Bathroom, bathroom, where is the bathroom?! I need it NOW!
Ugh. I look like I’m 6 months pregnant. This bloating has gotten out of control!
There’s no way I’m going to be able to fly to Disneyland on our family vacation with this horrible gas.
This abdominal pain is so severe. How am I going to go to work today?
I’m so tired and it’s only 10am. I feel like I could sleep all day and I would still wake up feeling tired.
If you find yourself relating to most of these statements, you might have SIBO (small intestinal bacterial overgrowth). SIBO is an increasingly common intestinal condition characterized by:
- Uncomfortable Bloating
- Abdominal Distension
- Chronic Diarrhea or Constipation
- Oscillating between diarrhea and constipation
- Abdominal Pain
It occurs when more than the healthy amount of bacteria migrate into the small intestine, which should be relatively low in bacteria as compared with the large intestine.
Because we at Nourish Health and Wellness specialize in integrative psychiatry and gut health, we tend to see SIBO a lot. The intersection of mental health and gut health is widely studied and confirmed by the scientific community, and we see SIBO rates rise with increasing rates of anxiety and depression.
This is why our integrative approach to mental health and gut health addresses the gut-brain connection through a comprehensive nutrition and lifestyle program.
What is the low FODMAP diet?
FODMAP stands for fermentable oligosaccharide, disaccharide, monosaccharide, and polyols, which are different plant fibers that tend to ferment more in the gut. These plant fibers are all well and good for the large intestine, but when they start to migrate up into the small intestine too much, this is where we get SIBO and the tremendous discomfort from uncontrollable bloating.
The low FODMAP diet focuses on removing these carbohydrates from the diet to prevent bacterial overgrowth. One important thing to keep in mind is that in a regular context, these fibers are NOT bad. They actually feed beneficial gut bacteria in your large intestine and support a favorable microbial composition.
One of the ways we heal SIBO and support gut health is by feeding those good gut bacteria and allowing them to crowd out the opportunistic, or harmful bacteria.
Is the low FODMAP diet necessary to heal SIBO?
The low FODMAP diet has been most commonly studied for IBS symptom relief since it reduces the amount of fermentable fibers and commonly decreases bloating. The most common treatment practitioners offer their clients is an antibiotic or herbal antimicrobial and the low FODMAP diet.
This can be beneficial for symptom management, but very rarely addresses the root cause of the dysfunction. Worst case scenario, it ends up making the SIBO worse or increasing the chance of recurrence. The idea behind this approach is “killing” or “starving” the bacteria, which is only one part of SIBO treatment.
The goal of the low FODMAP diet is symptom reduction, NOT healing SIBO
In order to fully heal SIBO, you must address the root cause, which could be:
- Insufficient stomach acid
- Chronic PPI use
- Chronic antibiotic use
- Large Intestine Dysbiosis (from antibiotics, diet, overtreating SIBO, etc)
- SIFO (small intestine fungal overgrowth)
- Nutrient deficiencies (can develop from restrictive diet and/or impaired digestive function)
SIBO unfolds differently in each unique person, so prescribing a blanket dietary approach to every single person does them a huge disservice. Foods high in FODMAPs typically aggravate SIBO symptoms, but each food on that list belongs to one or more of those groups and has varying levels of FODMAPs depending on the form and amount of the food.
What we see very often in the natural health community is a person starting on a dietary protocol in order to heal their gut or improve their symptoms, only to read that they need to take out a multitude of other foods as well, and then before they know it- they’re on a diet with only 20 “approved” foods and are not only feeling the same or worse physically, but now are compromising their mental health and relationship with food by feeling so restricted.
This is NOT the way to health, and scientific research supports the consumption of a wide variety of foods in your diet to heal the gut and improve the composition of the microbiome.
So What Do You Do?
Since each person experiences SIBO differently, the long term goal is to create a personalized dietary approach that incorporates as much variety in the diet as possible while keeping out or minimizing the foods that cause symptoms.
This involves following a modified low FODMAP diet IF it seems to improve symptoms, and only for a short period of time (no more than 4 weeks), and then going through a systematic reintroduction of each FODMAP group to identify your personal triggers and threshold in order to find a way of eating that works for you.
While we do that, we are also supporting digestive health from a root cause approach- restoring proper absorption and assimilation, stress management, and lifestyle.
This can be a tricky and tedious process!
That’s why we recommend working with an experienced nutritionist who can guide you through the steps and help you listen to how your body responds to treatment and the modified FODMAP diet. Staying on a restrictive diet for too long can have permanent consequences on your gut microbiome, and increases the chances of relapse since it starves the beneficial bacteria populations.
SIBO shouldn’t take over your life, and you shouldn’t have to stay on a restrictive diet long term in order to improve your health!
Schedule a complimentary phone consultation with us today to receive comprehensive clinical care, health and nutrition coaching, and support and education to treat your SIBO so that you can live life on your terms.
Bye SIBO! We WON’T miss you.
Yana Evans, MS received her master’s degree in Human Nutrition and Functional Medicine from the University of Western States. She specializes in working with individuals with digestive disorders (including SIBO), as well as optimizing the nutrition needs of pregnant and postpartum women.