A dietary approach towards treating SIBO
Small intestinal bacterial overgrowth or SIBO is a condition caused by misplaced gut bacteria. Treating SIBO can be really tricky. To treat this condition, doctors have prescribed antibiotics like metronidazole or levofloxacin in the past.  This has caused mixed results. Following are some of the salient points from clinical studies conducted with such antibiotics.
- They have at times been ineffective for up to 43% of the cases, with frequent relapses. 
- Even when effective, there is an inherent risk of destroying the beneficial gut bacteria, which can open the proverbial pandora’s box of digestive issues.
- They cannot eliminate all of the SIBO causing bacteria.
Off late, clinical studies have shown that a newer antibiotic, known as rifaximin has been somewhat more effective.  The major benefits of using this antibiotic are the following.
- They have a higher success rate.
- They have not hampered the beneficial gut bacteria.
- There has not yet been any documented evidence of bacteria developing a resistance to this drug.
However, before getting overtly excited about this treatment, we need to keep in mind the following caveats.
- Rifaximin keeps the symptoms of SIBO in check for far longer than any of the other treatments. However, it does not completely eliminate the bacterial overgrowth. People would need to take this medication permanently, until we stumble upon a more effective cure.
- The fact that the bacteria does not get eliminated goes to show that although there has not been any documented evidence of resistance yet, it is only a matter of time before resistant strains show up. After all, antibiotic resistance is a gradual process, rather than an overnight one. 
So do you just keep refilling your prescription? You could, or you could look at some natural and less intrusive options.
How to modify your diet to treat SIBO?
Bacteria, just like any other living organism, needs nourishment. Hence if you modify your diet to eliminate or drastically reduce the nutrients that these bacteria can feed on, you will end up starving them and thus be able to keep you symptoms in check for the long haul.
SIBO causing bacteria feed on fermentable carbohydrates. These can be further categorized as under.
- Prebiotics – Found in beans, agave and certain vegetables.
- Soluble fiber – Found in fruits, grains, beans and nuts.
- Sugar, even those that occur naturally in fruits.
- Starch – Found in starchy vegetables like potatoes and are also found in beans and grains.
- Resistant starch – Legumes, seeds and whole grains.
Doctors and nutritionists from all over the world have come up with several different diets for SIBO patients, such as the Cedars-Sinai Diet, Low FODMAP Diet, Gut and Psychology Syndrome Diet, etc. Discussing the nuances and the specifics of each and every such diet pattern is beyond the scope of this article. However, all of these diets have the following common themes.
- Fish, meat and poultry (including eggs) can be consumed, along with ripe fruits, non-starchy vegetables, nuts and seeds. Honey and artificial sweeteners (that do not contain any sugar) can be consumed in moderation as well.
- Sugar, grains, lactose and starchy vegetables cannot be consumed come what may.
Following such a restrictive diet can be especially hard for anyone. Also cooking for someone who is trying to control SIBO can be especially arduous. You need not worry as the following are a couple of recipe ideas.
SIBO Safe Recipes
- Honey Glazed Chicken Wings
Just because you are suffering from SIBO, does not mean that you cannot have anything lip-smacking. Our recipe for honey-glazed chicken wings will leave you drooling and will have you keep coming back for more!
You need to procure the following ingredients to make the honey glazed chicken wings:
- 3 lbs. of pre-cut chicken wings.
- 3 tablespoons of honey.
- Baking spray.
- ½ teaspoon of cumin seeds. If you use the powder instead, you would need an entire teaspoon.
- 1 ½ teaspoons of curry powder.
- ¼ teaspoon of black pepper, preferably freshly ground.
- ½ teaspoon of hot sauce. Either Sriracha or Tabasco will work!
- 1 teaspoon of salt.
- 1 tablespoon of soy sauce.
- Pre-heat your oven to 450 degrees (Fahrenheit). Most ovens take about 20 to 25 minutes to reach that temperature.
- Take two baking pans and apply a thin coat of baking spray on them.
- Take a look at the chicken wings and make sure that the wing tips have already been removed. If not, carefully chop them off!
- Apply the salt and pepper to the chicken wings. Toss them to ensure that it is evenly distributed.
- Place the wings on the baking tray. Divide them equally to ensure that there is ample room between the individual pieces.
- Bake the wings for about 25 minutes. After the first 25 minutes are over, flip the wings and rotate the position of the trays. Bake again for another 25 minutes. The chicken pieces should be crisp and golden brown after they have been baked for 50 minutes.
- Pour the honey, cumin, curry powder, hot sauce and soy sauce in a bowl and mix them thoroughly.
- Coat the baked chicken wings with the mixture and bake them for a further 5 minutes. Your chicken wings should look glazed and a bit charred in places.
That is it! Your honey glazed chicken wings are ready. Some serve it with a sweet, yet spicy dipping sauce, such as Mae Ploy, which unfortunately should not be served to patients suffering from SIBO.
- Halibut Salad
Not only is this unique fish salad provide you with some essential nutrients while you fight off SIBO, it tastes fantastic as well!
- ¾ lb. of pre-cut fresh halibut.
- 2 teaspoons of freshly ground black pepper.
- 1 tablespoon of black olives.
- 1 small head of green cabbage.
- 2 teaspoons of cumin powder.
- 1 teaspoon of garlic flakes.
- 2 limes.
- 3 tablespoons of olive oil.
- 2 teaspoons of salt.
- A small bunch of spring onions.
- Clean the fish and make sure that it is as dry as you can possibly make it. Use paper towels to extract as much of the extra moisture as you can.
- Mix the cumin, garlic flakes, 1 teaspoon of black pepper and 1 teaspoon of salt to prepare the seasoning for the fish. Thoroughly season both sides of the fish.
- Set the grill on medium and then cook both sides of the fish on it. Roughly 4 minutes for each side should do the trick. If you have never grilled fish before, it is really easy to determine when it has been cooked. Simply take a fork and apply it to the corner of the fish. If the flakes come apart easily, then it is ready!
- Mix all the veggies in a salad bowl and then add a teaspoon of salt and black pepper.
- Mix thoroughly again and then apply the olive oil as a final garnishing. It should be added in limited quantities, so please use your discretion.
You have prepared everything you need to put the halibut salad on the plate. Create a bed on the plate with the veggies. Slice the grilled fish and put it on top. Enjoy!
Does these Recipes Work? Real Life Test
The above picture shows the bowel of movement before having these recipes. The guy has constipation predominant SIBO for about 5 plus years thought to be caused by a combination of stress, anti acids and antibiotics. The stools are seen floating which is often due to more gases being trapped in the stool and are like this usually apart from itching in the anal area that accompanies hard stools.
Any deviation in diet from SIBO friendly edibles results in GERD symptoms, bloating and constipation.
Below is the next day bowel moment which is seen submerged in water and is not floating. The afternoon meal comprised of chicken wings and dinner comprised of the salad. The bowel movement was easy and quick to pass with the urge to defecate arising in the morning.
Stools also passed easily as opposed to little straining earlier.