SIBO 101
Disclosure: This post is not a substitute for professional medical or nutrition advice, diagnosis or treatment. All content, including text, graphics, images and information, in this post/on this site, or available through this site is for general information purposes only. You are encouraged to review any information you may have obtained from this site, regarding any medical condition or treatment, with your healthcare practitioner.
If you have a history of or are currently struggling with disordered eating patterns or eating disorders, this post may be triggering.
Content pulled from Phoebe Lapine’s Book SIBO Made Simple
Sections
My SIBO Story
Before you read any further, I would like to preface that there are many many approaches to navigating SIBO. My intention in sharing this blog post is to provide background information, a handful of strategies, and the approach I took to treat SIBO so you can take anything that resonates with you to your medical practitioner and together develop an individualized plan that fits your diagnosis and lifestyle.
It’s difficult to pinpoint exactly when my digestive issues unfolded. I was an anxious, hyper-academic kid and from a relatively young age I had “butterflies in my stomach” and struggled with going to the bathroom (aka my poops were either very hard or very loose). My digestive issues escalated during my four years in college - I was constantly bloated (no matter what I ate, I had abdominal distention), I also had a lot of gas, and just didn’t feel like my gastrointestinal tract (GI) was working like it should be. Anytime I talked to a healthcare practitioner about this, they responded with “You probably have IBS (irritable bowel syndrome).”
Does this experience sound familiar to you? I wouldn’t be surprised because IBS affects between 10% to 15% of people worldwide and is a disorder characterized by abdominal pain or discomfort and altered bowel movements (diarrhea, constipation, or both).
When I moved to New York, it felt like my GI issues had improved a bit, but I felt like my food wasn’t digesting properly and was sort of sitting in my stomach (aka slow gut motility); I was also still occasionally constipated. After complaining to my internist about my bloating and “hard” stomach, he suggested I do a SIBO breath test. He sent me a kit, I took the test, and I soon found out I did in fact have SIBO. After I tested positive for methane-dominant SIBO (I discuss the difference between methane-dominant and hydrogen-dominant SIBO further on in the post), I went back to my internist to find out what my next steps were. He told me about antibiotics, the low-fodmap protocol and suggested I make an appointment with a gastroenterologist. Does this sound a little like your story? Many doctors don’t have the expertise to appropriately manage digestive disorders, which in the first place are a great challenge to diagnose and treat. I ended up waiting over a year to take control of my digestive discomfort. I knew I needed a functional medicine doctor who regularly worked with SIBO patients and who offered a holistic, individualized approach to treatment and care. I was referred to a functional medicine doctor in Los Angeles who undertook an in-depth analysis of my body, mind, and spirit and developed a personalized treatment plan that would work specifically for my life and my needs. He also had a certified nutrition consultant on his team who helped me with the nutrition aspect of the SIBO treatment protocol. I want to acknowledge my financial privilege and how fortunate I am to have access to this kind of quality healthcare and recognize the privilege of that.
Before you keep reading, I want you to remember that everyone has their own SIBO story. There is no one-size-fits-all treatment for SIBO and no rule that applies to everyone. Your treatment plan is going to be different from someone else's based on the type of SIBO you have, the practitioner you are working with, your wants and needs, and where you are in your life.
Healing from digestive issues like SIBO is hard work. It requires patience, organization, commitment, and a positive attitude. It is a long road - it can take as long as a year or more to feel noticeable relief - but it is worth it. And as always, I’m here for you as you embark on your own journey:)
What is SIBO and How Do You Get It?
SIBO stands for small intestinal bacterial overgrowth. When you develop SIBO, normal populations of bacteria begin to colonize and multiply in the small intestine. How does this happen? It’s complicated and more research is needed to elucidate the underlying mechanisms. Symptoms of SIBO (abdominal pain, bloating, diarrhea and/or constipation, nausea, an uncomfortable feeling of fullness after eating, and malnutrition) are similar to those experienced by those with IBS. Fun fact - 60% of those with IBS have SIBO. Let’s dive deeper into the SIBO sphere...
The small intestine is the longest part of your gastrointestinal (aka digestive) tract and is the primary location for food digestion and absorption - it’s where the food you just ate mixes with digestive juices secreted primarily from the pancreas and is then absorbed into your bloodstream.
