SIBO

Your Comprehensive
Guide to Eliminating
Small Intestinal
Bacterial Overgrowth
Sylvie McCracken
ii
Sylvie McCracken of HollywoodHomestead.com
Copyright 2015 Sylvie McCracken
Disclaimer and Copyright Information

This book is not to be considered a replacement for medical advice, diagnosis, or treatment,
nor is it intended to treat, cure, or address any specific diseases or medical conditions. The
information contained herein is intended to be for informational purposes only, and any read-
ers of the material choose to implement the information into their lifestyles at their own risk.
We strongly recommend consultation with your doctor or primary care physician before mak-
ing any lifestyle changes. Please always use your best judgment and seek the advice of your
health professionals as needed.
By reading this guide, you expressly acknowledge and agree that neither the author, Sylvie Mc-
Cracken nor the author’s company, Sylvie McCracken International, LLC is responsible for any
express or implied results or guarantees relating to any information presented in the guide. Fur-
thermore, any statements or claims about the possible health benefits conferred by any foods or
supplements have not been evaluated by the US Food and Drug Administration and are there-
fore not intended to diagnose, treat, cure, or prevent any disease, medical condition, or injury.
Most of the outbound links here and on my websites are purely for informational purposes.
However, Sylvie McCracken International, LLC may earn a commission on some of the resourc-
es provided herein and on any websites owned, hosted, or promoted by Sylvie McCracken In-
ternational, LLC. As always, neither Sylvie McCracken nor Sylvie McCracken International, LLC
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er, neither Sylvie McCracken International, LLC nor its author, Sylvie McCracken provide any
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Copyright 2015 Hollywood Homestead. All rights reserved.

About the Author
Sylvie is a nutrition and health educator, sharing
her latest articles and recipes on her popular blog,
HollywoodHomestead.com
She is the author of two other books (available on her website): Paleo Made Easy: Getting
your Family Started with the Optimal Healthy Lifestyle and The Gelatin Secret: The Surprising
Superfood that Transforms your Health and Beauty
You can find out more Holding a Bachelor of Science in Finance, business is one of her first true loves which is why
about their lifestyle at the blog she recently launched a second website (SylvieMcCracken.com) to help others start and
hollywoodhomestead.com grow their own online businesses.
and follow her on Facebook,
Twitter, Pinterest, She’s also a wife and mother of three children ages 4 through 16. Last year she wrapped
and Instagram. up a decade-long career as a celebrity personal assistant in Hollywood and moved to Abu
Dhabi where her husband will be teaching for a couple of years.
Sign up for the newletter at:
hollywoodhomestead.com/ Sylvie and her husband Eric each lost over 60 lbs in the first year of adopting a paleo diet. You
sign-up can read about their paleo success stories on HollywoodHomestead.com
iv
Contents
Introduction 7 11 Herbal Antibiotics for SIBO 44
1 What is SIBO? 9 12 Elemental Diet 49
2 Symptoms of SIBO 13 13 Improving Motility 59
3 Causes of SIBO 19 14 Diet Protocols for Treating SIBO 63
4 Prevalence of SIBO 25 15 The SIBO Diet 67
5 Associated Diseases 27 SIBO Food Lists 70
6 How to diagnose SIBO 30 16 Preventing Recurrence 79
7 Breath Tests for SIBO 33 17 Healing the Gut 83
8 Methane vs. Hydrogen SIBO 36 18 Supplements 87
9 Treating SIBO 40 Parting Thoughts 90
10 Antibiotics for SIBO 42
v
Recipes 91
Basic Staples 93 Side Dishes 122
Garlic Infused Olive Oil 97 Honey Ginger Carrots 123

Homemade Yogurt 98 Sautéed Bok Choy 124
Spicy Italian Sausage Spice Blend 100 Roasted Root Vegetables 125
Savory Sage Spice Blend 101 Indian Style Cabbage 126
Lemon Ginger Vinaigrette Dressing 102 Mock Potato Salad 127
Breakfast 103 Snacks 128
Banana Nut Muffins 104 Sesame Seed Crackers 129

Banana Nut Smoothie 105 Labneh 130
Green Smoothie 106 Labneh Herb Dip & Veggie Platter 131
Breakfast Bowl 107 Banana Egg Muffins 132
Leek & Roasted Red Pepper Frittata 108 Honey Ginger Hot Wings 133
Main Courses 109
Beef 109
Beef Carnitas with Coconut Flour Tortillas 110
Spaghetti & Meatballs: Paleo Style 111
Quick Zucchini Noodles 112
Desserts 134
Beef & Veggie Soup 113
Beef and Broccoli 114 Whipped Banana with Walnut 135
Poultry 115 Honey Meringue Kiss 136
Yellow Zucchini Pasta with Turkey Meatballs 115 Macaroon Cookies 137
Lemon Dijon Chicken 116 Strawberry Preserves 138
Homemade Italian Spiced Turkey Sausage 117 Coconut Ice Cream Banana Split 139
Coconut Crusted Chicken with Spinach Salad 118 Shortbread Cookies 140
Seafood 119 Homemade Yogurt Parfait with Honey and Blueberries 141
Pecan Honey Mustard Crusted Salmon Salad 119 Coconut Custard 142
Fish Tacos 120

References 143
Shrimp Kabob 121
vi
Introduction
If you’re reading this ebook, my guess is that you, like me, have been diagnosed
with SIBO (Small Intestinal Bacterial Overgrowth). Or perhaps you’re simply
curious about whether you have SIBO based on your digestive symptoms. Either
way, you’ve come to the right place.
In this ebook you will learn all about what SIBO is, what causes it, how to accurately diagnose it, treatment
methods, and how to make sure it never comes back! I also have lots of great SIBO friendly recipes for you
to promote healing and prevent recurrence.
The SIBO Solution 7 HollywoodHomestead.com

Why did I decide to write about SIBO?
As with most of my work, it started as a struggle. When I was first diagnosed with SIBO, I was actually relieved
because I’d been jumping from one doctor to another bringing with me articles about SIBO and asking
them to test me for it since it seemed like a very likely possibility based on my symptoms. The fist doc just
rolled his eyes. The second doc told me to go ahead and assume I have SIBO and, without bothering to test,
wrote me a prescription for an antibiotic which I reluctantly accepted. It didn’t work. Turns out (as you and
I now both know) SIBO can’t be fixed by simply taking a pill. Luckily my third doc agreed to test me and sure
enough, by then I had a severe case of methane dominant SIBO, the hardest to treat. How long I had it or
what the cause was is still a bit of a mystery.
Of all the diagnoses I’ve had over the years, SIBO has been by far the most frustrating one and the most
complex to treat. Except for a few specialists, most doctors are not very knowledgeable on this subject and
many are quick to dismiss it as something of nominal importance. Some think it doesn’t even exist and that
you should just treat the symptoms and quit your whining. Even in the hands of a SIBO specialist, such as
the ones at the SIBO center in Portland, Oregon, there’s only so much that can be done in a 30 or 60 minute
consultation and the bulk of it is in your hands between appointments.
Does this sound familiar to you? I understand your frustration. I understand what it’s like to want to feel
well. I also understand how demoralizing it is when you finally start eating healthy foods and get sicker in-
stead of getting better.
As a side note, it is pretty ironic that certain healthy foods (like fermented foods) are bad for SIBO. Yet,
if we’d eaten these foods from the get-go, they could have prevented SIBO (such as by building a strong
immune system and gut flora). The fact that you’ve got to eliminate lots of healthy foods from your diet to
heal SIBO is downright maddening! And if someone that doesn’t understand SIBO hears you say you can’t
eat apples or garlic because they’re a FODMAP (see page 70 for more info on FODMAPs) they’ll likely try to
have you committed ;)
In writing this ebook, my goal isn’t just to offer you sympathy and understanding. I also want to give
you hope. I was able to eradicate my severe case of SIBO, and you can too. I know it. I also know it will take
a hefty dose of hard work and determination.
I hope that The SIBO Solution can serve as your guidebook to navigate you through diagnosing the con-
dition, understanding treatment options, a prevention strategy, and your diet. Your health is your hands and
you deserve it. ■

