You can eat
- With SIBO, you can eat these foods without being limited to this list: rice, potato, quinoa, millet and oat flakes.
- Meat, fish, egg and firm tofu, cooked simply.
- Carrot, courgette, aubergine, cucumber, spinach, green beans and tomato.
- Orange, mandarin, kiwi, strawberries, grapes and slightly underripe banana.
- Lactose-free milk and yoghurt, and mature cheeses.
- Extra virgin olive oil, fresh herbs, ginger and spices.
- Walnuts, peanuts or pumpkin seeds, in a small handful.
- Water and mild infusions.
- Soy drink made with soy protein, not whole soybean, and with at least 3% protein.
What to avoid
- If you have been advised a low-FODMAP elimination for irritable bowel, this list is limited to that phase: bread, pasta and pastries made with wheat, rye or barley.
- Garlic and onion, also powdered and in prepared stocks.
- Pulses such as lentils, chickpeas and beans, while the elimination lasts.
- Apple, pear, watermelon, mango and stone fruit.
- Milk, yoghurt and fresh cheeses containing lactose.
- Honey, agave syrup and glucose-fructose syrup.
- Sugar-free chewing gum and sweets with sorbitol, xylitol, maltitol or mannitol.
- Cauliflower, mushrooms, asparagus and sweetcorn.
- Cashews and pistachios.
Changes that help
Sauté base
Instead of garlic and onion, the green part of spring onion or leek, because the fructans concentrate in the white bulb.
Bread
Instead of wheat bread, rice or corn cakes if they suit you better, because wheat provides fructans.
Dairy
Instead of milk or yoghurt with lactose, lactose-free versions if you need them, because they keep the calcium without that sugar.
Fruit
Instead of apple or pear, orange, kiwi or mandarin if they suit you better, because they provide less free fructose and sorbitol.
Habits that help
- Eat without rushing and without screens, and chew well.
- Take a short walk after the main meals.
- Sleep at similar times, weekends included.
- Set aside a while each day for something that relaxes you.
The first instinct after a SIBO diagnosis is to cut out everything that appears on some list. It is understandable, because you have been bloated for a while and want it to stop. But the longer the list and the longer it lasts, the harder it becomes to eat normally again.
It is the question we hear most in clinic after diagnosis. What do I eat while I take the antibiotic, and what do I do when it ends.
What does the diet do in SIBO, and what does it not do?
SIBO, short for small intestinal bacterial overgrowth, is an overgrowth of bacteria in the small intestine, a section that normally has few. How it is suspected and confirmed is covered in the guide SIBO: symptoms and diagnosis. The doctor assesses the diagnosis.
In practice it is usually indicated by a breath test; culture of the intestinal aspirate has a different role and also has limitations [2].
Treatment is prescribed by the gastroenterologist. It is usually an antibiotic, often rifaximin, which is barely absorbed and acts inside the intestine [2] [3]. Which drug, for how long and whether it needs repeating depends on each case.
Your doctor also looks for the cause that allowed the bacteria to grow, to review which factors may make the problem come back [3].
Food can help you manage discomfort while you follow the treatment. Afterwards, nutritional work aims to widen variety according to your tolerance [4]. On its own it does not treat the cause of SIBO.
What to eat while you take the antibiotic
If you also have irritable bowel syndrome, a low-FODMAP diet may be indicated for a limited time. FODMAP stands for a group of sugars and fibres that the intestine absorbs poorly and that bacteria ferment quickly. When they ferment they produce gas, and with more bacteria than there should be, more gas and more bloating. This restriction does not apply during pregnancy, breastfeeding or childhood, or with diabetes treated with insulin, and we do not give portions for those stages.
In SIBO, food can help you ease discomfort while you follow the treatment [5]. If you also have irritable bowel, the low-FODMAP elimination phase lasts a maximum of 4 to 6 weeks [1]..
Set the end date from the first day and reintroduce foods with professional help.
If you follow that plan for irritable bowel, a simple day could look like this. For breakfast, lactose-free yoghurt with kiwi and oat flakes. For lunch, oven-baked chicken with rice, courgette and carrot. For dinner, potato omelette without onion and tomato dressed with oil.
The amounts each food is tolerated in and the full list are in the FODMAP diet.
How foods are reintroduced
If you have followed an elimination for irritable bowel, the reintroduction is the part that decides how you will eat afterwards, and the one most people skip. It helps you find out which food groups disagree with you, in what amount, and which you already tolerate [1]. The result is a personalised diet that is as wide as possible [1].
The pace we suggest in clinic for this guided reintroduction is this:
- Test one group at a time, for example wheat, lactose or fructose.
- Start with the portion agreed with your dietitian-nutritionist and record symptoms and amount.
- Go back to your base plan for the agreed time before trying the next group.