The large intestine is teeming with microbes with more than 1000 different species! We truly could not survive without our gut microbes. They help us metabolize our nutrients, synthesize vitamin K, protect against harmful pathogens, maintain the integrity of our gut mucosal lining, and play an important role in immunity.
Compared to the large intestine (aka your colon or gut), the stomach and small intestine, under normal circumstances, have relatively few bacteria because of the acidic environment of the stomach, the release of bile into the small intestine (bile is a digestive fluid that supports breakdown and absorption of fat alnd intrinsically damages many bacteria), the quick passage of food from the small intestine to the rest of the body, and release of digestive enzymes from the pancreas. The microbes that aren’t destroyed by acid, bile, or enzymes face our body’s immune cells, which secrete a multitude of antimicrobial chemicals and antitoxins (did you know that a straggering 70% of your immune system lives in your gut?!).
We also rely on our internal “housekeeper” more formally known as the migrating motor complex (MMC). The MMC is located in the small intestine and sweeps leftover undigested material through the GI tract. Its contractile activity kicks in between meals i.e. during a fasted state of ninety minutes or more. That gurgling sensation in your tummy is an indication that your MMC is doing a good job.
Once digestion and absorption are complete in the small intestine, the digested food materials flow from the small intestine into your large intestine via the ileocecal valve. The ileocecal valve is a muscle situated at the intersection of the ileum (last portion of your small intestine) and the colon (the first part of your large intestine) and essentially acts as a gatekeeper. It opens its door to permit digested material to pass into the large intestine but then closes to prevent the backflow of food and bacteria from your large intestine back into the small intestine. If this isn’t working properly, bacteria from your large intestine can make their way back into the small intestine.
Let’s quickly recap...a malfunctioning migrating motor complex, some sort of structural defect/injury in your small intestine, low stomach acid, deficient bile, and/or a compromised immune system sets you up for developing SIBO. Research suggests that a defective MMC or structural blockage is the primary underlying causes (Phoebe Lapine, SIBO Made Simple).
Now, you’re probably wondering, “well, how does your MMC start to malfunction?” Amazing question...There are several reasons why this can happen:
Stress - can hinder small intestinal motility and impede production of stomach acid which helps break down food and kills bacteria
Lack of sleep
Grazing throughout the day and not giving enough time for your body to completely digest between meals
Any kind of head or spinal injury
Regular use of meds that impair motility like antibiotics, opiates, and smooth muscle relaxants
Food poisoning.
Abdominal surgeries and structural abnormalities in the intestine
Testing For SIBO
So you’re thinking you might have SIBO and ask yourself “what’s my next step?” To get a better understanding of what’s going on in your GI tract, it’s recommended to do a hydrogen and methane breath test. Most SIBO experts recommend a 180-minute lactulose breath test. You can get the breath test kit sent to you to do in the comfort of your own home from a physician or you can do it in a doctor’s office. Here’s what the test entails:
You gently blow into the provided bag to get an initial breath sample.
Then, you drink a lactulose solution, a man-made sugar that humans cannot digest, but SIBO bacteria love feeding on. Lactulose travels all the way down to your large intestine and gives you a good read on what is happening throughout the digestive tract.
You then breath into the bag every 15-20 minutes, collecting the breath sample in several vials.
Ship off all the labeled vials to the lab and patiently await for your results.
Here’s a video showing you how to perform the breath testHere are instructions for the breath test (note: instructions may differ depending on the brand of your breath test)
What exactly is the breath test measuring?
Bacteria in the intestine produce hydrogen and/or methane gas through fermentation (aka breakdown) of carbohydrates. It is the gas that is produced from the bacterial fermentation that is responsible for bloating, abdominal discomfort, or diarrhea. In the lab, your breath samples are analyzed for levels of hydrogen and methane. It is the timing of the gas production that indicates whether the bacteria are primarily in your small or large intestine. Basically, the technician is looking for a significant rise in hydrogen gas, methane gas, or combination of the two, before the lactulose solution reaches the large intestine. A sharp rise in gases past the 120 minute mark is considered normal since the solution would have made its way into the large intestine, where gut bacteria are pervasive.