1
What is SIBO?
Not that long ago, the word “bacteria” brought up all sorts of negative
connotations and we’d do anything to keep it out of our bodies. Then we started
to realize how important some types of bacteria are for our bodies. Hence, the
boom of probiotic supplements and trendy yogurts. But it isn’t adequate to label
bacteria simply as “good” or “bad.” A type of bacteria might be “good” in one
part of your body, but “bad” in another. Likewise, too much “good” bacteria can
be a very bad thing. This is what happens with SIBO—Small Intestinal Bacterial
Overgrowth syndrome. Let’s start with the basics …
What is SIBO?
SIBO is a bacterial infection of the small intes-
tine. Now, bacteria is normal in the digestive tract
so that’s not the problem. But, with SIBO, it isn’t
the presence of bacteria which is the problem. The
problem is that there is too much bacteria and/or
the wrong type of bacteria and it’s in the wrong
place. By the “wrong type of bacteria,” it doesn’t
necessarily mean some weird strain of bacteria
is wreaking havoc on your gut. Most often, SIBO
occurs because bacteria which should be in your
large intestine gets into your small intestine or sim-
ply isn’t moving down to your large intestine as it
should.1 SIBO is not contagious so you don’t have
to worry about it spreading to anyone else.

Understanding the Digestive System
Before we can talk about what SIBO is and why you should be worried about it, we need to go over how the
digestive system works. When you eat, food passes through your body in a series of tubes. At each stage,
there are various acids which break down food so your body can absorb nutrients.
•• Mouth: Chewing and saliva start breaking down starches.
•• Esophagus: Swallowing brings food to the stomach.
•• Stomach: Muscle movements mix food with stomach acid.
•• Small Intestine: Food mixes with stomach acids, bile from the liver, and pancreatic juices. Food is
broken down and absorbed through the walls of the small intestine.
•• Large Intestine: The large intestine takes waste from the small intestine. It absorbs any remaining
nutrients. It also absorbs liquid so the waste turns into stool. The stool is then pushed out of the body
during a bowel movement.
The small intestine is really quite fascinating. It is

about 3.5 times your body height—or about 20 feet
long!2 Aside from the first few inches of the small in-
testine which are smooth, the small intestine is made
up of many folds called mucosal folds. It is also lined
with finger-like projections called villi. The folds and
villi increase the surface area of the small intestine
so it can better absorb nutrients, sort of like a towel
with increased surface area helps you absorb water.
The folds also help your small intestine mix food
with acids so they can be broken down.
The small intestine is arguably the most import-

ant part of the digestive process. It is in the small in-
testines that food is broken down into absorbable
parts. The small intestines are responsible for get-
ting these nutrients into our bloodstream so we can
use them.3,4

The Role of Gut Bacteria
Before you get scared off by the idea of bacteria in your digestive tract and take steps to eliminate all of it,
you need to be aware that we need bacteria. There are about 100 trillion bacteria in our intestines alone! This
is about 10 times the number of cells our bodies have.
Bacteria in the gut has numerous functions, including:
•• Breaking down carbohydrates so they can be absorbed;
•• Helping the gut’s immune system develop;
•• Protecting against disease-causing bacteria;
•• Stimulating the growth of the intestinal lining;
•• Converting vitamin K1 into vitamin K 2, which is an important nutrient for bone health.5
Bacteria is so important for our health that it is now often referred to as “the forgotten organ.”6
The vast majority of bacteria in our guts is located in the large intestine. To put this in perspective, there
are about 10–100 billion bacteria organisms present per teaspoon of fluid in the large intestine, compared to
just around 100 thousand organisms in the small intestine.7
Concentration of bacterial flora in different parts of the gastrointestinal tract
The location and concentration of bacteria throughout the intestines is really important for health. With
SIBO, the problem is NOT that you have bacteria in your small intestine. The problem isn’t even one type of
bacteria. The problem is that you have:
i. Too much bacteria and/or
ii. The wrong types of bacteria

It is thought that SIBO is most commonly caused when bacteria which should be in the large intes-
tine (and would be harmless there) gets into the small intestine. However, it is also possible for SIBO to
be caused by an overgrowth of the normal bacteria which should be in the small intestine. This may occur
when there is a problem with the Migrating Motor Complex which acts as a housekeeper to sweep bacteria
out of the small intestine, which we talk more about in chapter 13 about prokinetics.1
This is why SIBO is so hard to treat. If it were just a problem of one type of bacteria, or too much bacteria,
then we could take antibiotics and kill off the “bad” bacteria. But SIBO involves multiple types of bacteria,
including normal “healthy” bacteria which should be present—just that it is present in the wrong part of the
body and in too high of concentrations. While antibiotics are a great life-saving innovation, they are com-
monly overprescribed and very ineffective for treating SIBO.
Taking antibiotics may get rid of the overgrowth temporarily, but they can upset your gut flora balance
and the “bad” bacteria is just likely to proliferate again—which is why SIBO recurrence is so high. Because
antibiotics also kill off the healthy bacteria which should be in your gut, taking antibiotics can ironically be
a cause of SIBO! If you do use antibiotics to treat SIBO, they MUST be combined with and followed by a strict
diet for prevention as well as prokinetics. Otherwise, recurrence is almost inevitable. We will get more into
this more in the chapters about treating SIBO and diet protocols. ■

2
Symptoms of SIBO
As you’d expect, SIBO causes many gastrointestinal symptoms. However, because
the gut is linked to virtually every other part of the body, SIBO can cause a wide
range of symptoms from depression to skin rashes.
GI Symptoms of SIBO
When you have too much bacteria in your gut, the bacteria will start feeding off of undigested particles of
food. The bacteria causes the starches to ferment. The fermentation process produces hydrogen gas as a by-
product. If you have an overgrowth of bacteria, then the bacteria are going to have a field day eating away
at your food—before your body can even start digesting them. You end up with a gut full of hydrogen gas.
With the methane-producing type of SIBO (which we will get into in chapter 08), there is also an over-
growth of archaea, which are single-cell organisms without a nucleus. The archaea feed off of hydrogen, but
they produce methane as a byproduct. In either case, you end up with a lot of gas in your gut.
What happens when your gut is full of gas? Well, the obvious symptoms are that you are going to have
flatulence and/or belching. The gas can also cause severe bloating. Even if you are thin, the bloating can be
so bad that you look like you are 5 or more months pregnant.
Another problem which sometimes occurs with SIBO is severe abdominal pain. This is partly due to the fact
that the intestines are sensitive to pressure, so even a small amount of gas can cause pain. The pain can also
be caused by visceral hypersensitivity. Dr. Christina Lasich describes visceral sensitivity very well by comparing it
to a sunburn. When your skin becomes burned, even the slightest touch makes it hurt. This is hypersensitivity.
Well, the very same thing can happen when your gut is chronically damaged, making the pain more intense.8
Two common symptoms of SIBO are either diarrhea GI Symptoms Overview:
or constipation and sometimes alternation between
•• Flatulence and/or belching
the two. Hydrogen-producing SIBO is associated with
diarrhea. Methane, which slows down motility (the •• Bloating
transit of substances through the bowel), is associated •• Abdominal pain
with constipation. However, it is possible and common •• Cramps
even to have both hydrogen and methane present, so
having alternating bouts of both diarrhea and constipa- •• Diarrhea and/or constipation
tion are not uncommon SIBO symptoms.9

Other Symptoms of SIBO
If it were just digestive problems that we were talking about, then SIBO wouldn’t be such a big deal. But our
gut is responsible for much more than just eating. It’s not for nothing that experts refer to it as our second
brain. Problems in the gut can cause other problems including malnutrition, neurological and psychological
problems, and skin problems.
Malnutrition from SIBO