- Note what you eat and how it makes you feel, without rushing to conclusions.
A mild discomfort with one group does not mean removing it completely. Often it is tolerated in a smaller amount or spread across the day.
Why not follow a low-FODMAP diet for life?
Because the same sugars that ferment are the food of the bacteria that are good for you. Keeping up the elimination for a long time can reduce the diversity of the microbiota, the variety of bacteria in the gut, and cause more problems than it solves [5].
There is a second reason, which we see often in clinic. A diet that removes many foods can end in fear of eating. That is why, before restricting, it is worth reviewing your relationship with food [1].
The best diet for SIBO is the one that lets you return to eating with variety.
If you notice that each week you eat fewer things, that you avoid eating out, or that food distresses you more than it relieves you, say so. In those cases we work alongside our Psychology team.
Is it fructose, sorbitol or lactose intolerance, or is it SIBO?
With SIBO, fructose, sorbitol or lactose can upset you even when your intestine absorbs them well. The excess bacteria ferment them too early, and that looks a lot like an intolerance.
That is why it is worth ruling out SIBO before doing a fructose or lactose breath test, which could give a misleading positive result [6]. If you had those tests while SIBO was untreated, it is worth reassessing your tolerance once treatment ends.
Do not assume that restriction is permanent. If when you finish you still notice discomfort with fruit or sugar-free chewing gum, you have the guides on fructose intolerance and sorbitol. Check with your team whether it is appropriate to test lactose again after treatment.
What to do after treatment: relapses or new discomfort?
If the bloating or changes in bowel movements return after treatment, do not assume it is a relapse. Note which symptoms have come back, when they started and how your bowel transit is, and ask the medical team for a new assessment.
The AGA practice advice indicates that management focuses on identifying and correcting the underlying cause when possible, in addition to treating deficiencies and symptoms [3]. Do not repeat antibiotics or an elimination phase on your own.
Food can help you eat with variety and manage discomfort, but there is no validated weekly plan to prevent the overgrowth from returning. If you also have irritable bowel, check with your dietitian-nutritionist whether a temporary strategy for symptoms makes sense; do not turn an elimination plan into your permanent way of eating.
And what if you do not have SIBO?
SIBO has become fashionable, and its diagnosis is subject to debate [7]. The review cited analyses the limits of breath tests and the possibility of overdiagnosis. Symptoms also appear in other digestive problems [2].
One of the most commonly confused is irritable bowel syndrome (IBS), a disorder of how the intestine works with no visible lesion. Coeliac disease, lactose intolerance or constipation also cause bloating and changes in bowel movements.
If you were told you have SIBO on the basis of a symptom questionnaire or a test bought online, ask a gastroenterologist to assess it. And if you have already treated it and the symptoms are the same, ask too. Our team of digestive dietitians works on these conditions starting from the medical diagnosis.
What mistakes do we see in clinic?
- Extending the elimination for months. Many people come to clinic after months on a low-FODMAP diet they started on their own, and they usually tolerate less than at the beginning. If irritable bowel is also present, the low-FODMAP phase should not exceed 4 to 6 weeks [1]. If symptoms persist, ask them to review the strategy before continuing the elimination.
- Adding up lists from the internet. Cutting FODMAPs, histamine and sugar all at once leaves the plate empty.
- Reintroducing everything in the same weekend. If something upsets you, you do not know what caused it.
- Cutting fibre out of fear of gas. Some gas is normal, because the microbiota also eats.
Weekly menu for SIBO: example after treatment
This week is only an example for an adult with a prior medical assessment, after treatment and with stable symptoms.
It is not a menu for a person with diabetes treated with insulin, pregnancy, childhood or other special needs. It is not a low-FODMAP phase, it does not treat SIBO and it has not been shown to prevent relapses.
If there are active symptoms, allergies, intolerances, weight loss or special needs, adjust foods and energy with your team before using it. Food can help manage symptoms, but on its own it does not eliminate the overgrowth [4].
The amounts are guidance for one person: cereals and pulses are weighed dry, unless stated otherwise; fish, meat, tofu and vegetables raw. Each cell shows all ingredients added up for shopping, including oil. Water as the usual drink. Do not copy the portions as an individual plan.
Allergens this week: gluten —oats count as a gluten-containing cereal unless certified—, milk, egg, fish, soya, peanut and tree nuts. Milk, yoghurt and fresh cheese only fit if you tolerate them; if not, use the alternative agreed with your team.
