The Long Game: Living with SIBO Beyond Restrictive Diets

Colorful: Salad with Chickpeas & Tofu (aka low-FODMAP, plant-based proteins)

Recently, a reader asked how I was doing on my long-term keto diet. And I was like, what long-term keto diet?

So I'd like to make something clear.

I am not on a long-term keto diet! Yes, sometimes I eliminate carbs for a few days to get my digestion back on track, or to recover from a carbohydrate-induced IBS/SIBO flare. In cases such as these, three days of keto is a godsend.

I discuss doing a keto reset on one of the most popular Sexy Sibo blog posts to date: The Main Idea: Ketogenic Healing and a No-Bloat Food List for Meaningful SIBO Reduction, which you can read here.

That post, written in 2015 during a moment when I had been eating keto-style for 10 days, is a classic. However, please don't think for a moment that I have been following a strict ketogenic diet ever since then, nor that I think you should.

Au contraire.

Here's a fun fact. When I started Sexy Sibo back in 2015, it was one of the first blogs about SIBO in the world! Almost nobody knew what SIBO was in those days.

But things have changed. There are many SIBO blogs now, and many SIBO specialists. There is a SIBO summit here, and another SIBO summit there. There are SIBO conferences, SIBO books and SIBO protocols. And there are promises. Lots of promises. "Take this (or take that) and get cured." "Eat this (or eat that) and get cured."

I've even seen a recipe book that indicates you can clear your SIBO in 30 days.

Listen. I've been actively dealing with my SIBO for a solid 5 years now. And in that time, I've come to terms with another fun fact that, at first, was tough to accept.

It is quite possible, if not likely, that I may never 100% "clear" my SIBO. 

Once upon a time, it was very exciting to think I could figure this thing out and get permanent relief, once and for all. I no longer think this way.

I don't think the digestive tract of a middle-aged person can ever become the digestive tract of a 12-year old, or even a 25-year old person. Microbes build up over a lifetime. They move in, and they stick around—literally, inside a safe, sticky biofilm. A Biofilm of Doom, if you like.

But that's just how it is. THERE'S NO ESCAPE, MY FRIENDS!

And, as the saying goes, A man's gotta eat—(Note: by "man" here, I mean human). So, no. I am not following a lifetime diet of meat, fat and green vegetables.

Ketochrome: Short Ribs in the Slow Cooker

I've widened my scope quite a bit and regularly include many more plant-based, starchy/carby foods in my diet than I did at first. These foods include organic brown rice cakes and whole grain basmati rice, as well as Jasmine rice. They include extra-firm tofu now and then, roasted beets on a salad, winter squash several times a week, low-FODMAP fruits here and there and even, in season, a high-FODMAP fruit or two. For instance, Honeycrisp apples. Or a ripe, juicy peach on a hot summer day. (Did that peach make me bloat? Yes. Was it worth it? I think so.) I may even have some delicious medjool dates or Turkish figs with yogurt for dessert.

If you are just discovering you have SIBO, do please (with the blessing of your primary care provider or other healthcare professional) try the low-carb and SIBO-safe diets I recommend elsewhere on this blog. Consider doing a round or two of antimicrobials, herbal or allopathic. See how far you progress and pay attention to what works for you.

This last bit is the key. For a long-term approach, you'll need to find out what works best for you, and is sustainable for your body, mind and spirit.

It's important to have access to something like my 3-4 day keto reset to fall back on, because there will be times that you REALLY need relief. But it's also important to have pie once in a while. Finding the balance and learning to adapt is the journey.

One more thing.

Personal experience has taught me that if I restrict my diet too much, or for too long, I tend to binge. That is a miserable cycle. So, after 5 years of dealing quite intensively with my SIBO, I have consciously, lovingly, given myself permission to be bloated.

Today, 5 years in, my focus is on finding balance with my diet, digestion and lifestyle using an informed, intuitive eating approach. Because low-FODMAP diets are incredibly well researched for IBS, I tend to rely on low-FODMAP foods most of the time. If I flare, I drop back to keto. Day by day, I try to be aware of and honor my needs—physical, emotional, spiritual. Food has a place in all three.

Please check out my official website www.eat2evolve.com to learn more about my work, outside of the Sexy Sibo arena. I am currently becoming certified as an Eating Disorder Recovery Coach while keeping my Certified Nutrition Specialist credential up to date and offering Nutrition Therapy sessions—both in person at my office in Hadley, MA and via phone consultation for those who live at a distance. I would love to work with you!

May you be comfortable, joyful and deeply nourished.

xo Diana