What Helps: Foods That Support Symptom Relief

These lower-fermentable, easier-to-digest foods reduce the substrate available for bacterial fermentation in the small intestine, often leading to less gas, bloating, and abdominal distension.

Proteins (generally well-tolerated):

• Eggs, chicken, turkey, beef, fish, and seafood (plain, unprocessed)

• Firm tofu or tempeh (in moderation)

Vegetables (low-FODMAP options):

• Carrots, cucumbers, zucchini, spinach, lettuce, tomatoes, eggplant, green beans, bok choy, potatoes (white or sweet in moderation)

• Broccoli heads (small portions, < ¾ cup)

Fruits (limited portions):

• Strawberries, blueberries, grapes, oranges, kiwi, pineapple, cantaloupe

Grains & Starches:

• White rice, quinoa, oats, rice cakes, gluten-free crackers or pasta (corn- or rice-based), corn flakes

Dairy & Alternatives:

• Hard cheeses (cheddar, feta, brie, camembert), lactose-free milk, almond milk (unsweetened), soy milk (limited)

Other Helpful Choices:

• Eggs, olive oil, herbs like basil or parsley (instead of garlic/onion), dark chocolate (small amounts), maple syrup or table sugar (in very small quantities)

Bonus Tip from Our Approach: Spacing meals 4–5 hours apart supports the Migrating Motor Complex (MMC), your gut’s natural “housekeeping” wave that helps clear bacteria from the small intestine. Many patients also benefit from gentle prokinetic support (herbal or medication) alongside these foods.

What Doesn’t Help (Foods That Often Worsen Symptoms)

These foods are high in fermentable carbohydrates (FODMAPs) or other compounds that bacteria in the small intestine can rapidly ferment, producing gas and triggering bloating, pain, and irregular bowels.

High-FODMAP Foods to Limit or Avoid (Especially During Active Symptoms or Treatment):

• Vegetables: Onions, garlic, asparagus, cauliflower, mushrooms, peas, artichokes, Brussels sprouts

• Fruits: Apples, pears, cherries, peaches, watermelon, dried fruits, high-fructose items (honey, agave)

• Grains & Legumes: Wheat-based products (bread, pasta, cereal), barley, rye, beans, lentils, chickpeas

• Dairy: Regular milk, yogurt, soft cheeses, ice cream (due to lactose)

• Sweeteners & Additives: Sugar alcohols (sorbitol, mannitol, xylitol in sugar-free gum/mints), high-fructose corn syrup, sucralose

Other Common Triggers:

• Highly processed or sugary foods

• Large amounts of raw fibrous vegetables or beans

• Fermented foods (sauerkraut, kimchi, kefir) during active overgrowth phases — these can be reintroduced later for microbiome support

• Alcohol and carbonated drinks (they can irritate and add gas)

Surprising Fact: Even “healthy” foods like garlic, onions, and legumes — excellent for colon health in most people — can significantly worsen SIBO symptoms because the bacteria ferment them too early in the digestive tract.

How We Use Diet at Premier IFM

At Premier Integrative Functional Medicine, we customize the dietary approach for each SIBO patient rather than using a one-size-fits-all plan. Depending on your symptoms, test results, and any co-existing issues (such as candida overgrowth or severe dysbiosis), we typically recommend either a short-term low-FODMAP diet or an Anti-Candida diet.

• Short-term low-FODMAP phase (usually 2–6 weeks) to quickly reduce fermentable carbohydrates that feed bacterial overgrowth in the small intestine, providing rapid relief from bloating, gas, and abdominal discomfort.

• Anti-Candida diet when testing or symptoms suggest concurrent yeast overgrowth. This approach limits sugars, refined carbohydrates, and certain fermented foods while emphasizing vegetables, quality proteins, and healthy fats to help restore microbial balance.

• Phased reintroduction of foods after the initial restrictive phase. This careful process helps identify your personal triggers and safely expands your food choices without triggering a return of symptoms.

• Transition to a balanced, anti-inflammatory diet / detox diet focused on whole foods, adequate protein, healthy fats, and a gradual, well-tolerated increase in fiber to support healthy gut motility and help prevent recurrence.

• For severe or stubborn cases, we may discuss a temporary elemental diet (a predigested liquid nutrition formula) under close supervision. This approach has been shown to significantly reduce bacterial load in a short period while giving the gut a chance to rest and heal.

Our goal is never long-term restriction or elimination. Instead, we use diet strategically as a therapeutic tool — creating a clear window for healing the gut, reducing overgrowth, and then building a sustainable, nourishing way of eating that supports long-term balance and keeps SIBO from returning.