The good (and bad) of SIBO diets – and what to do when you’re stuck on a restricted diet

It starts innocently enough: you decide to try an elimination or other specific diet for Small Intestine Bacterial Overgrowth like:

  • Low-FODMAP
  • Low-Fermentation
  • 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?”

“What’s that?”

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!

Check out Intestinal Repair Formula on Dr. Ruscio’s site HERE.

(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 – this is not a paid partnership! 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 off of the sale of this product.

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15 thoughts on “The good (and bad) of SIBO diets – and what to do when you’re stuck on a restricted diet”

  1. I have SIBO and my practitioner has recommended this product. I believe I am sick with covid now as well. Any contraindications using this product then?

    1. Oh no… I hope you’re coping well or at least as well as can be expected!

      Unfortunately, CoVID is novel. So I don’t think Dr. Ruscio’s research team has had any opportunity to definitively study if Elemental Heal might be contraindicated for CoVID… I don’t think many product has been tested for CoVID in general to tell you the truth. But I’d still reach out to Dr. Ruscio’s support desk here just to be sure!

      Loop back and let us know what you find out! I think a lot of people would find that information useful.

  2. the 3/23 FB still did not answer Gina’s question: “Hi. So I’m a little unclear. For mild it says take 5 grams and severe 10 grams. Reading the label it appears that 4 pills = 3 grams? So how many pills for trial for mild vs severe. Thanks!” I have the same question. Please clarify.

    1. Hi Frances,

      The correct dosage from The Ruscio Institute is:
      5 caps, 2x per day for mild
      10 caps, 2x per day for severe

      Hope this helps.
      SIBO SOS Team Member

  3. Hello,
    I’m so sorry that I’m some days to late for the Q&A, can I see a video or transcript of it? I’m very interested in this new supplement.
    I would really like to know if it is a good idea to take immunoglobulin when I’m intolerant for dairy.
    Thank you so much for your answer.

  4. Hi
    I am suffering from methane sibo, how this therapy could be relevant to me? I exactly have the problem that my diet gets more and more limited, can’t go back to some foods and it looks like my primary therapy from Allimed after 3 months gets limited and everything goes back
    Thanks for your answer doctor

  5. Do you need to have a diagnosis of SIBO for this to be beneficial? I have SIBO but my 3 yr old son has same symptoms but it is too challenging to get him tested yet. Due to our FUT2 genes I’m lead to believe we have a predisposition for SIBO infections so my gut feeling is that he may have SIBO too. Is it safe for children (3 yr) and breast feeding mums?

  6. Hi. So I’m a little unclear. For mild it says take 5 grams and severe 10 grams. Reading the label it appears that 4 pills = 3 grams? So how many pills for trial for mild vs severe. Thanks!

  7. Hi
    Just wondering if this can help with gastritis along with sibo?
    Also any contraindications? Is it ok to take with autoimmune issues?

    1. Wendy,

      All great questions and you should discuss with your physician. It’s hard to say not knowing your medical background. Our goal is to empower you and others to take the information that resonates with you and discuss it with your health practitioners. Thanks so much for reaching out. Let us know how your doctor responds, we’d love to know.

      SIBO SOS Team member

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