Small intestinal bacterial overgrowth (SIBO) is a digestive condition caused by an excessive amount of bacteria in the small intestine. Under normal circumstances, the small intestine contains very few bacteria, but health conditions like motility disorders, low stomach acid, and autoimmune diseases can allow bacteria from the colon to move upward and multiply excessively in the small intestine.

This overgrowth may lead to symptoms such as bloating, abdominal discomfort, diarrhea, and poor absorption of nutrients. Although antibiotics are the standard treatment for SIBO, dietary changes may also help relieve symptoms and prevent nutrient deficiencies.

Foods to eat if you have SIBO

While research is still developing, early findings suggest that certain dietary changes may support the management of SIBO symptoms. Many people with SIBO also have irritable bowel syndrome (IBS), and the dietary needs for both often overlap.

Some foods are known to worsen symptoms like gas and bloating. In contrast, others may help support digestive health and prevent deficiencies. Studies have mainly focused on low-fiber and gluten-free diets, along with nutrients like vitamin D and B12.

Low-FODMAP foods

Low-FODMAP diets aim to reduce fermentable short-chain carbohydrates that feed bacteria in the small intestine. These carbohydrates—Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols—are poorly absorbed and rapidly fermented, which can trigger symptoms.

Although clinical evidence for the low-FODMAP diet in SIBO is limited, it has shown benefits in patients with IBS, which frequently co-occurs with SIBO.

examples of low-FODMAP foods:

  • Proteins: eggs, fish, and chicken

  • Fruits and vegetables: strawberries, cantaloupe, green beans, potatoes, cucumbers, and carrots

  • Nuts and seeds: walnuts, macadamia nuts, pumpkin seeds

  • Gluten-free grains: oats, quinoa

  • Dairy alternatives: almond milk, lactose-free milk

If you plan to follow a low-FODMAP diet, it is advisable to work with a healthcare provider who understands gastrointestinal conditions, as the elimination and reintroduction phases require careful planning.

Foods high in vitamins

SIBO can contribute to deficiencies in several essential nutrients, especially in cases where malabsorption and chronic diarrhea are present. This can lead to fatigue, anemia, and other complications if left unaddressed.

focus on foods rich in:

  • vitamin A: sweet potatoes, goat cheese, organ meats, salmon, eggs

  • vitamin B12: poultry, fish, meat, eggs

  • vitamin D: beef liver, sardines, vitamin-D-fortified foods, salmon

  • vitamin E: nuts, seeds, avocado, trout

In many cases, people with SIBO may require dietary supplements to reach optimal nutrient levels, particularly if absorption is significantly impaired.

Foods to avoid

While there is no universal list of foods that all SIBO patients should avoid, many providers recommend limiting foods that are known to promote bacterial overgrowth or worsen digestive symptoms. This often includes high-FODMAP foods and fermentable sugars.

Dietary restrictions should be individualized and made in consultation with a healthcare provider to ensure nutritional adequacy and effectiveness.

Foods high in FODMAPs

Many individuals with SIBO find symptom relief when reducing or eliminating high-FODMAP foods. These foods can also trigger symptoms in people with IBS, which frequently overlaps with SIBO.

examples of high-FODMAP foods and drinks:

  • Fruits and vegetables: apples, mangos, cherries, figs, watermelon, garlic, onion, leeks, mushrooms, artichokes, cauliflower

  • Dairy: milk, soft cheeses, ice cream

  • Sweeteners: honey, high-fructose corn syrup, sorbitol, erythritol, xylitol

  • Nuts: cashews, pistachios

  • Legumes: lentils, beans

  • Grains: wheat, rye, wheat-based snacks

Each person's tolerance varies. While some may handle moderate FODMAP foods in small amounts, others may need to avoid them entirely. This diet is not intended as a long-term solution, and tolerated foods should gradually be reintroduced with professional guidance.

Meal ideas for SIBO

Because each person with SIBO has unique health considerations, meal plans must be customized. Someone with SIBO and diabetes may have very different dietary needs than someone with SIBO and IBS.

That said, the following meal ideas emphasize low-FODMAP, nutrient-dense options that may be helpful for some individuals with SIBO.

breakfast options:

  • Omelet with eggs, zucchini, and parmesan, served with cantaloupe and herbal tea

  • Oatmeal with blueberries and walnuts

  • Smoothie with almond milk, strawberries, and raspberries

lunch options:

  • Thai peanut noodles using brown rice noodles, grilled chicken, low-FODMAP peanut sauce, cucumbers, and bell peppers

  • Quinoa bowl with tofu, kale, pumpkin seeds, and winter squash

  • Salad with chicken, lettuce, cucumbers, radishes, and a hard-boiled egg

dinner options:

  • Grilled salmon with baked potato and green beans

  • Roasted chicken with sweet potato and sautéed eggplant

  • Gluten-free pasta with shrimp, tomato, and spinach

snack ideas:

  • Macadamia nuts with a mandarin orange

  • Banana with almond butter

  • Carrot sticks with cheddar or asiago cheese

Diets for SIBO

There are no universally recommended diets for SIBO, but some patients respond well to more restrictive approaches such as the elemental diet. This diet provides all essential nutrients in a pre-digested, liquid form that is easy to absorb.

Because nutrients are already broken down, they are less available to gut bacteria. This may help reduce bacterial populations in the small intestine.

benefits of the elemental diet:

  • Highly absorbable

  • May induce remission in SIBO

  • Can be an option for those who don’t respond to antibiotics

drawbacks:

  • Unpleasant taste

  • Highly restrictive

  • Difficult to follow without supervision

Though early research indicates a high remission rate with elemental diets, they are not suitable for everyone and should be considered a short-term option under medical supervision.

A quick review

SIBO is a digestive condition caused by excess bacteria in the small intestine. Although antibiotics are the primary treatment, certain dietary changes—like reducing FODMAP intake and increasing nutrient-dense foods—can help ease symptoms and address deficiencies.

There is no one-size-fits-all diet for SIBO. A personalized nutrition plan, designed with your healthcare provider, can help manage symptoms and support long-term health. Supplements or specialized diets such as the elemental diet may be used in more complex cases.