Some guidelines for the breath test:
Two weeks before the test - finish taking any antibiotics/antifungals/herbal antimicrobials (except those who are retesting following SIBO treatment); do not undergo colonoscopy, barium enemas, or colonics.
Four days before the test - Avoid all laxatives/motility agents (this includes magnesium)
24 hours before the test - avoid all nonessential medications and supplements (including probiotics); limit diet to baked chicken, fish, or turkey cooked only with salt and pepper, plain steamed white rice, eggs, and white bread. Foods like pasta, whole grains, fruit, veggies, dairy, nuts, and seeds must be avoided.
12 hours before the test - Begin fasting (do not eat or drink anything other than water).
Day of your test - No sleeping, vigorous exercise, or smoking for at least 1 hour before or any time during the test; you can brush your teeth; no eating or drinking during the test.
I’ve taken the breath test for a total of 3 times. Since the test takes at least 3 hours, I like to start at 8 am (which means waking up at 7 am since you have to be awake for at least 1 hour before the test), finish up around 11 am, and enjoy a delicious breakfast.
I Tested Positive For SIBO: Interpreting Results
The gas that peaks more dramatically indicates which form of SIBO you are diagnosed with: hydrogen-dominant SIBO or methane-dominant SIBO. In addition to hydrogen and methane gases, hydrogen sulfide is a major gas in SIBO cases; there is a lack of research on this form of overgrowth and it can be challenging to manage and treat effectively (1).
Hydrogen-dominant SIBO is typically associated with diarrhea.
Methane-dominant SIBO is commonly associated with constipation and is more difficult to treat.
SIBO Treatment Options
After you receive your results, it’s time for the game plan. This is where collaborating with an experienced doctor and/or registered dietitian with expertise in SIBO is extremely valuable. Everyone has their own SIBO story. There is no one-size-fits-all treatment for SIBO and no rule that applies to everyone. Your treatment plan is going to be different from someone else's based on the type of SIBO you have, the practitioner you are working with, your wants and needs, and where you are in your life.
Remember that you are the expert of your body and recognize that you have choice and autonomy. If the practitioner you are working with recommends a treatment plan that you don't think aligns with you and your life, know that there are other options. Seek out a second opinion. I believe the key is to be honest with yourself and others, which is not easy work.Your treatment protocol depends on your breath test results and your doctor. There is no one size fits all SIBO treatment plan and what works for one person won’t necessarily work for you.
SIBO is essentially treated by killing and starving the bacteria in the small intestine. This is known as the “kill phase.” This can be done through conventional antibiotics, herbal antimicrobials, and/or the elemental diet.
Conventional antibiotics: commonly prescribed by physicians for treatment of SIBO; works by specifically targeting the bacteria in the small intestine. Mild side effects. Expensive if not covered by insurance. For methane-dominant SIBO which is more resistant, in addition to Xifaxan, Neomycin or Metronidazole is needed. Unlike xifaxan, these other antibiotics kill non-selectively.
Herbal antimicrobials: many clinicians have found success with herbal supplements. Even though they can in cases be as effective as antibiotics, you are taking more pills for a longer period of time and you may experience more side effects. Herbal supplements should not be used by pregnant women or women trying to conceive. If considering the herbal route, be sure to consult with your healthcare professional.
Elemental diet: involves drinking a medical shake for all of your meals. Since the nutrients are essentially pre-digested and in their most basic form, they are easily digested and absorbed in the small intestine and the bacteria don’t have a chance to access the nutrients.
No matter which treatment protocol you go with, I strongly urge you to work with a medical professional to tailor the plan to your needs. It is also very helpful to work with a dietitian or nutritionist with expertise in this area to help with the diet/nutrition aspect.
My “Kill Phase” treatment was a combination of antibiotics and herbal supplements.
I first took xifaxan and neomycin with guar gum*
*The bacteria we are trying to target and kill in the small intestine love guar gum, a polysaccharide derived from guar beans. It’s high in soluble fiber (slows digestion) and is commonly used as a thickener in many food products. Research has shown that consuming guar gum during the antibiotic phase can increase the effectiveness of antibiotics since the guar gum attracts the bacteria out of hiding, increasing access to the antibiotics. I tolerated the guar gum best in smoothies. You can also mix with coconut water and chug quickly before it thickens.
