SIBO Diet Plan: A Complete Phase-by-Phase Guide to Eating With SIBO

Managing your diet during SIBO treatment is one of the most impactful things you can do to support recovery. The foods you eat directly influence the bacteria in your small intestine, either feeding the overgrowth or starving it. A well-structured SIBO diet plan works alongside antimicrobial treatment to reduce symptoms, support healing, and prevent relapse.

This guide walks you through each phase of the SIBO diet, from the strict restrictions during active treatment to the gradual reintroduction of foods as your gut recovers. Whether you are working with a gastroenterologist, a naturopath, or managing independently, understanding the dietary framework will help you make informed decisions at every meal.

What Is the Goal of a SIBO Diet?

The primary goal of a SIBO diet is to reduce the fermentable substrates that feed the overgrown bacteria in the small intestine. When bacteria have less to eat, they produce less gas, which means less bloating, pain, and disruption to your digestive system. The diet is not a standalone treatment. It works best as an adjunct to antimicrobial therapy, whether pharmaceutical or herbal.

A SIBO diet also supports gut healing by reducing inflammation, improving nutrient absorption, and allowing the intestinal lining to repair. Because SIBO often causes damage to the brush border enzymes of the small intestine, careful food choices during recovery help these enzymes regenerate.

How Does the SIBO Diet Differ From the Standard Low-FODMAP Diet?

The low-FODMAP diet and the SIBO diet share significant overlap, since both aim to reduce fermentable carbohydrates. However, there are important differences. The standard low-FODMAP diet was developed for IBS management and focuses on identifying personal FODMAP triggers through elimination and reintroduction. The SIBO diet takes a more aggressive approach during active treatment, often restricting a broader range of fermentable and starchy foods beyond what the standard FODMAP protocol requires.

For a deeper comparison, see our guide on how the low-FODMAP diet relates to SIBO treatment. The FODMAP Food Guide is also a valuable reference for understanding which foods fall into each FODMAP category.

What Should I Eat During Phase 1: Antimicrobial Treatment?

The antimicrobial phase is the most restrictive period of the SIBO diet. During this 2 to 4 week window, you are actively killing the overgrown bacteria with either prescription antibiotics or herbal antimicrobials. Your dietary goal is to avoid feeding the bacteria while keeping yourself nourished.

Foods to emphasize during Phase 1:

• Proteins: chicken, turkey, fish, eggs, tofu (firm)
• Safe starches: white rice, potatoes (peeled), carrots, parsnips
• Low-FODMAP vegetables: zucchini, bell peppers, spinach, cucumber, tomatoes, bok choy
• Low-FODMAP fruits (limited): blueberries, strawberries, oranges, unripe bananas
• Fats: olive oil, coconut oil, butter, garlic-infused oil for flavor
• Bone broth for gut healing

Foods to strictly avoid during Phase 1:

• Garlic and onion in all forms (use infused oils instead)
• Wheat, rye, barley, and most grains
• Legumes, beans, and lentils
• Milk and soft cheeses (hard cheese in small amounts may be acceptable)
• Honey, agave, and high-fructose sweeteners
• Sugar alcohols (found in sugar-free products)

Some practitioners advocate for an even stricter approach during Phase 1, such as the Bi-Phasic Diet or a modified Specific Carbohydrate Diet. Discuss with your healthcare team which level of restriction is appropriate for your case.

What Should I Eat During Phase 2: Maintenance and Healing?

Once you have completed your antimicrobial course, the maintenance phase begins. This period typically lasts 4 to 8 weeks and focuses on gut healing while maintaining a reduced-fermentation diet. Restrictions loosen slightly, but you are not yet reintroducing high-FODMAP foods systematically.

During this phase, you can begin to add back some moderate-FODMAP foods in small portions. Oatmeal in small servings, ripe bananas, and small amounts of sourdough bread may be trialed. Pay close attention to your symptoms. If bloating returns, pull back to Phase 1 restrictions and reassess.

This is also the phase where prokinetic agents become important. Supporting your migrating motor complex through meal spacing and prokinetics helps prevent the bacteria from re-establishing in the small intestine.

What Should I Eat During Phase 3: Reintroduction?

