains like wheat or rye. Gluten-containing grains must be avoided 100% by gluten-free people.
What Is Celiac Disease?
Celiac Disease is an autoimmune condition that causes damage to the small intestine. When someone with Celiac Disease eats gluten, their immune system reacts by damaging the small intestine.
About 40% of the population has the genes for Celiac Disease. You can have the genetic test easily with just a cheek swab. But, having the gene for Celiac doesn’t mean you necessarily have the disease. Only about 1% of the population actually has Celiac Disease.
But, about 5% of people who DO have Celiac Disease don’t have the gene for it, either.
Basically, this means having the gene for Celiac isn’t a sure way to know if you do or don’t have Celiac Disease. Instead, you need to be tested for Celiac Disease specifically using either a blood or stool test.
For a blood test to be accurate, you have to be eating gluten regularly. For the stool test, you don’t have to be currently eating gluten for the results to be accurate.
If you DO have Celiac Disease, you must stop eating gluten. You need to stay on a gluten-free diet for the rest of your life.
Beyond Celiac Disease
If only 1% of the population has Celiac Disease, does that mean only 1% of us need to avoid gluten?
It’s not quite that simple.
Doctors once believed that either you had Celiac and must avoid gluten, or you could tolerate it without any adverse symptoms. What the evidence shows, however, is that someone can have non-celiac gluten sensitivity, and that can cause a whole range of symptoms.
As mentioned earlier, gluten has two sub molecules, gliadin and glutenin. As a molecule itself it’s already very large and hard to digest for a vast majority of people.
While you may not think you have a gluten sensitivity, you really need to test for it to be sure. Cyrex is one laboratory that does offer the non-celiac gluten sensitivity panel along with the celiac panel. It may be an extra cost, but arming yourself with information could definitely be worth it, especially if your results are positive.
The Role of Gluten When It Comes to SIBO
SIBO, celiac disease and non-celiac gluten sensitivity appear to intertwine. While you may eliminate gluten, if you’re still heavily eating carbs, you may still have symptoms.
In many instances, patients who were celiacs, or who had non-celiac gluten sensitivity who eliminated gluten, may have felt great for a long time. But after eating gluten-free foods like cookies, English muffins, tortillas and gluten-free cakes, or even rice, sorghum, millet and nut flours like almond or cashew flour, found that they still had bloating and diarrhea.
If you have SIBO, indulging in a gluten-free carb-heavy diet might be the cause of a whole list of uncomfortable symptoms: burping, reflux, heartburn, abdominal pain, stomach pain, gurgling, distention, bloating, gas, diarrhea, constipation, alternating diarrhea constipation, and painful bowel movements.
This shows that it isn’t just gluten, but processed grains in general that people with SIBO really struggle with in terms of digesting them properly.
Another issue is mis-diagnosing a gluten intolerance or Celiac Disease as SIBO.
Gluten & Leaky Gut
Why doesn’t everyone with the gene for Celiac Disease actually develop the condition?
It’s because for Celiac Disease to develop, leaky gut must also be present. If you have the gene for Celiac Disease but never develop leaky gut, you will not develop Celiac Disease.
Sounds great, right?
The only problem is that leaky gut is incredibly common and can be triggered by everything from medications, to environmental toxins, to diet (yes, eating gluten!), and stress.
Should I Go Gluten Free?
Even with all we know today, there still isn’t a one-size-fits-all answer to this question.
However, there are certain steps you should take BEFORE eliminating gluten. If you eliminate gluten without testing for Celiac first, for example, you will never know if you have just a sensitivity or a potentially life-threatening autoimmune condition.
And even if you decide to go gluten-free, replacing gluten-containing foods with GF replacements may make your SIBO symptoms WORSE!
Do you have questions? Need more information about gluten, SIBO, and leaky gut?
Join Us For An All-New Masterclass with Dr. Lisa Shaver About Gluten
Introducing an all-new SIBO SOS™ Masterclass:
Taught by Dr. Lisa Shaver, ND
Masterclass On-Demand | Live Q&A Nov 1. At 3 PM Eastern
Dr. Shaver is a naturopathic physician, licensed acupuncturist, and holds a master’s degree in Oriental Medicine. She specializes in Celiac Disease and non-Celiac gluten sensitivity (NCGS).
In this all-new Masterclass, Dr. Shaver will explain the way gluten impacts the digestive system, the different ways a gluten intolerance can manifest, and how gluten intolerance can interplay with Small Intestine Bacterial Overgrowth and leaky gut.
And the best part? We’re offering a special price for this Masterclass: just $27. This information is critical to healing (and so misunderstood) so we are lowering the price to make it accessible to as many people as possible.