Once those finished I took the following supplements*:
Dysbiocide and FC-cidal: herbal supplements
Megasporebiotic: spore-based broad-spectrum probiotic using soil-based microorganisms; survives acid in stomach and does’t require refrigeration.
Megamucosa: to support repair and maintenance of the mucosal barrier.
Betaine HCL supplements: since I had low stomach acid.
Digestive enzymes: I took these and Betaine HCL with every meal.
*While taking the herbal supplements, I also followed a combination of a low-fodmap/specific carbohydrate protocol (discussed in further detail below)
SIBO Dietary Approaches
Whether or not you modify your diet during your SIBO treatment again depends on the severity of your symptoms, personal preference, and your doctor’s recommendation. But most importantly, it depends on whether it’s something you want to do or believe might benefit you.
If your practitioner recommends an elimination diet such as the low-FODMAP or SIBO-specific diet as an adjunct to your treatment plan, I encourage you to take caution before starting. For many, a restrictive diet can trigger fear of certain foods/food groups, obsession with food, and disordered eating behaviors and, as a result, can cause more anxiety than relief. Following a restrictive diet isn't the only way to support your healing and there are alternatives (yoga, meditation, hypnotherapy). Especially if you have a history of or are currently struggling with disordered eating, I urge you to see whether these other forms of stress-relief work or gut-targeting strategies are effective before considering an elimination diet.
The goal of temporarily altering your diet is to support the treatment of symptoms, starve the bacteria in the small intestine, limit inflammation, and give your gut lining time to recover. Currently, there is no gold-standard diet specifically designed for SIBO. There are a ton of approaches though: low fodmap, specific-carbohydrate diet, bi-phasic diet, paleo, low-fermentation diet...What these diets all have in common is that they limit easily fermentable, and often not easily digested carbohydrates, which the bacteria we want to kill love to feed on.
The most commonly followed diet is the low-FODMAP approach. My protocol, known as the sibo-specific diet consisted of a combination of the low-FODMAP diet and the specific-carbohydrate diet. It is important to keep in mind that if you choose to follow a SIBO diet protocol, that it is temporary (2-6 weeks). It is not meant to be long-term and can actually have negative consequences if you do it for an extended period of time since you end up starving the good bacteria in your large intestine, which we don’t want.
The three phases typically include: Phoebe Lapine
Phase 1: Treatment via dietary modification - reduce bacterial overgrowth and help heal the gut (approximately 2 weeks)
Phase 2: Reintroduction - slowly reintroduce foods over a 2-4 month period
Phase 3: Personalization and Diversification - by this stage, you’ll have a much better sense of what foods work well with your system and which foods you don’t tolerate as well. It’s during this time that we want to feed our beneficial gut flora with a variety of foods (6 months-forever).
Let’s dive deeper into the low FODMAP diet, SCD, and sibo-specific diet:
Low-FODMAP
An acronym that describes groups of sugars (short-chain carbohydrates) that are not completely digested or absorbed in our intestines. In the small intestine, the FODMAPs travel slowly and attract water. Once they reach the large intestine, they are fermented by gut bacteria producing gas. The extra gas and water result in distention of the intestinal wall. FODMAPs are found naturally in many foods like legumes, dairy, grains, certain fruits, and vegetables. The purpose of this approach is to limit/remove hard-to-digest foods to help our gut heal, to also help starve out any unwanted bacteria in the small intestine, and to hopefully give you some relief from digestive signs and symptoms.
Specific Carbohydrate Diet
Removes specific carbohydrates (polysaccharides, some oligosaccharides, disaccharides, and polyols) such as sugars, grains, and starchy vegetables; unlike low FODMAP diet, it includes garlic and onion and includes some high-FODMAP vegetables. It utilizes a system of “legal/illegal” foods and can thus be very triggering for anyone experiencing disordered eating/eating disorder.
SIBO specific diet
Combines low FODMAPs and SCD diets and helps starve bacteria and eliminate hard-to-digest grains.