Refrigerate leftovers and eat cooked dishes within two days at most. Cooked rice keeps for a maximum of 24 hours. Freeze what you will eat later and transport food chilled.
| Day | Breakfast | Lunch | Dinner |
|---|---|---|---|
| Monday | Plain yoghurt with oats, banana and walnuts; mandarin yoghurt 200 g, oats 50 g, banana 100 g, walnuts 20 g, mandarin 100 g |
Lentils with rice, carrot and spinach; apple dried lentils 70 g, dry rice 40 g, carrot 100 g, spinach 150 g, apple 150 g, olive oil 10 g |
Hake with potato and courgette hake 160 g, potato 220 g, courgette 200 g, olive oil 10 g |
| Tuesday | Wholemeal bread with fresh cheese, pear and almonds; kiwi wholemeal bread 80 g, fresh cheese 80 g, pear 150 g, almonds 20 g, kiwi 100 g |
Chicken with couscous and aubergine; orange chicken 160 g, dry couscous 40 g, aubergine 200 g, orange 150 g, olive oil 10 g |
Omelette with potato and tomato and lettuce salad egg 2 units, potato 220 g, tomato 150 g, lettuce 80 g, olive oil 10 g |
| Wednesday | Milk with buckwheat flakes, peanut butter and strawberries; mandarin milk 250 ml, peanut butter 20 g, strawberries 150 g, mandarin 100 g, buckwheat flakes 50 g |
Chickpeas with quinoa, pepper and courgette; pear dry chickpeas 70 g, dry quinoa 40 g, pepper 100 g, courgette 150 g, pear 150 g, olive oil 10 g |
Sardines with bread and cucumber and tomato salad sardines 160 g, wholemeal bread 80 g, cucumber 120 g, tomato 150 g, olive oil 10 g |
| Thursday | Plain yoghurt with muesli, kiwi and walnuts; apple yoghurt 200 g, muesli 50 g, kiwi 100 g, walnuts 20 g, apple 150 g |
Turkey with wholemeal pasta, broccoli and carrot; banana turkey 160 g, dry wholemeal pasta 40 g, broccoli 180 g, carrot 100 g, banana 100 g, olive oil 10 g |
Tofu with rice and mushrooms with spinach tofu 180 g, dry rice 40 g, mushrooms 150 g, spinach 100 g, olive oil 10 g |
| Friday | Corn cakes with boiled egg and cucumber; orange, kiwi and almonds egg 1 unit, orange 150 g, kiwi 100 g, corn cakes 40 g, cucumber 100 g, almonds 20 g |
Beans with potato and chard; apple dry beans 70 g, potato 220 g, chard 180 g, apple 150 g, olive oil 10 g |
Salmon with couscous and green beans salmon 160 g, dry couscous 40 g, green beans 200 g, olive oil 10 g |
| Saturday | Milk with oats, pear and almonds; mandarin milk 250 ml, oats 50 g, pear 150 g, almonds 20 g, mandarin 100 g |
Rabbit with rice, pumpkin and green salad; orange rabbit 160 g, dry rice 40 g, pumpkin 180 g, lettuce 80 g, orange 150 g, olive oil 10 g |
Lentil burger with bread, asparagus and tomato wholemeal bread 80 g, asparagus 180 g, tomato 150 g, olive oil 10 g, dried lentils 70 g |
| Sunday | Yoghurt with buckwheat flakes, banana and peanut butter; strawberries yoghurt 200 g, banana 100 g, peanut butter 20 g, strawberries 150 g, buckwheat flakes 50 g |
Fresh cod with sweet potato, pepper and salad; grapes fresh cod 160 g, pepper 100 g, lettuce 80 g, olive oil 10 g, sweet potato 220 g, grapes 150 g |
Tofu with wholemeal pasta and roasted vegetables tofu 180 g, dry wholemeal pasta 40 g, aubergine 100 g, courgette 100 g, olive oil 10 g |
Shopping list for the 21 meals
The shopping list adds up the net amounts in the table. Adjust packaging sizes and waste when shopping, without turning the list into an elimination plan.
Pantry
- olive oil 140 g
- almonds 60 g
- peanut butter 40 g
- walnuts 40 g
Cereals and bread
- dry rice 120 g
- oats 100 g
- buckwheat flakes 100 g
- dry couscous 80 g
- muesli 50 g
- wholemeal bread 240 g
- dry wholemeal pasta 80 g
- dry quinoa 40 g
- corn cakes 40 g
Pulses and tofu
- dry beans 70 g
- dry chickpeas 70 g
- dried lentils 140 g
- tofu 360 g
Fish, meat and eggs
- fresh cod 160 g
- rabbit 160 g
- eggs 3 units
- hake 160 g
- turkey 160 g
- chicken 160 g
- salmon 160 g
- sardines 160 g
Dairy
- milk 500 ml
- fresh cheese 80 g
- yoghurt 600 g
Fruit
- strawberries 300 g
- kiwi 300 g
- mandarin 300 g
- apple 450 g
- orange 450 g
- pear 450 g
- banana 300 g
- grapes 150 g
Vegetables and tubers
- carrot 200 g
- spinach 250 g
- potato 660 g
- courgette 450 g
- aubergine 300 g
- tomato 450 g
- lettuce 240 g
- pepper 200 g
- cucumber 220 g
- broccoli 180 g
- mushrooms 150 g
- chard 180 g
- green beans 200 g
- pumpkin 180 g
- asparagus 180 g
- sweet potato 220 g
Whether pulses, fruit, dairy, wheat and other ingredients are included depends on your tolerance and clinical situation; there is no universal list of permitted foods for SIBO. This distribution uses the variety from a population dietary guide [8], which does not validate these portions as treatment. Do not replace a medical treatment with this menu.