Digestion starts the moment you put something in your mouth. Chewing starts to break down starches and
saliva further breaks them down. Powerful acids in your stomach break down proteins. Bile from the liver and
pancreatic juices flow into the small intestine where they mix with stomach acids to break down carbohydrates,
proteins, and fats. It is here in the 20 feet of small intestine that the bulk of digestion occurs. It is also in the small
intestine that nutrients are absorbed.
The villi in the small intestine absorb broken down food so we can get the nutrients we need.
There are t wo ways that

For example, bile usually helps break down fats.
SIBO causes malnutrition:
When you have SIBO though, the bacteria decon-
•• Bacteria compete for nutrients jugate (disrupt) bile salts, leading to insufficient
amounts of fat absorption. This is NOT a good thing!
•• Bacteria produce byproducts which Your body relies on dietary fat to transport fat-solu-
irritate and inflame the small intestine, ble vitamins. This is why SIBO can cause deficiencies
hindering nutrient absorption10 in vitamins A, D, and E. Vitamin K is also a fat-soluble
vitamin. However, because it is produced from fer-
mentation, vitamin K deficiency is rare in SIBO.11

What’s the big deal with these vitamin deficiencies any way?
•• Vitamin A Deficiency = poor immune system, vision problems like night blindness
•• Vitamin D Deficiency = poor bone health, hormonal problems, increased cancer risk
•• Vitamin E Deficiency = muscle weakness, vision problems, poor immunity 12
The unabsorbed fatty acids can also cause other nutritional problems. The acids can bind with minerals
like calcium and magnesium (important for bone health) and form “soaps” which your body can’t break
down. This drastically increases the risk of bone diseases.13
B12 deficiency is also a major problem with SIBO because the bacteria consume the B12 before the body
can absorb it. It might seem like popping a few B12 supplements would solve this problem but, because peo-
ple with gut disorders can also have trouble absorbing B12, those oral supplements might not help. You’d need
to take B12 injections or B12 as a nasal spray to fix the deficiency while working on your SIBO attack plan.14
B12 has many important roles, including making DNA and keeping the body’s blood and nerve cells
healthy. Without enough B12, you can experience symptoms like:
•• Fatigue •• Poor memory
•• Depression •• Nerve problems like numbness or tingling
•• Confusion •• Megaloblastic anemia15
And this is just the tip of the iceberg! Because the bacteria can inflame and damage the sensitive villi
lining the small intestine, the body can have problems absorbing all sorts of nutrients. You can eat an in-
credibly healthy diet full of superfoods but it won’t do you any good if your body can’t absorb the nutrients!
Psychological Symptoms of SIBO

Recently, experts have come to recognize a strong connection between the brain and the intestines. They
call this the gut-brain axis. The gut-brain axis is so powerful that our gut bacteria is now often referred to as
the “second brain.”16
The gut-brain axis isn’t exactly a new discovery. For over 100 years, scientists have known that the brain
can influence the gut. One example is the army surgeon William Beaumont who, in the 1830s, found that
changes in mood affected gastric secretions in the gut. Even people without a medical background can
recognize the gut-brain axis. Think about it: when you are stressed, you often get indigestion. When you are
depressed, you often feel the urge to eat.
What is new information about the gut-brain axis is that researchers finally realized that it is a two-way
street. Actually, more like a cylindrical street. The brain affects the gut, and the gut can affect the brain. For

example, stress is thought to be a major cause of SIBO. But, a damaged gut can also affect your brain and
make you feel stressed. That is why stress can be both a cause and a symptom of SIBO.17
The gut-brain axis is fairly complex, especially when you take into account that there billions of neurons
in our brains, trillions of bacteria in our guts, and upwards of 1,000 distinct species of bacteria in the gut.
Obviously, there is a lot to analyze!
The vast majority (90%) of the brain’s output goes through the pontomedullary area of the brain stem, which
then goes to the vagus nerve. The vagus nerve goes through the heart, esophagus, and lungs and into the gut.17
Studies now show that changes to gut microbiota can affect the brain. (*Microbiota, also known as gut
flora, is a term which includes all microbes living in the gut, including bacteria, archaea, fungi, and viruses).
The microbiota influence the brain even when the immune system isn’t activated, which means it is the
microbiota which are directly “talking” to the brain! Note though that it isn’t just the microbiota itself which
is doing the talking. Bacteria in the gut can cause inflammation, which is an immune response, and the im-
mune system also communicates with the brain.16, 18
Most of the studies to date have been on animals, but the results are pretty amazing. For example, when
rats were fed an antibiotic-laced drinking water, it caused anxiety-like behavior. When the antibiotic treat-
ment stopped, their behavior went back to normal two weeks later.16 The human studies which have been
done mostly involve administering probiotics, and have found that probiotics can influence mood.18
The vagus nerve goes down through the lungs and heart into the gut

Because of the gut-brain axis, these are some of the SIBO symptoms you might experience:
•• Stress
•• Brain fog
•• Poor memory
•• Anxiety
•• Depression
Remember, the gut-brain axis is a two-way street. Stress, neurological, and

psychological problems aren’t just symptoms of SIBO, but can also be causes
of SIBO!
To learn more about the brain connection with SIBO, I highly recommend read-
ing Dr. Kharrazian’s brain book called Why Isn’t My Brain Working. In the book, he
teaches you nutritional strategies for improving brain function, like how gargling
several times a day for long-ish periods of time can stimulate your vagus nerve
which improves blood flow to the gut. You can find the book on our resource page
www.hollywoodhomestead.com/sibo-ebook-resources

Skin Conditions as Symptoms of SIBO
Do you have acne, rashes, or eczema? Or maybe you just have uneven, flaky skin? These can all be symptoms
of SIBO. On a basic level, SIBO can cause skin problems because it interferes with nutrient absorption, and
poor nutrition often reveals itself first through your skin. As talked about earlier, SIBO particularly interferes
with the absorption of fat-soluble vitamins, including Vitamin E which is known for its role in skin health.
However, the main reason that skin conditions are a symptom of SIBO probably goes back to the gut-
brain axis. Well, we need to add one more axis: The gut-skin axis. You have already experienced your brain-
skin axis, such as when your skin flushes when you become embarrassed or you get a breakout right before
a stressful exam. Since the gut influences the brain, it follows suit that the gut can influence your skin.
Interestingly, the gut may be able to influence the skin directly. Your skin is teeming with bacteria: there
are about 1 million bacteria living on each square inch of skin you have.19 Research indicates that signals
from your gut bacteria can interact directly with the bacteria on your skin.20 The bacteria in SIBO can also
cause inflammation, which also is a trigger for acne.
Like with the gut-brain axis, much more research is needed before we can fully understand the gut-skin
axis. However, we do know these facts:
•• A study found that SIBO is 10 times

more prevalent in those with acne
rosacea vs. healthy controls (people
without acne)
•• Correction of SIBO leads to marked

clinical improvement in patients with
rosacea
•• A Russian investigation reported that

54% of acne patients have marked
alterations to the intestinal microflora
•• A Chinese study involving patients

with seborrheic dermatitis also
noted disruptions of the normal
gastrointestinal microflora21 ■

3
Causes of SIBO
Obviously, SIBO is caused by having too much bacteria in your small intestine.
However, when talking about the cause of SIBO, we can’t put the blame on the
bacteria itself. Remember, you are supposed to have bacteria in your gut and
SIBO is most often caused by an overgrowth of bacteria which should be there.
Instead of blaming bacteria as the cause of SIBO, the real causes are the things
which made the bacteria proliferate in the first place.
In this chapter, we will talk about the main underlying causes of SIBO. It is important to understand these caus-
es so you can take steps to eliminate them. Otherwise, your SIBO will probably just come back after treatment.
Stress
The majority of SIBO cases are likely caused by stress.1 Stress is also what makes SIBO so likely to come back
after you treat it. As we talked about in the chapter about symptoms, the gut is linked to the brain in what is
called the gut-brain axis. Without rehashing all of the info found in that chapter, researchers have now dis-
covered that it isn’t just our brains which communicate to the gut, but bacteria in our gut “talk” to the brain.
If you take a group of healthy people, they each will have different bacterial compositions in their guts. Yet,
each person’s gut bacteria stays pretty much the same—even when compositions are measured months or
more apart. But, when you take a person and put him in a stressful situation, the bacterial composition
drastically changes. This creates an imbalance in bacteria which can affect health.16
Stress can also indirectly cause SIBO by creating conditions which lead to SIBO.
•• Stress → Inflammation → Low Stomach Acid → SIBO
•• Stress → Weakened Immunity → Overgrowth of “Bad” Bacteria → SIBO
•• Stress → Weakened Immunity → Infection → Antibiotic Use → SIBO
•• Stress → Motility Problems → Bacteria Proliferation → SIBO
Remember, the gut-brain axis is a two-way street! This is why stress can be both a cause and symptom
of SIBO. To cure SIBO for good, it isn’t enough to take antibiotics and make changes to your diet. You’ve also
got to manage stress.

