Gut-Healing and Symptom-Management Protocol for SIBO

Food  Base your diet  Can be introduced after  Eliminate high-carb &
groups on real foods a few weeks, if tolerated hard-to-digest foods
Low-FODMAP* and low-carb  High-FODMAP* Higher-carb vegetables:
Vegetables

veggies (in small amounts at first; non-starchy vegetables  Starchy vegetables

personal tolerance needs to be  Avocado/guacamole (potatoes, yams, sweet potato,
assessed; thoroughly cooked and  Squashes (spaghetti squash, yucca, cassava, etc)
peeled at the beginning):
butternut, acorn, pumpkin)  Parsnip
 Zucchini  Rutabaga, turnip
 Green beans  Beets Mucilaginous vegetables:
 Carrots  Nightshades vegetables  Okra
 Spinach (tomatoes, eggplants, bell  Lotus root
 Mushrooms peppers, hot peppers...)
 Avocado/guacamole
 Coconut oil  Olives
 Ghee  Butter  Vegetable oils and high
 EVOO May be introduced later if pro-inflammatory

Fat
 Macadamia oil tolerated: omega-6 fats (canola,
 Avocado oil  Nuts sunflower, safflower, grapeseed,
 Animal fat from pastured  Nut butters soybean, cottonseed, peanut)
animals (lard, duck fat)  Nut flour (almond flour, etc)  Commercial mayonnaise
 Red palm oil  Unsweetened dried and salad dressings
 Homemade mayonnaise coconut
 Coconut milk (no guar gum ) 

Animal protein:
Vegetarian protein:
 Meat  Whole Eggs  Beans
 Organ meat Nuts
Protein  Egg yolks

 Nut butters


Lentils
Soy products
 Fish & Seafood  Nut flour
 Poultry  Peanuts
 Probiotics (find 1 that
Important

 Homemade bone broth





works for you; avoid those

every day (drink at least 1-2
cups a day or include it in stews,
soups or sauces)
 Liver from pastured
animals 1-2/week
(to replenish your vitamin B12,
iron and other nutrients you may
be deficient in because of SIBO)
Avoid all dairy
Dairy products for the
first few weeks
with inulin, chicory root,
fructo-oligosaccharide or FOS,  Be SUPER careful when
although can be ok for some if eating out (bring your own
in small amounts) food, call ahead of time to find
 Fermented foods suitable alternatives and
question staff about
(raw, unpasteurized sauerkraut
or lacto-fermented vegetables, preparation methods &
ingredients)
homemade fermented dairy)
 Cod liver oil
 Fish oils
High-fat, low-lactose dairy
products made from the milk of
pastured cows (ideally from raw
All commercial dairy
milk; only if well-tolerated): products made from the
 Kefir (fermented 24 hours**)
 Yogurt (fermented 24 hours**)
milk of non-pastured
grain-fed cows, such as
 Cream commercial yogurt and
 Cheese (preferably aged) pasteurized milk
 Butter

 Aglaée the Paleo dietitian. All Rights Reserved, 2012. More info about SIBO here. Need help? {paleo-dietitian.com}
 Gut-Healing and Symptom-Management Protocol for SIBO (cont’d)
Food  Base your diet  Can be introduced after  Eliminate high-carb &
groups on real foods a few weeks, if tolerated hard-to-digest foods
 High-FODMAP* non-
starchy vegetables
 Squashes (pumpkin,  Artificial sweeteners
spaghetti, butternut, acorn...)  Chemical ingredients
& Treats
Carbs

Only from low-FODMAP*  Fruits (start by low-FODMAP* (MSG, colorings, etc.)

non-starchy vegetables fruits; peeled, deseeded and  Grains & flours
cooked, at least at first)  Gluten-free products
if you have cravings, try my grain-  Dark chocolate and  Legumes (beans, lentils,
free, sugar-free carrot “muffin” and cocoa powder soy, peanuts)
cinnamon treat to help you
 Coconut flour  Other sugars, including
(can also be made with squashes,
if well-tolerated)  Nuts, nut butters refined sugars, sugar-
and nut flours alcohols and artificial
 Honey (small amounts) sweeteners
 Maple syrup (small
amounts)
 Salt (Celtic sea salt, Himalayan  Sugar-, grain- or gluten-
Seasonings

salt, Murray River salt)

 Garlic, pepper, other containing seasonings or
 Chives herbs & spices, ginger condiment (ketchup, soy
 Basil  Vinegars (sugar-free aged sauce, some tamari sauce,
balsamic, red wine...) regular balsamic vinegar,
 Cinnamon
 Gluten-free tamari sauce balsamic glaze, commercial
 Lemon/lime juice
 Coconut aminos mayonnaises, salad dressings
 Apple cider vinegar or other sauces)
 Green tea, rooibos tea  Alcohol (best to be
 Water (flat or sparkling; with  Herbal tea (without avoided, especially if it
Drinks lemon/lime juice if desired)
 Homemade bone broth
sweeteners or processed
ingredients)
contains gluten and/or sugar)
 Coffee, black tea
 IF alcohol: dry wine, gluten-
and sugar-free alcoholic drinks  Decaf (unless Swiss water treated)
 NSAIDS & BCP (can irritate
Supplements
& meds

It is a good idea to stop all st

gut/disrupt gut flora, consult 1 before changing)

your supplements for a few  Reintroduce your  Any supplement or

weeks at first, but you should supplements (containing medications containing
safe ingredients only)
continue taking your one at a time, if desired sugar, sugar-alcohol or
medications as prescribed gluten (consult your pharmacist or
doctor before making any changes!)
*consult the Paleo FODMAP list here; **fermenting for 24 hours allows the probiotic to eat all the lactose found in the dairy products and make the
kefir/yogurt lactose-free (commercial yogurts/kefir are usually not fermented more than 8 hours and contain lactose).

can be gut irritants for many/some people; NSAIDS refers to non-steroidal anti-inflammatory drug and BCP to birth control pill.
Additional tips:
 Chew your food well;
 Implement relaxation and stress management techniques in your life;
 Try to space your meals 4 to 5 hours apart and try to “fast” overnight for at least 12 hours to promote the migrating motor complex (MMC);
 Start with well-cooked, deseeded, peeled and even pureed vegetables to improve digestibility;
 Meats, poultry and fish should be boiled, stewed or gently cooked with some water at first. After a few weeks, you can try grilling, roasting,
broiling, stir-frying, barbecuing and, if you want, dried (jerky);
 Fruits are better tolerated cooked, peeled and deseeded at first;
 Probiotics and fermented foods should also be introduced very gradually;
 Add new foods one at a time, every 3 to 4 days;
 Keep a food journal to track your symptoms and reactions to new foods;
 Remember that everybody is different and while foods in the 1st column are generally well-tolerated by most people, there is a lot of variability
in the tolerance to foods in the second column (and your own tolerance may even vary over time);
 Fill up your slow-cooker with meat, safe vegetables, bones, seasonings, water and a bit of apple cider vinegar for easy all-in-one meals with a
dose of gut-healing bone broth;
 Be aware that die-off symptoms (a worsening of your previous symptoms or new symptoms) is common in the first weeks;
 Always consult your doctor before changing your diet, medications or dietary supplements.
 Aglaée the Paleo dietitian. All Rights Reserved, 2012. More info about SIBO here. Need help? {paleo-dietitian.com}