After treatment, you can talk through the discomfort that has returned and the restrictions you keep with our team of SIBO dietitians. We coordinate nutritional work with your gastroenterologist, in Barcelona and online. The link leads to information about the service.
Your first step this week
If you do an elimination, set a date
If you have irritable bowel and are advised a low-FODMAP elimination, mark from day one when it ends and when you start reintroducing foods.
Your 7-day menu, ready for the fridge
- 7-day menu with the shopping list
- Easy recipes to cook at home
- Written by dietitian-nutritionists
Where should we send it?
Free PDF, in your inbox in a moment.
Data controller: Alimmenta Tu Vida, S.L. Purpose: to send you the guide and, only if you tick the second box, tips by email on the topic. You can withdraw your consent and exercise your rights at [email protected]. Legal basis, recipients and retention periods are in our privacy policy.
When to see a doctor
When to see a doctor
Food supports treatment and aims to keep variety. Diagnosis and decisions about medication are the doctor’s responsibility.
Book a medical appointment without waiting to change your diet if you notice any of these signs:
- You see blood in your stools, you have a fever or severe abdominal pain
- You lose weight without trying, or you pass greasy stools that float and are hard to flush
- You notice tingling in your hands and feet, you lose your balance, or you have been told you have anaemia
What to do. Blood, fever or severe pain: emergency care today. Weight loss, fat in the stools or signs of vitamin B12 deficiency: gastroenterologist, through your GP this week. If your diet is closing in on you, dietitian-nutritionist, to open it up again.
Tell us about your symptoms and diagnosis, and we will guide you
Tell us whether you have had a breath test and which treatment you are having. If you do not yet have a diagnosis, we tell you which doctor to see before booking. If you already have one, at the first appointment we organise what to eat while treatment lasts.
Keep reading
FODMAP diet: what to eat, what to avoid and how long it lasts
You have been told to follow a low-FODMAP diet and all you find are lists of hundreds of…
Fructose intolerance: which foods contain it and how much you can tolerate
Fruit seems to upset your stomach, and you have read that fructose may be to blame. You want…
Sorbitol: what it is, which foods contain it, and why it can cause symptoms
You read “sorbitol” on the label of sugar-free gum, or pears make you feel bloated and you do…
Irritable bowel symptoms: what to eat
Your stomach hurts, your bowel habits have changed, and you want to know what to eat without making…
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Your gastroenterologist diagnoses SIBO with a breath test. From there, we take care of helping you with food.
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Sources
- Chey WD, Hashash JG, Manning L, et al. AGA Clinical Practice Update on the Role of Diet in Irritable Bowel Syndrome: Expert Review. Gastroenterology. 2022;162(6):1737-1745.e5. doi:10.1053/j.gastro.2021.12.248
- Pimentel M, Saad RJ, Long MD, et al. ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. Am J Gastroenterol. 2020;115(2):165-178. doi:10.14309/ajg.0000000000000501
- Quigley EMM, Murray JA, Pimentel M. AGA Clinical Practice Update on Small Intestinal Bacterial Overgrowth: Expert Review. Gastroenterology. 2020;159(4):1526-1532. doi:10.1053/j.gastro.2020.06.090
- American Gastroenterological Association. Small intestinal bacterial overgrowth (SIBO): Managing with diet. Información para pacientes revisada por especialistas. AGA.
- Velasco-Aburto S, Llama-Palacios A, Sánchez MC, et al. Nutritional Approach to Small Intestinal Bacterial Overgrowth: A Narrative Review. Nutrients. 2025;17(9):1410. doi:10.3390/nu17091410
- Rezaie A, Buresi M, Lembo A, et al. Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus. Am J Gastroenterol. 2017;112(5):775-784. doi:10.1038/ajg.2017.46
- Suárez Terán J, Guarner Aguilar F. Sobrecrecimiento bacteriano del intestino delgado (SIBO), ¿una entidad clínica sobrediagnosticada? Gastroenterol Hepatol. 2024;47(9):502190. doi:10.1016/j.gastrohep.2024.502190
- Agencia Española de Seguridad Alimentaria y Nutrición. Recomendaciones dietéticas saludables y sostenibles. Guía alimentaria poblacional. AESAN.
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