Antibiotics
As someone who took entire arsenals of antibiotics during the first 2 decades of my life (including large
doses of penicillin injected into my rear more times than I can count!), I can attest to how quick doctors are
to prescribe antibiotics. In Argentina where I grew up, you can even get antibiotics without a prescription.
I would just call my doctor who lived in another province and tell him my symptoms. He’d tell me what
antibiotics to pick up, increasing my dosage each time. Now, I’m not anti-doctor nor anti-medicine by any
means and I think antibiotics can be a great, even life saving, tool in some instances but using them as a first
recourse for things that could have been treated with some chicken soup and a little rest doesn’t come with-
out consequences.
It isn’t just in Argentina were antibiotic over-prescription is a problem. One survey found that American
medical doctors prescribe antibiotics in about 101 million visits yearly!22 Other studies have found that these
antibiotics are often unnecessary—such as when they are given when the underlying problem is actually
a virus.23 It also doesn’t help that antibiotics are regularly given to livestock animals, which is another reason
to buy antibiotic-free meat.24 Actually, if you want to improve your gut and overall health, buy pasture raised
meat which has a better Omega-3 to Omega-6 ratio. For bonus points, visit the farm to confirm the quality!
Overuse of antibiotics leads to antibiotic-resistant superbugs, which is a major threat to health. To learn
more about the importance of meat quality for health, I recommend reading my first book, Paleo Made Easy,
which can be found on the resource page www.hollywoodhomestead.com/sibo-ebook-resources. But let’s
just look at what antibiotics can do to our gut health.
When you take antibiotics, they don’t just kill off the “bad” bacteria which are causing your infection. They
kill off the “good” bacteria which need to be in your gut. This upsets the balance of your gut flora. Without
enough good bacteria to keep the bad bacteria in check, the bad bacteria can proliferate and lead to SIBO.
Once you consider the link between antibiotic use and SIBO, it is easy to understand why SIBO has such
a high recurrence rate. Doctors traditionally prescribe antibiotics for SIBO, which temporarily may solve the
problem. However, the antibiotics do not address the underlying cause of SIBO. Because the healthy bacteria
are also affected when you take antibiotics for SIBO, the bad bacteria just proliferate again and SIBO comes
back. This is why it is so important to follow diet and lifestyle protocols to prevent SIBO recurrence.
Low Gastric Acid

Acid reflux is incredibly common: 50% of adults will experience some type of gastroesophageal reflux dis-
ease in a 12 month period and 20–30% will have weekly symptoms.25 Based on all those heartburn medicine
ads you see on TV, you would think that acid reflux is caused by having too much gastric acid and that antac-
ids are the solution to all your problems. Really, heartburn is caused by too little acid.26
The symptoms of acid reflux do not occur from having too much acid, but rather occur when acid gets
into the esophagus. This can happen when there is too much pressure (such as from inflammation and
excess stomach gas) and the pressure causes stomach acids to be pushed up into the esophagus. Antacids
do wonders for suppressing the symptoms of acid reflux but, because you need acid, they don’t address the
underlying problem and actually make the problem worse in the long run.27

Our bodies need gastric acid to digest food and break it down. Without enough stomach acid, you end up
with undigested carbohydrates in your digestive tract. Bacteria in your small intestines love most carbohy-
drates and they start to feed off of them. Not only do the bacteria proliferate, leading to SIBO, but the bacteria
produce hydrogen gas as a byproduct of digesting carbs. You end up with a belly full of gas, which in turn cre-
ates intra-abdominal pressure and pushes your stomach acid up into your esophagus—causing acid reflux.
According to researchers Suarez and Levitt, just 1 ounce of carbohydrates that escapes absorption in
a day could produce more than ten quarts of hydrogen gas in small intestine. This gives you an idea of
how much pressure undigested carbs can produce!28
Low Undigested
Stomach Food
Acid Particles
Bacteria
Overgrowth
Intra-
Acid
Abdominal
Pressure Reflux
Gastric acid not only helps digest food, but also suppresses ingested bacteria naturally. So, low gastric
acid is a double-edged sword. Bacteria proliferate because there is so many undigested carbs to feed off of,
and they continue to proliferate because there isn’t enough gastric acid to suppress growth.29
Why Would You Have Low Stomach Acid?
The obvious answer to this question is that you have been prescribed proton pump inhibitors or are tak-
ing antacids for acid reflux. But what caused you to have the acid reflux symptoms in the first place?
Though the drug industry would rather you didn’t know about it, research shows that ulcers are caused
by a bacteria called h. pylori which is present in as many as ⅔ of the population.30

There are many other reasons why your stomach acid production might be low. Some of these include
old age, stress, adrenal fatigue, chlorinated water, and alcohol consumption.31 A big contributing factor
though, is diet. The junk foods and carbs which make up the Standard American Diet are very inflammatory.
As Dr. Myhill explains:
You may have low stomach
“The stomach is lined with cells that are proton
acid which caused SIBO if:
pumps—that is to say they pump hydrogen ions from
the blood stream into the lumen of the stomach. Stom- •• You have h. pylori infection
ach acid is simply concentrated hydrogen ions. There
is a natural tendency for these hydrogen ions to diffuse •• You have leaky gut syndrome (mainly
back from where they came but this is prevented by caused by food sensitivities like gluten)
very tight junctions between stomach wall cells. How- •• You take proton pump inhibitors
ever, if the gut becomes inflamed for whatever reason, or antacids regularly
there is leaky gut and hydrogen ions leak back out.” 32
In this way, SIBO is linked to leaky gut syndrome, which is the cause of all autoimmune disorders.
Poor Immunity
Our immune systems are a heck of a lot smarter than antibiotics at controlling “bad” bacteria. A healthy im-
mune system will control bacteria in the small intestines by secreting mucus containing immunoglobulins.
When your immune system becomes compromised, SIBO can occur. SIBO has been linked to many immu-
nodeficiency syndromes.11
Instead of asking how impaired immunity causes SIBO, we should be looking at the root cause: why is
your immune system not functioning in the first place? Of course, there are many possible reasons for this,
such as stress and poor diet. Do you see a recurring theme here? Stress and poor diet are at the root of
most causes of SIBO!
Dysmotility
Another major cause of SIBO is dysmotility, which is a condition in which the muscles of the digestive sys-
tem become impaired and are no longer able to empty contents efficiently. The contents become trapped
in the small intestine. Motility is incredibly important for protecting against SIBO: the movements in the
bowl prevent organisms from attaching to the wall of the small intestines. When you’ve got food waste
sitting in your small intestines instead of exiting through the large intestine, bacteria can start to proliferate
as it feeds on the waste.11
The movements of our digestive system are actually on a rhythmic schedule which is known as the mi-
grating motor complex (MMC). It is thought that MMC has a “housekeeping” role. One of the biggest mistakes
I made when first attempting to treat SIBO was not immediately taking a prokinetic after treatment. A proki-
netic is different than a laxative, which stimulates peristalsis, or the movement of food through the gut.