The reintroduction phase mirrors the standard FODMAP reintroduction protocol but with additional caution. You systematically test individual FODMAP groups one at a time, starting with small amounts and increasing over three days, then monitoring for symptoms for two to three additional days before moving to the next group.

The seven FODMAP groups to test are fructose, lactose, fructans from alliums, fructans from grains, galacto-oligosaccharides (GOS), sorbitol, and mannitol. Tools like FODMAPSnap can be especially valuable during this phase, as the app’s SIBO profile support tracks your treatment phase and bacteria type, providing personalized guidance on which foods to trial and when.

Reintroduction order for SIBO patients:

Most dietitians recommend starting with the FODMAP groups least likely to cause issues and progressing to the most fermentable. A common order is:

1. Lactose (small amounts of yogurt or milk)
2. Sorbitol (a few slices of avocado)
3. Mannitol (small serving of mushrooms)
4. Fructose (half a mango or a teaspoon of honey)
5. GOS (small serving of canned lentils)
6. Fructans from grains (a slice of wheat bread)
7. Fructans from alliums (a small amount of garlic or onion)

Fructans from alliums are typically tested last because garlic and onion are the most common triggers for both IBS and SIBO patients.

How Should I Plan My Meals With SIBO?

Meal planning with SIBO goes beyond just choosing the right foods. How you eat matters as much as what you eat.

Meal spacing is critical. Leave 4 to 5 hours between meals to allow your migrating motor complex to activate. This cleansing wave sweeps residual bacteria and food debris from the small intestine. Constant snacking keeps the MMC from firing, which can contribute to bacterial regrowth.

Meal size also matters. Smaller, well-spaced meals reduce the fermentable load at any one time, resulting in less gas production. Avoid large meals, particularly in the evening when motility naturally slows.

Meal composition should prioritize protein and healthy fats, which do not feed bacteria the way carbohydrates do. Build each meal around a protein source, add low-FODMAP vegetables, include a modest serving of a safe starch, and use healthy fats for satiety.

A sample day during Phase 1 might look like this: scrambled eggs with spinach and bell peppers cooked in garlic-infused oil for breakfast, grilled chicken over white rice with roasted zucchini and carrots for lunch, and baked salmon with mashed potatoes and a side salad with olive oil dressing for dinner.

What Adjustments Are Needed for Different SIBO Types?

Your SIBO type influences which dietary modifications are most important. Hydrogen-dominant SIBO tends to cause diarrhea, so dietary emphasis is on reducing rapidly fermentable foods while maintaining adequate hydration and electrolytes. Methane-dominant SIBO (IMO) causes constipation, which means fiber must be managed carefully. Too much fermentable fiber worsens bloating, but too little fiber worsens constipation.

Hydrogen sulfide SIBO requires attention to sulfur-containing foods. Eggs, cruciferous vegetables, and alliums may need stricter limitation. See our comprehensive SIBO guide for detailed information on each type.

How Do I Maintain Good Nutrition During a Restrictive SIBO Diet?

Nutritional deficiencies are a real concern during SIBO treatment. The condition itself impairs absorption of B12, iron, fat-soluble vitamins, and other nutrients. Adding a restrictive diet on top of existing malabsorption makes supplementation important.

Work with your healthcare provider to monitor iron, B12, vitamin D, and zinc levels. A high-quality multivitamin, additional vitamin D, and potentially B12 injections may be warranted. Bone broth provides bioavailable minerals and gut-healing collagen. Ensuring adequate caloric intake from protein and fats prevents unwanted weight loss.

FODMAPSnap can help you maintain nutritional balance by analyzing the FODMAP content of your meals in real time, ensuring you are not accidentally consuming trigger foods while keeping your diet varied enough to meet your nutritional needs.

When Should I Seek Professional Guidance?

While this guide provides a framework, SIBO dietary management benefits greatly from professional oversight. Consider working with a registered dietitian experienced in SIBO and the low-FODMAP diet if you are losing weight unintentionally, struggling to identify safe foods, dealing with multiple food intolerances, or experiencing die-off symptoms that concern you.

The IBS and SIBO education hub provides additional context on the relationship between these conditions and the evidence supporting dietary interventions.

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This article is for informational purposes only and does not constitute medical advice. SIBO requires proper diagnosis and treatment by a qualified healthcare provider. Always consult your doctor or registered dietitian before making significant dietary changes or starting any treatment protocol.