Things to Consider When Following a SIBO Dietary Protocol
No matter what approach you go for, here are some things you may want to consider:
Focus on progress, not perfection. These diets are already restrictive and especially for those who have dealt with or are dealing with disordered eating and/or eating disorders, these diets can definitely be a trigger (I touch on this later on)...While I followed my dietary protocol 95% of the time, I allowed myself to be flexible; this was so important for me. Also, give yourself time to adjust to this new normal and practice self-compassion.
Think of this as an opportunity to get creative in the kitchen. Rather than focusing on all the foods I couldn’t eat, I challenged myself to think about everything I could eat. I made it my mission to experiment with ingredients I didn’t normally cook with like rutabaga and celery root and came up with interesting flavor combinations to keep me happy and going.
Redefine plant-forward. On my blog and social media platforms, I like to share “plant-forward” recipes because I love fruits, veggies, grains, and legumes. Also, many people ask me how to make vegetables, beans, and different grains exciting, satisfying, and tasty; so I aim to elevate these plant foods with spices and unique flavor combinations to accentuate their natural flavors and make them even more exciting to eat! I want to take a moment to distinguish between eating plant-forward and plant-exclusive. Plant-forward generally means that plant-based foods (think fruit, veg, grain, legumes, plant proteins, nuts, and seeds) are emphasized; but it is by no means strictly limited to these types of foods. For me, plant-forward means bringing plant foods to the fore while also including animal foods when I’m in that kind of mood. It’s all about listening to your body. Some nights I’m craving a grain bowl with a ton of veggies, sweet potatoes, tofu, and a tahini sauce. Other nights, I feel like a stir-fry that is heavy on the veg with some steak mixed in. Plant-exclusive on the other hand typically means that your meals are only composed of plant foods and do not incorporate animal foods. While following my SIBO diet protocol, I incorporated animal protein more frequently since I was not able to eat plant-based proteins like tofu, tempeh, beans, lentils, etc. I paired chicken, fish, and beef with lots of SIBO-friendly veggies, grounding rutabaga or celery root, and flavorful dressings.
If you’re living at home with family, get them on board! At least four nights a week, my family would eat my SIBO-friendly dinner. We were more conscious about not using garlic and onion in our recipes. Having their support throughout the process made all the difference.
Make sure you are eating enough and incorporating carbs into your meals. When following a restrictive diet, it can be easy to undereat and think that carbs need to be strictly eliminated. I definitely had to make an effort to eat until I was satisfied and had to get inventive when it came to carbs.
Remember that this way of eating is temporary and is supporting your healing journey.
A few other notes…
Mindful eating - It’s not just what you eat that matters. How you eat greatly impacts your digestion and your relationship with food, your body, and your mind.
Try your best to eat without/limited distractions.
Chew food thoroughly so that digestive enzymes in saliva have time to mingle with what you’re eating.
Engage your senses: How does the food taste? What are the aromas, textures, and colors?
Anxiety, Stress, and SIBO
The gut-brain connection is profoundly powerful. Our gut and brain bidirectionally communicate with each other via the vagus nerve, which is involved in the parasympathetic (“rest and digest response”) control of the heart, lungs, and digestive tract. Your gut is constantly sending signals to the brain and vice versa. Think about what happens before you’re about to take a big exam or walk into an interview...butterflies in the stomach, urge to use the restroom, rapid heart rate, shallow breathing. If we are chronically stressed and anxious, we can damage our vagus nerve. As a result, our vagus nerve isn’t able to properly transition from the fight-flight-freeze mode into rest-and-digest mode. I’m certain that all the pressure and stress I put on myself during adolescence and young adulthood damaged my gut microbiota and contributed to SIBO.
I strongly believe that healing your mind helps heal your body. An integral part of my recovery from SIBO was working through my anxiety and cultivating a grounding routine that helped me return to a place of ease. We have to confront the root causes (stress, anxiety, etc.) in order for the issue (SIBO/digestive issues) to eventually improve. This is hard work. Embarking on your SIBO journey, changing your lifestyle, and adopting a diet that is more restrictive than you’re used to can all contribute to anxiety in your day-to-day life. I personally found it helpful to practice gentle yoga flows, morning walks, affirmations, meditation, gratitude journaling and breathwork throughout my day. Start slow…you don’t have to do everything all at once. Maybe you start by going on a walk outside during your lunch break or wake up ten minutes earlier to do a meditation. I believe the key is finding things that bring happiness and joy to your every day and leaning on others for support. If you’re interested in learning more about my spiritual journey, I wrote two blogs about trading anxiety for peace and love and leading a life of happiness, abundance, peace, and love.