Prokinetics are what stimulate the MMC to empty food residue and bacteria left in the small intestine.33 We
will talk about prokinetics and improving motility in chapter 13.
Dysmotility can be a genetic problem. In genetic cases, it is common for family members to also have
other muscle contraction problems, such as incontinence from not being able to control the bladder. Dys-
motility can also be caused by problems like:
•• Parkinson’s Disease •• Thyroid disorders •• Muscular dystrophy
•• Diabetes •• Lupus •• Inflammation of the

intestines34, 29
•• Scleroderma •• Amyloidosis
This last point is very important. Note the recurring theme. Stress and bad diet can cause gut inflamma-
tion. This can then led to low stomach acid, which in turn leads to bacterial overgrowth. This in turn leads to
more stress, which creates a vicious cycle. Again, this is why it is so important to treat SIBO with a compre-
hensive strategy which includes diet and stress management.
Heavy Metals as a Cause of SIBO

Another possible cause of SIBO is heavy metals toxicity. Every day, we come into contact with a barrage of
toxic heavy metals. For example:
•• Aluminum found in toothpaste, baking soda, and aluminum cans
•• Cadmium in drinking water, plastics, and paint
•• Lead in car exhaust, eating utensils,

and canned foods
•• Mercury in air conditioner filters, overconsumption of certain fish, and floor waxes
•• Arsenic in wine, household detergents, and preservatives

Even if you take steps to eliminate heavy metals from your life (such as by making your own toothpaste
and cleaning products), it is still impossible to completely avoid toxic heavy metals. These heavy metals
have been shown to have adverse effects on your body, including on your digestive tract.35, 36
Even “healthy” heavy metals can be harmful to your gut health. For example, iron and some other nutri-
ents are considered heavy metals but your body needs them to function. But, if your gut is damaged (such
as from inflammation and leaky gut), then you won’t be able to absorb these nutrients into your body.
“Bad” bacteria use some heavy metals to form biofilms. Biofilms are basically mesh-like structures where
bacteria live. To form biofilms, bacteria use iron, calcium, and magnesium (amongst others). The biofilm
acts as a shield which protect the bacteria and makes it very difficult for probiotics or antibiotics to kill the
bacteria. This is obviously a Catch-22 because you need those metal nutrients to stay healthy, but they also
can help the bad bacteria thrive.37

On a Personal Note …
The truth is that I don’t know 100% what the cause

of my SIBO was. For me, there were probably nu-
merous underlying causes of my SIBO … chronic
antibiotic use in my formative years, a damaged
gut from the junk food diet I used to eat, heavy
metal exposure (I tested high for mercury and
lead to be specific), h. pylori, chronic stress …
SIBO can be a vicious cycle. It is caused by
stress. Trying to figure out SIBO makes you
more stressed. The SIBO comes back and you
get more stressed.
Understanding that cycle is the easy part. Breaking it is the tricky part.
All of the causes above are issues that I have personally struggled with. It is hard to pin down, but you’ve
got to do your best to attack SIBO with a multidimensional approach. Just taking antibiotics probably won’t
cure you if you don’t make major changes to your lifestyle and diet. The good news is that, once you master
these changes, it isn’t just your gut health which will be better—you entire health and happiness will improve.
Carbohydrate Malabsorption
Carbohydrate malabsorption, also called carbohydrate intolerance, is a condition in which your body is
unable to digest or properly absorb certain carbohydrates. There are numerous carbohydrate intolerances
but some of the most common are fructose, lactose, sucrose, and sugar alcohols (such as sorbitol and
xylitol). When the body is unable to digest these carbs properly, bacteria are able to use it as food and pro-
liferate. As with many things related to SIBO, carbohydrate malabsorption can be a vicious cycle. Not only is
it a potential cause of SIBO, but SIBO can cause malabsorption problems—thus giving bacteria more carbs
to feed off of and worsening the SIBO.38, 29 ■

4
Prevalence of SIBO
It was only recently that medical researchers discovered just how important
the gut is to our overall health. So, it isn’t surprising that the gut was (and still
is) often overlooked. To put this in perspective, consider that Crohn’s Disease
wasn’t even described until the 1930s. Irritable bowel syndrome (IBS) wasn’t
mentioned until the 1950s. It took even longer for these diseases to get much
recognition in popular medicine. 39, 40, 41
By comparison, SIBO is even newer. It wasn’t until 2004 that the link between SIBO and constipation was
discovered. In recent years, interest and research in SIBO from the medical community has greatly increased—
but don’t be surprised if your doctor seems amazingly unaware of the disease and treatment protocols.42
I mention all this to point out that we really don’t know how prevalent SIBO is. If your doctor isn’t aware
of it, then he/she probably isn’t going to order a breath test, let alone the right breath test as discussed on
page 33. Even if you are given a breath test, your doctor might only order a hydrogen test instead of a hy-
drogen and methane test (you’ve got to do both tests; we will discuss why in chapter 06 about diagnosing
SIBO). There are still no established protocols on how to read the results of SIBO breath tests, so one doctor
might give a negative diagnosis whereas another might diagnose positively.
There also have been very few studies on the prevalence of SIBO in seemingly-healthy subjects (there
have been ample studies about the occurrence of SIBO in patients with IBS and other GI disorders). Further,
the prevalence rates also depend on what diagnostic method is used. Even with these limitations in re-
search, it is pretty clear that SIBO is a very common health problem, even in “healthy” people.
One analysis of SIBO research from 1966 to 2006 found these prevalence rates in “healthy” groups:
•• 0% (glucose breath test)
•• 5.9% (glucose breath test)
•• 13% (lactulose breath test)
•• 14.5% (glucose breath test)
•• 20% (lactulose breath test)29
I find it interesting that the one study which found a 0% rate of SIBO was in Japan. The other studies were in
westernized countries like the US, UK and Australia. The Japanese are known for their really low obesity rates,
their long lives, and a gut-healthy diet which traditionally doesn’t include any wheat (gluten). It makes you think …

In a different analysis of the literature, SIBO prevalence was found to be:
•• 0–12.5% by the glucose test
•• 20–22% by lactulose test
•• 0–35% by xylose test 43
Keep in mind these statistics are for healthy subjects. When you look at the prevalence rates of SIBO for
people with IBS, Crohn’s or other gut problems/symptoms, then prevalence rates skyrocket. For example,
one research paper found that 36% to 84% of patients with IBS also have SIBO. Consider that IBS affects
10–15% of the North American population and you can see how big of a problem SIBO may turn out to be.44
Note also that the research clearly shows that advanced age is a risk factor for SIBO. Up to 35% of “healthy”
elderly adults have been found to have SIBO.
The bottom line?
If you’ve got digestive issues, don’t hesitate in testing for SIBO. Insist on a hydrogen and methane 3 hour
lactulose breath test. If your doctor is reluctant to order one, then consider switching doctors! ■

5
Associated Diseases
I really want to stress that the gut is linked to virtually every part and system
of your body. We don’t just have the gut-brain axis, we’ve got the gut-skin
axis, gut-liver axis, gut-kidney axis, gut-bone axis … Since your gut is what is
responsible for taking in nutrients and getting them into your bloodstream,
your gut is also going to be linked to any nutrient deficiency disorder.
If you’ve got SIBO, you’ve got more than just a grumbling tummy and bloat to worry about!
Because of the gut’s connection to every part of the body, we could potentially link SIBO to virtually
every disease out there. At her website, Dr. Siebecker has a list of 50+ of these diseases and conditions, such
as (to name just a few): 45
•• Acne Rosacea and Acne Vulgaris •• GERD
•• Anemia •• Hypothyroidism
•• Autism •• Pancreatitis
•• Chronic fatigue syndrome •• Rheumatoid arthritis
•• Gallstones
However, there are some diseases which are particularly associated with SIBO. They are Irritable Bowel
Syndrome, Crohn’s Disease, Celiac Disease and Histamine Intolerance.
Irritable Bowel Syndrome (IBS)

