Table of ContentsView AllTable of ContentsElemental DietLow-FODMAP DietConsiderationsResearch
Table of ContentsView All
View All
Table of Contents
Elemental Diet
Low-FODMAP Diet
Considerations
Research
Two commonsmall intestinal bacterial overgrowth(SIBO) diet treatments include the elemental diet, a type of liquid diet, and the low-FODMAP diet, which focuses on limiting certain types ofcarbohydratesthat are not easy to digest.
The goal oftreating SIBOis to restore an average balance ofgut bacteria. SIBO can be the result of several problems, from damage to the gut to certain medications.A SIBO diet can help:
No diet is proven to treat SIBO in every patient, but your provider might recommend a diet plan that can help keep the condition from coming back. Your SIBO treatment plan may also include antibiotics and specific treatments for any underlying health condition you have (e.g.,Crohn’s diseaseorirritable bowel syndrome).This article discusses the use of the elemental diet and low-FODMAP diet for SIBO. It covers what to eat and avoid on a SIBO diet.
Daniel Ingold / Cultura / Getty Images
If you have SIBO, talk to your healthcare provider and/or a registered dietitian before changing your diet to make sure that you are meeting your daily nutritional needs.
How the Elemental Diet Works for SIBO
Theelemental dietis aliquid dietor a powder mixed with water. It is often used for people who have trouble digesting food because they have compromised digestive systems.
The diet gets its name because the nutrients are introduced into the body as close to their primary (elemental) form as possible.
The elemental diet has been studied as a possible add-on (adjunct) treatment to antibiotics for the following reasons:
What to Eat
The elemental diet is given either as a beverage that you drink or through a feeding tube. The amount of liquid you take in slowly increases over the first few days to reduce side effects likediarrheaor abdominal pain.
Each formulation contains nutrients that are in an easy-to-digest form. Typical formulations for the elemental diet include:
Different commercial variations of the elemental diet can bepurchased online. The powdered mixes contain only essential nutritional ingredients, providing 150 to 300 calories or more. Your healthcare provider can tell you how much you need to get adequate nutrition.
No artificial flavors or colors are added to elemental diet mixes (which are only combined with water). The beverage has a bland taste that many people find unpalatable. Some experts suggest adding ice to give the drink texture, which can make it easier to drink.
Duration
The length of time you stay on an elemental diet depends on your symptoms and how well you can stick with the program.
One of the biggest challenges of the elemental diet is giving up solid food:
People who cannot take on a complete elemental diet might be able to use a partial essential diet that combines liquid feeding with foods that they are able to tolerate, depending on what their healthcare providers recommend and approve. For some people, this approach might be used for long-term maintenance.
Important WarningsThe elemental diet must be used only under medical supervision, as it carries risks.Do not try a homemade elemental diet formulation. Doing so puts you at risk for significant nutritional deficiencies that could negatively affect your health.The elemental diet is not to be used at the same time as any antibiotic treatment for SIBO.
Important Warnings
The elemental diet must be used only under medical supervision, as it carries risks.Do not try a homemade elemental diet formulation. Doing so puts you at risk for significant nutritional deficiencies that could negatively affect your health.The elemental diet is not to be used at the same time as any antibiotic treatment for SIBO.
Overview of the Elemental Diet
How the Low-FODMAP Diet Works
One of the first-line treatment options for SIBO is alow-FODMAP diet. FODMAPs are a group of carbohydrates that include:
During the elimination phase, avoid foods that arehigh in FODMAPs. High FODMAP foods contain one of thefive typesof FODMAPs:
Almost every food group has options that are high in FODMAPs as well as some that are low FODMAP.