Disordered Eating and SIBO
To learn more about the overlap between SIBO/IBS, mental well-being, and disordered eating, I strongly encourage you to listen to Phoebe Lapine’s interview with Christy Harrison on her podcast, SIBO made Simple. I will include some of my biggest take-aways in this section.
Before your healthcare practitioner recommends a SIBO-diet or you decide to follow one, it is so so important to be honest with yourself and your practitioner about disordered eating patterns or behaviors. Again, this is by no means easy and takes strength, openness, courage, and self-awareness. More often than not, health care professionals are not aware of the mental health pitfalls of these elimination diets. Following a restrictive diet may trigger old patterns of behavior or overwhelming feeling, which is why doing some self-reflection is extremely important.
Following a restrictive diet may trigger old patterns of behavior or overwhelming feeling, which is why doing some self-reflection is extremely important. After listening to Phoebe Lapine’s interview with Anti-Diet, Intuitive Eating Registered Dietitian, Christy Harrison, my attitude towards elimination diets shifted. I didn’t realize that there are other therapies that can be as effective in helping heal gut issues since they target the gut-brain connection without the damaging mental health implications (anxiety, stress, food fear, disordered eating, etc.). Restrictive diets should not be the first line recommendation or a recommendation at all for people with a history of or currently struggling with disordered eating or a diagnosed eating disorder. Maybe it’s an option for someone who is deep into their recovery and strongly feels the need to try a temporary elimination diet. If you are someone struggling with disordered eating/eating disorder I encourage you to address your disordered eating first so that “you can be safe, survive, and so that the gut, body, and mind are able to heal” (Christy Harrison). You may consider working with a dietitian who specializes in eating disorders, and digestive conditions to help you liberalize your diet, eat more, make peace with food, and practice a self-care way of eating. There’s a big chance that you’ll significantly heal your digestive issues while healing your relationship with food.
If you read my blog post about healing my relationship with food, you learned how I struggled with orthorexia (unhealthy obsession with “healthy” eating), restrictive eating, undereating (a risk factor for SIBO - it contributes to low stomach acid production and slow metabolism), and food fears which fueled constant thoughts about food, anxiety, and led me to lose weight and my period. Before beginning my SIBO journey, I began making peace with food and focusing on eating more. While I made significant progress, there was so much more I wanted to tackle. I worried if following the SIBO diet would reverse all the work I had put in to heal my relationship with food and if I would revert to my disordered eating tendencies. I was concerned about adequately nourishing my body. I talked through how I was feeling with the registered dietitian I was working with at the time to help me figure out if taking this step was right for me. Ultimately, I felt confident enough in where I was in my journey towards giving myself unconditional permission to eat all foods to begin the SIBO protocol. Before making a decision, I encourage you to take a step back and really evaluate whether following this diet will be helpful or harmful. Remember that just because this might not be the right time to start a SIBO diet does not mean that the time will not come.
It took me a few weeks to get into the groove of things and adjust to my new way of eating. Because I wasn’t able to eat so many of my favorite foods (grains, legumes, tofu, dessert, oats, etc.) and had a relatively limited selection of foods I could choose from, I found myself thinking about food more often. I felt like I had to pre-plan some of my meals to make sure I had proteins and carbs on-hand for lunch and dinner. The way I was feeling is reflective of how most dieters and individuals with disordered eating or eating disordered also feel. When we deprive and restrict ourselves of certain foods and/or food groups, our natural response is to desire those forbidden foods even more. We become obsessed with food and it can become consuming. These feelings gradually dissipated as I started eating my AWG bread with peanut butter and caramelized banana in the morning, my perfectly sweet and creamy hot chocolate, and nourishing myself with carbohydrates from root vegetables and cassava products. To boost the energy density of my meals, I incorporated quality fats like olive oil, olives, nuts, nut butter, and tahini and SIBO-friendly carbohydrates. As the diet progressed, I introduced white rice a few times a week and ate small quantities of chocolate and dessert because it felt right. I ate cookies on my birthday and some matzah and flourless chocolate cake during passover. Having some dessert, bread, or foods that you are supposed to avoid during the diet, is not make or break. You will not undo all the work you have done. We still have to do our best to enjoy life. Giving myself permission to eat some of a cookie or some pasta helped me continue to make peace with food and prevented me from fearing these foods.