IBS is an incredibly common disease which affects about 10–15% of the US population, and 9–23% of the
population worldwide. The disease can affect anyone, but is most common in women. Having IBS is defi-
nitely no picnic. The symptoms are nearly identical to those of SIBO: abdominal pain, bloating, diarrhea and/
or constipation, nausea, fatigue …46
There has been quite a bit of research on the occurrence of SIBO in IBS patients. The results can’t be
ignored: upwards to 84% of IBS patients test positive for SIBO with a hydrogen breath test!45

There seems to be a very strong link between SIBO and IBS, but medical professionals aren’t in agree-
ment on what exactly this link is. One possibility is that many people diagnosed with IBS really have SIBO.
This is backed up by the fact that treatment for SIBO often gets rid of IBS symptoms. Another possibility is
that SIBO is a root cause of IBS (no one knows for sure what causes IBS).10
However, some are skeptical of the link between SIBO and IBS. People with IBS have a shorter transit time
from the stomach to the small intestine, which could cause a false positive on breath tests.47
Crohn’s Disease
Crohn’s Disease is an autoimmune condition in which the gastrointestinal tract is chronically inflamed.
Crohn’s most often affects the end of the small intestine, but can occur anywhere throughout the GI tract.
This disease is definitely not something you want to have. It causes symptoms like persistent diarrhea, ab-
dominal pain, rectal bleeding, and constipation.39
The cause of Crohn’s Disease isn’t fully understood, but scientists think it has to do with an immune re-
sponse. Our immune systems generally do a great job of protecting our bodies against invaders like viruses,
bacteria and fungi. With Crohn’s Disease though, the immune system might mistakenly think that bacteria
which normally should be in our GI tract is actually harmful. The immune system attacks these harmless
bacteria, causing an inflammatory response.39
Because SIBO is a disease in which you’ve got too much or the wrong kind of bacteria in your gut, and
Crohn’s may be caused by gut bacteria, it isn’t surprising that the two conditions are linked. Studies have
found that 23–34% of Crohn’s patients also tested positive for SIBO.
The theory is that Crohn’s Disease predisposes people to SIBO because Crohn’s causes motility prob-
lems. Disrupted motility means you have undigested food particles and waste sitting in your gut for longer,
allowing bacteria to feast and grow.48
Celiac Disease
Celiac Disease is finally getting a lot of attention and the world is waking up to the fact that gluten is not
a friend of your gut. But the truth is that we may not know as much about Celiac Disease as we think. It is
thought that Celiac is an autoimmune disorder. When people with Celiac eat gluten, the immune system
attacks the gluten as though it were a foreign invader. This leads to inflammation which damages the lining
of the small intestine.
There is another theory about the cause of Celiac Disease though.
Before gluten was even discovered, it was thought that SIBO was the cause of Celiac Disease. The first
person to propose this theory was Dr. Sidney Haas in his 1951 book The Management of Celiac Disease.
Dr. Haas treated over 600 cases of Celiac Disease using the Specific Carbohydrate Diet (which we will discuss
in the diet chapter). In each case, he noted that prognosis was excellent.49, 50

One study found that ⅔ of Celiac patients who still had GI problems even after eliminating gluten tested
positive for SIBO.50
It is worth noting that the only way to diagnose Celiac Disease is with an endoscopic biopsy, not
a blood test. During the endoscopy, a scope is inserted through the mouth and down into the esopha-
gus, stomach and small intestine. A sample of tissue is taken from the lining of the small intestine to look
for damage to the villi.51
Even if you don’t have Celiac Disease, gluten can still be a problem. Many people have a food sensitivity
to gluten (called non-celiac food sensitivity). Depending on which study you go by, around 7–29% of people
are sensitive to gluten, though some experts believe everyone is sensitive to gluten to some degree. The
condition causes many of the same symptoms as Celiac Disease, including the inflammation which can
lead to a damaged gut. Gluten sensitivity can be diagnosed with a blood test which looks for the presence
of certain antibodies.52, 53
Gluten is definitely not good for your gut and can cause holes to form, so eliminating gluten might help
elevate GI symptoms. But if you’ve been diagnosed with Celiac and still have problems even after elimi-
nating gluten, you should get tested for SIBO and start following The SIBO Diet, not just a gluten-free diet.
Histamine Intolerance
Histamine intolerance (HIT) is another condition which is also closely linked to SIBO. We tend to think of
histamine as the chemical which our bodies release during an allergic attack, but histamine also has many
roles in our body such as regulating stomach acid and immunity. Histamine is also found naturally in many
foods. When you have HIT, your body has more histamine than it is able to break down and you experience
allergy-like symptoms. Many practitioners, such as Chris Kresser, believe that HIT is caused by SIBO. Certain
types of bacteria produce histamine from undigested food, causing excess histamine and symptoms. Find-
ing out that histamine intolerance and SIBO are closely linked was the final clue that made me seek testing
because my HIT was so bad at the time.109 ■

6
How to diagnose SIBO
When you have SIBO, you can experience a wide range of symptoms from gas and
flatulence to fatigue and depression. It is impossible to diagnose SIBO based
on symptoms alone because the disease shares so many symptoms of other gut
diseases. There is also a strong link between SIBO and other gut diseases such
as Irritable Bowel Syndrome and Celiac Disease.
So, even if you have already been diagnosed with a gut disease which accounts for your symptoms, it is still
good practice to test for SIBO. There are numerous different ways of diagnosing SIBO, but some tests are much
more reliable than others. Here we will go over the different ways to diagnose SIBO and which ones are best.
Small Bowel Aspirate Test for SIBO

This test used to be considered the “Gold Standard” for diagnosing SIBO. It involves putting a tube down the
nose, through the stomach, and into the small intestine to take a sample of fluid. Bacteria from the fluid is
then grown (cultured) to determine what type and how much bacteria are present.
This test is no longer considered a good method for diagnosing SIBO. For starters, it is invasive and defi-
nitely not a pleasant experience for the patient! It also requires a highly-skilled professional to perform,
and is costly. These problems might be acceptable, except that culturing bacteria isn’t even a very accurate
method of diagnosing SIBO. According to research published in the journal Science, this method only reveals
about 20% of the microbiota in the small intestine, so SIBO could easily be missed.54, 55
Stool Tests for SIBO

Stool testing cannot diagnose SIBO because it mostly reflects the large intestine, and not the small intestine.
This doesn’t mean that it can’t be a valuable diagnostic tool though. A stool test can suggest whether there
is a bacterial overgrowth in the large intestine. It can also show fat malabsorption which may occur due to
SIBO. Further, stool testing can be used to diagnose or eliminate other potential gut problems, such the
presence of specific parasites. Some of the markers which may be measured in a stool test are:
•• Digestion and Absorption Markers (pancreatic elastase, pancreatic enzymes, putrefactive SCFAs.)
•• Gut Immunology Markers (inflammation markers)

•• Metabolic Markers (pH, bile acids, levels of short chain fatty acids … )
•• Microbiology Markers (pathogenic bacteria, beneficial flora … )
•• Parasitology (presence of parasites or their eggs)56, 57
Urine Organic Acids Tests for SIBO

Bacteria and fungi in your gut produce organic acids as byproducts. These organic acids are then excreted
in your urine. The presence of certain types of organic acids in your urine can be an indication that you have
an overgrowth of bacteria or yeast.
Urine tests can only indirectly tell you if you have a bacterial overgrowth. They cannot tell you where the
overgrowth is occurring, and thus can NOT be used to diagnose SIBO. However, some experts like Chris
Kresser prefer the test because it also contains other markers which are useful for diagnosis.56, 58
Breath Tests—the Best Method for Diagnosing SIBO

Because of the limitations with the other SIBO diagnostic tests, breath tests are now considered the best
way to diagnose SIBO.
The bacteria in our guts feed off of certain carbohydrates. They produce gases as a byproduct, including
hydrogen and methane. Some of the gases are then absorbed through the lining of the colon and get into
our blood. From there, the gases make it to our lungs and are exhaled in our breath. The amount of hydrogen
and methane in our breath can indicate whether there is an overgrowth of bacteria in the small intestine.
Breath tests also aren’t perfect for diagnosing SIBO, especially because there is no consensus on how
to interpret test results. However, since it is thought that the only source of hydrogen in the body is from
bacterial fermentation of carbohydrates, the hydrogen breath test is likely the most accurate method of
diagnosing SIBO. It also has the benefit of being cheap, easy, and non-invasive.54
Note that not all breath tests for SIBO are the same. In the next chapter, we will get into the details about
what you need to know about breath tests for SIBO.
Diagnosing SIBO Doesn’t Diagnose the Cause!