Low-FODMAP FoodsVegetables: eggplant, green beans, cucumber, lettuce tomato, zucchiniFruits: cantaloupe, grapes, kiwi, strawberriesDairy: feta, camembert, hard cheeses, almond milk, soy milkProtein: eggs, firm tofu, tempeh, seafoodGrains: corn flakes, oats, rice cakes, corn pasta, barley-free breadsSweets: dark chocolate, maple syrup, table sugarNuts and seeds: peanuts, macadamia nuts, sunflower seedsHigh-FODMAP FoodsVegetables: asparagus, cauliflower, peas, mushrooms, onionsFruits: apples, cherries, dried fruit, peaches, watermelonDairy: cow’s milk, evaporated milk, ice cream, yogurtProtein: most legumes, marinated meats, some processed meatsGrains: wheat, rye, and barley-based breads and snacksSweets: honey, high-fructose corn syrup, sugar-free treatsNuts and seeds: cashews, pistachios
Low-FODMAP FoodsVegetables: eggplant, green beans, cucumber, lettuce tomato, zucchiniFruits: cantaloupe, grapes, kiwi, strawberriesDairy: feta, camembert, hard cheeses, almond milk, soy milkProtein: eggs, firm tofu, tempeh, seafoodGrains: corn flakes, oats, rice cakes, corn pasta, barley-free breadsSweets: dark chocolate, maple syrup, table sugarNuts and seeds: peanuts, macadamia nuts, sunflower seeds
Vegetables: eggplant, green beans, cucumber, lettuce tomato, zucchini
Fruits: cantaloupe, grapes, kiwi, strawberries
Dairy: feta, camembert, hard cheeses, almond milk, soy milk
Protein: eggs, firm tofu, tempeh, seafood
Grains: corn flakes, oats, rice cakes, corn pasta, barley-free breads
Sweets: dark chocolate, maple syrup, table sugar
Nuts and seeds: peanuts, macadamia nuts, sunflower seeds
High-FODMAP FoodsVegetables: asparagus, cauliflower, peas, mushrooms, onionsFruits: apples, cherries, dried fruit, peaches, watermelonDairy: cow’s milk, evaporated milk, ice cream, yogurtProtein: most legumes, marinated meats, some processed meatsGrains: wheat, rye, and barley-based breads and snacksSweets: honey, high-fructose corn syrup, sugar-free treatsNuts and seeds: cashews, pistachios
Vegetables: asparagus, cauliflower, peas, mushrooms, onions
Fruits: apples, cherries, dried fruit, peaches, watermelon
Dairy: cow’s milk, evaporated milk, ice cream, yogurt
Protein: most legumes, marinated meats, some processed meats
Grains: wheat, rye, and barley-based breads and snacks
Sweets: honey, high-fructose corn syrup, sugar-free treats
Nuts and seeds: cashews, pistachios
Low-FODMAP Diet for Vegetarians and Vegans
The elimination phase of the FODMAP diet can last from two to eight weeks. During this time, you may notice a decrease in your symptoms.
The next phase, the reintroduction process, is very important. The time needed for this phase varies widely, depending on your symptoms.
Here are a few things to keep in mind:
Most experts recommendkeeping a food diaryto help you get a better sense of the relationship between the foods that you eat and your symptoms.
The FODMAP diet is not intended for long-term use. Many high-FODMAP foods are an important part of a nutritious, balanced diet. Many also containprebiotics, which can help keep a healthy balance of bacteria in your gut.
Recommended Timing
The timing of your meals and snacks is not a factor when following either the elimination or reintroduction phase of the FODMAP diet. You can consume food according to a schedule that works best for you.
However, since re-introducing FODMAP foods may cause symptoms, you may want to pick a time to re-introduce them when you can be at home and take it easy.
SIBO Diet Considerations
Many people with SIBO have other conditions that may need to be managed with specific treatments, including certain diets:
People with these chronic health conditions may have SIBO andmalnutrition. For example, if you have SIBO, fat-soluble vitamins (A, D, E, and K) may not be adequately absorbed in your intestines. You may also bedeficient in ironor vitamin B12. If you can’t replenish your stores with food, you may need to take supplements.
You should work with your healthcare provider and a nutrition expert to manage SIBO and any underlying condition that’s contributing to it. Your treatment needs to be tailored to your symptoms and needs.
What Does Research Say About SIBO Diets?
The research on SIBO diets has been mixed.Some studies have suggested it can be helpful to follow a certain diet if you have SIBO. However, the research has not always been high quality and experts generally say that there is not enough scientific evidence to support a particular diet to treat SIBO.
Here are a few things to consider about the research on SIBO diets:
Experts do tend to agree that a key part of treating SIBO is to figure out the underlying cause and make sure that it is managed effectively. In some cases, such as for people with chronic diseases that affect their GI system, dietary changes might be part of their treatment.
Summary
While there is no one diet that will cure SIBO and work for everyone, making changes to your diet is likely to be part of your SIBO treatment plan. The elemental and low-FODMAP diets are comfy approaches to SIBO. The goal of these diets is to restore a healthy balance of gut bacteria.
If you have SIBO, it’s important to work with your provider on a treatment plan that addresses all your symptoms and needs. You may need antibiotics, nutritional supplements, or specific therapies that help you manage an underlying condition that could be contributing to SIBO.
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