 Hey everyone, this is Dr. Ruscio, let's discuss what is the best diet for SIBO or for small intestinal bacterial overgrowth. If you haven't heard of small intestinal bacterial overgrowth, it may be an overgrowth of bacteria that underlies a proportion of irritable bowel syndrome or IBS. So in truth, we could ask the question and answer the question of what is the best diet for SIBO and or what is the best diet for IBS because there's a lot of overlap in between the two. In short, there is no best diet for SIBO or for IBS. And I would encourage you simply to eat a diet that you feel best on for that condition. Now I know that's not very helpful. I'm going to give you some very specific guidelines in a moment. But one thing I'd like to start off with pointing out or advising you on is not trying to pick a diet based upon the diagnosis or based upon the lab finding, because in my experience that oftentimes distracts you. So if someone, let's say, has small intestinal bacterial overgrowth, they may have read that they have to avoid, let's say they've read that they have to avoid many forms of carbohydrate. And they avoid all these foods that they only then later come to realize are actually fine for them. So they actually put themselves on a restrictive diet just because they've heard that because I have SIBO I shouldn't eat X. So they avoid X, but they haven't done what we'll go over in a moment, a short simple experiment to figure out what your ideal diet is. And this can be much more accurate and much more beneficial. So if you have SIBO, again, don't only treat based upon the diagnosis of SIBO or what your lab show. So another example would be someone has H. pylori. They may say, well, I've read that certain foods are good or bad for H. pylori. And again, the gut is actually, it's simple but it's not that simple, right? So the best diet for someone's gut is a diet for which or on which someone feels the best. And what this should do is it should allow you to have the healthiest gut environment which causes healthy bacteria and healthy fungus and a healthy balance in the ecosystem that is your gut. So the diet that's best for the host is best for the ecosystem. Now that best diet can be different from person to person or for person to person. So I'll put up here on the screen something that I essentially develop in my book, Healthy Gut, Healthy You, which walks you through a series of short experiments to determine what the best diet for you is. So at the bottom you have the paleo diet. If you haven't tried the paleo diet, a two to three week try on the paleo diet is definitely advisable. The paleo diet pulls out of your diet many inflammatory foods. The most notable would be grains, dairy, soy, and processed food. Now that's a good starting point but if that doesn't provide adequate resolution, then you can move up the pyramid here to potentially paleo plus low FODMAP or the standard low FODMAP. And these two are very similar but there's some subtle differences. Now if you've responded partially to paleo by pulling out some of the grains and dairy but not fully, then you may want to go a step further in that direction. Stay paleo but also combine along with paleo the low FODMAP plus ending up at the paleo low FODMAP diet. And by the way, handouts for all these diets can be found on our website. I'll put a link here in the show notes and if you go to DrRusher.com slash gutbook you can find a redirect page to take you to all these resources. However, so that's the one path you may go. Now if you go paleo and you don't notice any improvement at all, then the issue for you may not be the removal or needing to undergo the removal of some inflammatory foods like grains and dairy as an example. But you may do or you may benefit from reducing the highly fermentable foods because that feed gut bacteria can cause gas and bloating and abdominal distention and pain as is laid out by the low FODMAP diet. So you could undergo the standard low FODMAP diet. So each one of these can be determined with about a two to three week experiment. So start on paleo two to three weeks. If you're improving you could potentially ride that a little further to paleo low FODMAP. If you notice no improvement you could go to standard low FODMAP. You could also go to the paleo plus low FODMAP. It's just that diet's a little bit more restrictive. So if you haven't gotten any benefit from paleo there's no need to go any further in that same direction. You may want to change our tact a little bit. And then finally if you're not getting the ideal improvement from either one of those diets two final considerations are the autoimmune paleo diet which is a stricter version of paleo which also cuts out eggs, nightshade vegetables and a few others but those are the main differences. Or you could do the low FODMAP with SCD diet which is essentially going further in the direction of low FODMAP and it's also a very restrictive diet but it can be helpful for a two to three week experiment to see if you gain benefit from that. Now all these experiments are only about two to three weeks in duration. When you find a diet that works best for you ride that wave and see okay I'm feeling good at three weeks. Ride that wave see at week six or ten where do you plateau? Once you've plateaued I'd stay there for a few weeks and then start to bring in some of the foods that you previously cut out to try to personalize the diet to you so that you can eat the broadest diet possible. Using the low FODMAP diet as an example it cuts out many foods that feed bacteria like avocado, asparagus, broccoli, onions and garlic which are healthy foods that are seemingly healthy on the surface but may not work for some people but not everyone has to avoid all those foods. So you'd reintroduce those one at a time to determine what works for you and what doesn't work for you and most people notice that there's a number of foods, probably the majority of foods that they're okay with but there's a small handful they have to at least not overdo it on. So that's how you use these restrictive diets in the short term to then get you to a broader version of the diet in the longer term. Now if diet doesn't produce satisfactory improvement then you may need to use other supports for your gut to get you all the way there. And that is again what we detail on healthy gut healthy you gives you a very personalized action plan, a series of steps to apply the available gut treatments in the most logical, efficient and effective sequence and so I'd start off with this dietary pyramid so to speak that's also detailed in healthy gut healthy you but if you don't see adequate resolutions from that then the book healthy gut healthy you gives you more strategies that you can employ to get you to a point where you're feeling healthier. So there is no ideal diet for SIBO it's really the question is better asked what is the best diet for you your individual gut and your gut ecosystems needs and we talked about a model you can work through for that and remember if that doesn't get you there then you may need to undergo a non dietary steps to finally get you to a point where you're fully improved. Alright this is Dr. Russo hopefully this helps you get healthy and get back to your life. Thanks.