The problem with most SIBO treatments is that they aim to starve out or kill an overgrowth without healing the gut and the enteric nervous system, which are crucial in overcoming SIBO long-term.
To address this I’ve always recommended a Low-FODMAPS version of the GAPS Diet, coupled with relaxation practices, and more recently, the No-Plant GAPS Diet for SIBO.
SIBO is not an infection
Recent research has shown that a low-FODMAPs diet lowers symptoms, but worsens microbiota diversity over the course of three weeks. If we’re working to heal and bring healthy diversity back, we should aim to bring these foods back in as soon as they’re tolerated.
Recent research has also shown that SIBO testing is not testing what we thought. It appears to be revealing the malabsorption of carbohydrates, not any specific overgrowth. What was thought to be SIBO, may just turn out to be dysbiosis in the small intestine, which could be from bacterial or archea imbalance, as well as yeast overgrowths or parasites, as the symptoms are generally the same.
The FODMAPS Question
Listening to the case studies and research at the 2015 SIBO Symposium, a question kept popping in to my mind:
“If it’s the FODMAPS foods that are problematic in the small intestine and those are only found in plants, why don’t we just trial a diet where people don’t eat plants for a couple of weeks?”
It sounded a lot more appetizing than the 2-week elemental diet, which I had tried. The cramping and time spent in the bathroom in the middle of the night, coupled with the high carbohydrate formula, wasn’t sustainable for me. That experiment lasted six days.
Enter the “No-plant GAPS Diet,” which Dr. Natasha Campbell-McBride was already using for people with the most severely damaged digestive systems.
The No-plant GAPS Diet for SIBO
No-plant GAPS is version of the GAPS Diet which literally consists of meat stock (not bone broth), meats and seafood, organ meats, eggs, salt, and dairy ferments. Not a speck of plant material.
- Meat stock, including the naturally present fats and bone marrow. You may blend this if you prefer a smooth texture. 5 cups a day for adults.
- All kinds of meat, poultry, and seafood, in soup or gently cooked for easiest digestion.
- Organ meats of any type, necessary for nutrient-density. I’m ok with taking them as a supplement, if that’s where you’re willing to start.
- Eggs: raw yolks added to stock or soup first, and then whole eggs cooked softly.
- Salt: use natural forms to taste. Do not limit salts because when carbohydrates are reduced, the body excretes more sodium.
- Homemade dairy kefir, sour cream, or yogurt, fermented for 24 hours. Start with no more than 1 teaspoon a day, being mindful of die-off reactions.
In addition, I find that beet kvass is tolerated and useful in improving fat digestion in people with a SIBO diagnosis.
As described in the Gut and Physiology Syndrome book, Dr. Natasha Campbell-McBride has had people with certain severe conditions thriving on a No-plant GAPS Diet for many years, but I don’t find that it’s necessary to eat this way forever for SIBO. A couple of weeks, in conjunction with building resilience in the nervous system through the lifestyle changes, may be all that’s required.
For best results, implement the lifestyle changes today, then make plans for dietary changes.
SIBO Diet and Lifestyle Recommendations
- No-plant GAPS Diet.
- Supplement with cod liver oil and a spore-forming probiotic.
- Optionally, as indicated by symptoms, include stomach acid support, enzymes, or bile support.
- Cold therapy to retrain the nervous system. I find it most accessible to start with 1 second of cold water at the end of your normal shower, and then building by adding one second each day, to 30-45 seconds. You could also use cold plunges, cryotherapy, or outdoor cold exposure, if that’s available where you live.
- Deep breathing twice a day.
- Spending time outside daily, for at least 20 minutes.
- Laughter yoga or regularly engaging in activities that bring joyful laughter (not cynical, ironic, or nervous laughter, like from comedic news).
- Protection from or reduction of unnatural blue light from electronics and lighting.
- Purpose in life and letting go of unfulfilling obligations, including jobs you hate or relationships with people who are unwilling to grow in a healthy direction.
As my colleague, Shantih Corro says, “You need to cure your life, not your illness.”
The evolution of scientific research like we’re seeing around SIBO reinforces that we must always look to heal the deep root causes of imbalance, going beyond addressing the symptoms, even if it’s through ‘natural’ methods. The longer I practice nutrition, the more I find myself returning to the basics of nourishing, traditionally prepared whole foods, and getting back in touch with nature – both outdoors, and our own.