Q & A Library

Print this page | Sign up for free e-bulletins
 | Bookmark This Page

Diet to Cure SIBO?

I heard on the news that the SIBO diet can cure intestinal overgrowth. How effective is it, and is SIBO as prevalent as it seems?

Answer (Published 9/30/2013)

Small intestinal bacterial overgrowth, or SIBO, is a condition that occurs when there are a lot more bacteria than normal in the small intestine. This can lead to symptoms such as bloating and distension, flatulence, diarrhea, and abdominal pain. Normally, there are fewer than 10,000 bacteria per milliliter of fluid in the small intestine compared to one billion bacteria per milliliter of fluid in the colon (large intestine). SIBO symptoms develop when the excess bacteria in the small intestine are similar to those normally found in the colon. This can be due to a change in the ability of the small intestine to sweep away the organisms that shouldn’t be there.

Related Weil Products
Dr. Weil's Vitamin Advisor for Digestive Health - Digestive problems can be uncomfortable and impact your quality of life. Simple changes to your diet, lifestyle and supplement routines may help - learn more, and get your free, personalized vitamin recommendation today.

I discussed your question with Gerard Mullin, M.D., an integrative gastroenterologist at Johns Hopkins Medical Center in Baltimore. He tells me that SIBO affects about 56 percent of patients with irritable bowel syndrome, but we do not know how common it is in the general population.

Most physicians treat SIBO with antibiotics (primarily rifaximin), which can work but sometimes have adverse effects. Dr. Mullin prefers to use oregano oil, wild garlic and berberine (the active constituent of Oregon grape root and other plants used as GI remedies), which can help reduce the excess bacterial growth.

As for diet, Dr. Mullin says dietary modification is essential to treatment but will not by itself cure SIBO. He recommends a diet low in fructose and especially avoiding foods containing high fructose corn syrup. Patients should also avoid agave nectar, honey, apples, pears, peaches, mangoes, watermelon, coconut and dried fruits and fruit juices. In his book The Inside Tract, Dr. Mullin also advises avoiding fructans (a type of carbohydrate found in wheat and rye, inulin, and fructo-oligosaccarides added to foods as a fiber supplement). Fructans also occur in a number of vegetables including artichokes, asparagus, beets, broccoli, Brussels sprouts, cabbage, chicory, garlic, leeks, okra, onions, radicchio, lettuces shallots, and snow peas. It is also important to limit intake of legumes (including beans, peas lentils and peanuts), which encourage bacterial overgrowth and gas production. You don’t have to avoid all of these foods forever. Instead, the idea is to cut back on the ones that are most problematic, which are likely to be wheat, apples, pears and raw onions.

Dr. Mullin tells me that the Gut and Psychology Syndrome (GAPS) diet sometimes recommended for SIBO lacks a clear scientific rationale and is challenging to follow even for those who believe that it may be worthwhile. The GAPS diet is an offshoot of the earlier Specific Carbohydrate Diet (SCD), developed in the 1920's to treat patients with celiac disease and still promoted as an alternative treatment for a number of digestive disorders. The SCD diet eliminates all grains, dairy products, processed sugars and canned vegetables. I've seen no studies indicating it to be effective for any of the disorders for which it is recommended.

Andrew Weil, M.D.

Creative Commons License Some Rights Reserved Creative Commons Copyright Notice
A portion of the original material created by Weil Lifestyle on (specifically, all question and answer-type articles in the Dr. Weil Q&A Library) is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.

The Weil Vitamin Advisor
Get your FREE personalized vitamin recommendation & supplement plan today!

Dr. Weil on Healthy Aging
Your Online Guide to the Anti-Inflammatory Diet. Start eating for your health - begin your free trial now.

Dr. Weil's Spontaneous Happiness
Achieve emotional well-being in just eight weeks! Start your 10-day free trial now!

Vitamin Library
Supplement your knowledge with Dr. Weil's essential vitamin facts. Learn why they are necessary and more.

Dr. Weil's Optimum Health Plan
Your 8-week plan to wellness.
Begin your journey today!

Dr. Weil's Head-to-Toe Wellness Guide
Your guide to natural health.
Use the Wellness Guide today!

Dr. Weil's Anti-Inflammatory Diet
Food Pyramid

Our interactive tool can help improve overall health through diet.

Condition Care Guide
Learn about health conditions from acne to vertigo, and Dr. Weil's view of the best treatment options for each.

Healthy Recipes
Discover a treasure trove of healthy, healing foods and creative, delicious ways to prepare them.

Q&A Library
Over 2,000 questions from you and their corresponding answers from Dr. Weil.

Copyright © 2015 Weil Lifestyle
Information on this web site is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information on this web site for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment.

Ad Choice
Advertising Notice

This Site and third parties who place advertisements on this Site may collect and use information about your visits to this Site and other websites in order to provide advertisements about goods and services of interest to you. If you would like to obtain more information about these advertising practices and to make choices about online behavioral advertising, please click here