These diagnosis tests are simply used to tell whether you have an overgrowth of bacteria in your small intestine or
not. Of course, this is important—but the tests do not tell you what caused the SIBO in the first place.
Bacterial overgrowth is an indication of an underlying problem. If you don’t treat this root problem, then
the SIBO is just likely to come back—regardless of how many rounds of antibiotics you take to kill the bac-
teria in your gut. Unfortunately, there are many possible reasons for SIBO. To really cure SIBO, you’ve got to
take an multifaceted approach and make major lifestyle and diet changes so you don’t create the conditions
which allow your gut bacteria to become unbalanced.■

Before and After SIBO Breath Test Results

7
Breath Tests for SIBO
In the last chapter, we talked about the many ways to diagnose SIBO. Though
they aren’t perfect, breath tests are generally the most reliable and affordable
method of diagnosing SIBO. It can be a bit confusing because there are numerous
types of breath tests. Here we will talk about what breath tests are used for,
how to take a breath test, which type of breath test you need to take to diagnose
SIBO and how results are interpreted.
What Are Breath Tests Used For?

The bacteria in our guts feed off of carbohydrates. They produce gases as a byproduct. Some of the gases
are then absorbed through the lining of the colon and get into our blood. From there, the gases make it to
our lungs and are exhaled in our breath. Thus, by measuring the levels and types of gas in our breath, we can
get an idea of what and how much bacteria are in our guts.
Breath tests aren’t just used to diagnose SIBO. They can also be used to diagnose H. pylori, lactose in-
tolerance, and fructose intolerance among others. However, it is important to note that the breath tests are
slightly different for each of these conditions. For example, the bacteria H. pylori produces carbon dioxide,
so this is the gas that labs will be looking for in the breath test samples.59
To diagnose SIBO with breath tests, labs need to look for elevated levels of hydrogen and/or methane. Note
that there is a difference between Hydrogen SIBO and Methane SIBO, which we will address in the next chapter.
How SIBO Breath Tests Are Performed

SIBO tests must be ordered by a doctor. You can take SIBO breath tests at home or you can perform them at the
lab. You will be required to fast for at least 12 hours before the test is taken. That means no food, but prescrip-
tion meds and water are okay. You may also need to stop taking certain supplements and antibiotics for two
weeks prior to the test. You will also have to follow a special diet for 24 hours before the test. The diet basically
removes any fermentable foods so you don’t have gas in your GI tract prior to the test and get a false positive.
To take the test, you first breathe into a little tube (see picture) to measure your base hydrogen and meth-
ane levels. Then you immediately drink a special lactulose or glucose solution. You breathe into the tubes

again every 20 minutes. To do it, you just breathe into them through a cocktail straw for a few seconds (as
directed). You will see the condensation form. Then put the lid on and restart your timer. The test measures
how the levels of hydrogen and methane change. A positive SIBO breath test is defined as one where there
are peaks of hydrogen and/or methane after taking the sugar solution.11
These are the tubes I had to breath in every 20 minutes for the SIBO breath test
You Must Test for Both Hydrogen and Methane

If your doctor tells you to get a test for just hydrogen, you should insist on testing for methane (and also
consider switching specialists!). The bacteria in your gut feed off of carbohydrates and produce hydrogen as
a byproduct. However, 8–27% of people do not have detectable levels of hydrogen production in their guts
from bacteria. Instead, they produce methane. This is because our guts also contain archaea, which are sim-
ilar to bacteria but in a different kingdom of organisms. Archaea feed off of hydrogen and produce methane
gas as a byproduct. So, a bacterial overgrowth could cause increases in hydrogen, methane, or both. We will
get into this more in the next chapter which addresses the difference between Hydrogen and Methane SIBO.
Further, certain types of bacteria in the gut produce methane instead of hydrogen. Some of these include:
Staphylococcus aureus, Streptococcus viridans, Enterococci, Serratia and Pseudomonas species. If you were
to test just for hydrogen, you could miss overgrowths of these bacteria and get a false negative.54

Lactulose vs. Glucose SIBO Breath Tests
Both lactulose and glucose are types of sugars. Not sugar as in the white stuff you buy in supermarkets, but
sugar as in the substance that our bodies break carbohydrates down into. Bacteria digest the sugars and
produce gas as a byproduct, which can be measured in a breath test. The difference between the two tests
is that Glucose is only absorbed in the first three feet of the small intestine (remember, the small intestine
is about 20 feet long!). The glucose test cannot diagnose SIBO in the last 17 feet of the small intestine.
SIBO is thought to be more common in the end parts of the small intestine, so the lactulose test is
generally going to be more accurate for diagnosing SIBO.60
There are also other breath tests available, such as one using the sugar xylose, but these aren’t as reliable
and may give a false negative.
3-Hour Lactulose Test is the Gold Standard

The 3-Hour Lactulose breath test is considered the Gold Standard for diagnosing SIBO. You may see some
laboratories offering shorter tests, such as 60 minutes. These tests are NOT as reliable! It takes time for hy-
drogen and methane to travel through the gastrointestinal tract, into the blood, and out the lungs into our
breath. For this reason, don’t waste your time and money on any test but a 3-hour test.56
I recommend both Quintron Labs and Commonwealth Labs for SIBO breath testing. They both offer the
3-Hour Lactulose test. The test must be requested by a doctor. ■

8
Methane vs. Hydrogen SIBO
Ke y Points a bout the Two Ty pes of S I BO
•• SIBO can be methane-producing, hydrogen-producing, or both

•• Bacteria produces hydrogen
•• Archaea produces methane
•• Hydrogen SIBO usually causes diarrhea
•• Methane SIBO usually causes constipation
•• Breath tests for SIBO will measure levels of methane and hydrogen
When you take a breath test for SIBO, first your baseline hydrogen and methane levels are tested. Then
you will take a sugary substance (lactulose) and have your levels tested again.
If your hydrogen levels are high, then you may have Hydrogen-dominant SIBO. If your methane levels are
high, then you may have Methane-dominant SIBO. A diagnosis of Hydrogen SIBO or Methane SIBO doesn’t
mean you only have that type of gas present. You can have both types of gases, just one is more dominant
than the other.
*Note I say “may have SIBO” because high breath test levels can indicate other problems as well, not just SIBO.
What’s the Difference between Hydrogen and Methane SIBO?

In a healthy gut, food is broken down and absorbed into the blood through the small intestinal wall. With
SIBO, there is too much bacteria in your small intestines, and/or the wrong type of bacteria. Bacteria causes
unabsorbed carbohydrates in food to ferment before they can break down. The process of fermentation
creates hydrogen gas as a byproduct. So, if you have too much bacteria in your small intestines, then you will
have high levels of hydrogen—hence the hydrogen breath test for SIBO.
But things aren’t that simple. Your small intestines can also contain archaea. Archaea feed off of hydro-
gen. They produce methane as a byproduct. This helps reduce the levels of hydrogen in the body. This is why
you can have a negative hydrogen test and still have SIBO.61

