The FODMAP diet for SIBO?

For any of you who don’t know- SIBO (small intestinal bacterial overgrowth) is a condition whereby too many bacteria, or the wrong kind, populate the small intestine. It can lead to uncomfortable symptoms such as gas and diarrhoea. It can also inhibit your ability to digest and absorb nutrients from food. We often associate it with adults however it can happen at any age.

Some studies indicate that up to 80% of people with irritable bowel syndrome (IBS) have SIBO.

When people are told they have SIBO, it is often seen as the cause of all their problems and an aggressive attack programme is created to kill off the excess bacteria and starve them of their food sources. I have learnt to question any such approach, whatever the condition. SIBO didn’t just happen overnight. The causes are different depending on the individual and by taking a careful case history it is normally evident what has lead to SIBO. It is key to identify these triggers in order to create a personalised plan of action.

The low FODMAP diet minimises the consumption of fermented, short chain carbohydrates, which are not easily digestible and end up being fermented by the gut bacteria. This can significantly reduce symptoms in SIBO patients. FODMAPs or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols are short chain carbohydrates that are poorly absorbed in the small intestine and are prone to absorb water and ferment in the colon. The diet is very restrictive and it can be very challenging to make such drastic changes to your diet and still know how to get the right balance of nutrition. Let alone trying to do it when you have a family! It is not meant as a long term solution-rather to help reduce symptoms which it does more often than not and to help identify the specific foods that are most troublesome.

So what is my take on the FODMAP diet? Well, I am not anti-FODMAP. I think it can certainly help the person feel more comfortable in terms of reducing symptoms however I usually take a different approach because I want to help my clients work towards long term balance without compromising their relationship with food. Restrictive diets encourage unhealthy eating habits and induce the fear factor around food which I am strongly against, even more so when it comes to children. Restricting these foods over time, changes the makeup of bacterial colonies in the gut, which may negatively impact intestinal health and possibly worsen digestive issues in the future. The gut microbiota is very complex but it is important to note that just because the initial digestive symptoms reduce, it doesn’t necessarily mean that you are not negatively impacting the balance of bacteria and your overall health. For example, by increasing your intake of lots of animal fats on the FODMAP diet instead of eating the high FODMAP pulses, this can also negatively impact the microbiome over time and in turn, other aspects of our health.

I try to take a much more balanced approach to SIBO, taking elements of the FODMAP diet and applying them in a way that works for the individual. My focus is on building FODMAP tolerance. These foods are not bad and they are a very important part of the diet. By taking a holistic approach, I help clients with a range of supportive tools rather than stripping their diets away to the point that they are miserable. The more good stuff you add in, the less room there is for the bad. SIBO is not the main cause, it is only part of the picture and only part of how the imbalances in the body have manifested. There are many aspects of diet and lifestyle that can be addressed alongside supplements in order to help resolve the condition and improve the symptoms.

I am a registered Naturopathic Nutritional Therapist and specialist in Clinical Paediatric Nutrition. If you are interested in starting Nutritional Therapy for yourself, your family or your child then please contact me for more information/FREE discovery call or you can check out my services on my website.