Also - just because you are on a restrictive diet does not mean that you can’t continue working on your relationship with food. Trust me when I say this is possible. Throughout my SIBO journey, I have had several #foodpeacewins. I’ve been eating more, listening to my body, and have been focusing on nourishing every cell of my body. I’ve also noticed that now that I’m eating more, my metabolism has been improving and my body can tolerate greater quantities of food. I now give myself permission to eat two slices of toast because one piece does not satisfy me. I now can eat a SIBO-friendly bagel and a smoothie. I now eat a complete, balanced lunch whereas before I would not eat nearly enough.
During this time, I also found it especially helpful to tune into my hunger and fullness cues as much as possible. I want to acknowledge that it can very challenge and uncomfortable for individuals who are undeating or who are working through disordered eating to properly detect hunger and fullness cues
Here is a diagram that has helped me connect with my internal body cues:
I like to remember that my body is not going to heal if I’m not nourishing it with enough food.
Here is meditation you can recite before meal time:
I thank my body for all it has allowed me to do today.
I appreciate every cell that works tirelessly for my existence.
From my beating heart cells to breathing lung cells.
May I nourish every cells, in every organ, to complete satisfaction.
-Intuitive Eating for Every Day by Evelyn Tribole
Recipes! (SIBO-friendly, low-FODMAP/specific carbohydrate diet)
Getting diagnosed with SIBO can be really overwhelming, especially if you don’t have a practitioner guiding you through the process. I’ve created nourishing SIBO-friendly recipes to make it a little bit easier. I’ve also created a SIBO recipe e-book titled Healing SIBO which includes 30+ SIBO-friendly breakfast, lunch, dinner, and snack recipes. Finally, I am offering a SIBO-friendly cooking class on Sunday, April 18th: sign up here or shop the recording after the class!
Instead of focusing on the things you have to cut out right now, let’s focus on the ABUNDANCE and how to make healing more fun!
I’ve been loving experimenting with different animal proteins like fish, chicken, steak, ground beef, ground turkey, and shrimp and using spices like sumac, pomegranate molasses, paprika, and cumin and all the herbs!
There’s a ton of fruits and vegetables you can incorporate, nutrient-rich fats like tahini, olive oil, certain nuts like pecans and walnuts and certain nut butter (almond butter, peanut butter, pecan butter), seeds, and olives.
To satisfy my love for starchy carbs, I relied on squash, celery root, rutabaga, spaghetti squash, cassava tortillas/chips/pasta, and this gluten-free, grain-free bread made from arrowroot, almond flour, and coconut flour. After about 3 weeks on the diet, I added in some white rice since it’s one of my favorite foods and personally tolerated well.
I also tried to eat as many of my vegetables cooked (love steaming zucchini and broccoli and roasted my other veg) rather than raw for better digestion.
Gelatin and collagen also became my new friends: gelatin to make my pomegranate-berry jello and collagen in my smoothies, pancakes, and hot drinks.
Resources
Sydney’s SIBO-friendly recipes
Phoebe Lapine’s Blog Feed Me Phoebe for great SIBO posts, content, and recipes
Phoebe Lapine’s Podcast SIBO Made Simple
Phoebe Lapine’s Cookbook SIBO Made Simple
A Gutsy Girl - Blog and Recipes
Monash University Website and App for information about the low FODMAP diet and recipes
SIBO-Friendly Food Products
AWG Everyday Bread (can be purchased online or at Erewhon Markets in the refrigerated section)
Four Sigmatic Mushroom Cacao Mix
Siete Cassava/Almond FlourTortillas
Siete Cassava Hard Shell Tacos
Santa Cruz Organic Peanut Butter
Dream Pops (I like the Berry Dream flavor and Chocolate Lion’s Mane flavor)
Supplements
Soil-Based, Spore-Based Probiotic