What are Archaea?
Archaea are single celled organisms which lack a nucleus. They are actually pretty cool in that they’ve been
found in virtually all places where anaerobic degradation of organic compounds occurs. They’ve even been
found in the extreme heat of ocean floor vents! Up until recently, archaea were considered a bacteria. How-
ever, they are a completely different kingdom than bacteria.62
When you eat fiber, the bacteria in your gut start to ferment it. The fermentation produces hydrogen.
What do archaea feed off of? Hydrogen! When the archaea consume the hydrogen, they produce methane
as a byproduct. In this sense, archaea help reduce the amount of hydrogen gas in our colon—but the meth-
ane can have its own negative effects.
A compound which creates methane in the body is called a methanogen. The process of forming meth-
ane is called methanogenesis. Some animals rely on methogen-forming archaea. One example is cows
which produce a huge amount of methane because of all the bacteria in their stomach which ferment grass.
The archaea love the hydrogen from all the fermentation going on. They proliferate and produce methane,
which comes out as flatulence. Methane is actually very flammable—don’t get any ideas :)
This is a very simplified description of methane production in our bodies, and there are many more path-
ways involved with methane metabolism. However, for the sake of understanding SIBO, this should be enough.
Interestingly, we don’t start producing methane until we are about 3 years old. And not everyone produc-
es methane. Depending on which study you go by, about 33% to 72% of adults produce methane.62
Bacteria
Overgrowth
→ Hydrogen
Gas
→ Archaea → Methane
Gas
Problems Caused By Methane

For a long time, people thought that methane was a completely harmless substance in the body—other
than causing flatulence and a bit of bloating. However, research is starting to show that high levels of meth-
ane may be linked to certain health issues. The main problem caused by methane is constipation (though
constipation can be caused by numerous other things).
Because methanogens cause a higher production and absorption of short-chain fatty acids, they
are also linked to obesity.63
Hear that? Methane is linked to obesity. In one study, mice were given a methane-producing archaea and
it caused an increase in body fat. In human studies, it was shown that subjects with higher methane levels
in their breath tests had higher BMIs.64
When it comes to methane and digestive disorders like SIBO, there still isn’t much research. However,
evidence shows a strong link between methane-producing archaea and SIBO.
As Chris Kresser points out, methane-producing archaea is present in 45% of people with SIBO.
Not only that, but the amount of methane produced by people with SIBO is higher.65

Is it the archaea themselves which are the cause of the problem? Or are the archaea thriving because they
have so much hydrogen to consume because of a bacterial overgrowth? We still need further research to an-
swer these questions, but the answer is probably that both too much bacteria and archaea cause problems.
That is why experts like Chris Kresser recommend taking steps to eliminate both bacteria and archaea from
the small intestine for treating SIBO.
How This Affects Treatment of SIBO

As a patient, you probably don’t need to know about all the scientific differences between archaea and bac-
teria and how they produce hydrogen and methane. However, it is good to know why your doctor is testing
for hydrogen and methane (if your doctor orders only a hydrogen test, insist on getting a methane test too!
If the archaea is eating up all the hydrogen, you will have a false negative with the hydrogen test!!!). It is also
important to understand that each type of SIBO can have different symptoms.
Here is a picture of my first SIBO breath test. You can see that methane levels are high, not hydro-
gen—which is a good example of why it is so important to test for both hydrogen and methane!

Methane is strongly linked to constipation. So, the following is usually true of the symptoms of SIBO:
•• Constipation = methane SIBO
•• Diarrhea = hydrogen SIBO
Because of these symptoms, you will often hear the terms SIBO-C (for constipation) and SIBO-D (for diarrhea).
This chart which was published in the journal Nature62 shows the prevalence of constipation and diarrhea
in patients with high levels of hydrogen, methane, and both. H2 = hydrogen. CH4 = Methane.
You also need to know that the treatment for SIBO is different depending on whether it is methane
or hydrogen producing. Most of the archaea which produce methane are somewhat resistant to the antibi-
otics used to treat SIBO. So, if your problems are caused by archaea overgrowth, then taking those antibiot-
ics aren’t likely going to cure your SIBO, even if you take multiple rounds. Methane SIBO is definitely the most
difficult to treat because of archaea’s resistance to antibiotics.
Actually, antibiotics alone aren’t likely to cure any type of SIBO. Sure, if you take enough rounds of antibi-
otics, you will kill off the bacteria. But antibiotics don’t fix the root problem which allowed bacteria to pro-
liferate in the first place, so the SIBO is just likely to come back (hence the high recurrence rate for SIBO). To
beat SIBO for good, you need to take comprehensive steps including antibiotics, diet, and lifestyle changes. ■

9
Treating SIBO
Here is where we are going to get into the steps you need to take to beat SIBO
for good. You’ll note that I constantly say “for good” when talking about
beating SIBO. That is because SIBO has an incredibly high recurrence rate. I want
to emphasize the fact that it probably won’t be enough to just gulp down some
antibiotics to kill off the bacteria overgrowth. You’ve got to treat the root
problems which allowed overgrowth to happen in the first place.
Treating SIBO has been a very frustrating but educational process for me. Here is what I did:
•• Round 1: Antibiotics for •• Round 2: Vivonex Elemental •• Round 3: Homemade

two weeks—didn’t get rid of Diet for 17.5 days followed by Elemental Diet for 14 days
the overgrowth, might have prokinetics—didn’t get rid of + Herbal Antibiotics followed
made it worse! overgrowth but made great by prokinetics—negative
progress. SIBO results!

The good news is you likely won’t have to go through all of this to cure your SIBO and you can learn from
my experiences with each of the treatments. I had a pretty severe case of methane-dominant SIBO, which
is the hardest to treat. The initial course of antibiotics didn’t come close to getting rid of the SIBO. I was later
told that I probably would have likely had to take 4 courses of antibiotics (8 weeks) to beat it and even then
they may not have worked, not to mention my body probably wouldn’t have been very happy about that.
Since antibiotics are ironically also one of the causes of SIBO, and they can have side effects, I didn’t want to
rely on them again. I decided to go hardcore and tackle it with Elemental Diet, which is the most aggressive
treatment option out there. It’s the fastest but also the most difficult, no doubt. You can imagine my frustra-
tion when even 17.5 days of this didn’t completely get rid of the SIBO.
On round 3, I went even more hardcore and attacked SIBO with everything I had: herbal antibiotics,
a prokinetic to keep things moving along through the GI tract, and the Elemental Diet. After treatment, I kept
taking the prokinetic and did my best to follow the SIBO Diet (though I admittedly slipped up a bit). This is
what finally did the trick although I know the first round of elemental also helped set this up for success. I got
a negative breath test result which diagnosed me as SIBO free.
Right now, and for the next several months I will be focusing on making sure SIBO doesn’t ever come
back (since recurrence rates are high). That means taking prokinetics, following the SIBO diet, and getting
stress out of my life. So far, so good! Since my SIBO journey will be an ongoing process, and I know many of
you would like to hear about any updates or new recommendations that might come up after finalizing this
ebook, feel free to bookmark the resource page where I’ll be sure to link any new articles, resources, or up-
dates from me in months and years to come until I’m able to release an updated edition of the ebook: SIBO
resource page www.hollywoodhomestead.com/sibo-ebook-resources
If I had to do it again? I would have done a homemade elemental for three weeks. During the first two
weeks of elemental, I would have taken herbal antibiotics. During and after the treatment, I would have tak-
en a prokinetic to keep things moving along. That would have been the fastest, cheapest, and least grueling
way to get rid of the overgrowth.
Though treating SIBO has been frustrating, it has also been educational. In the upcoming chapters, I will share
with you what I’ve learned so you can take treatment into your own hands and finally beat this disease for good. ■

10
Antibiotics for SIBO
SIBO is caused by an overgrowth of bacteria in your small intestine, so it
would make sense to treat it with antibiotics—right? While antibiotics may be
an integral part of the SIBO treatment process, antibiotics alone rarely cure
SIBO in the long term. Here we will talk about which antibiotics can be used for
treating SIBO and why you shouldn’t rely solely on them to overcome SIBO.
What Antibiotics Are Used for Treating SIBO?

There are two antibiotics which are mainly used for treating SIBO: Rifaximin (generic: Xifaxan) and Neomycin
(added in addition to Rifaximin in the case of methane-dominant SIBO). The reason these are chosen is be-
cause they are non-systemic, meaning they mostly don’t get absorbed into the bloodstream and instead stay
in the intestines, allowing them to kill bacteria residing in the intestines and not elsewhere. Less frequently,
the systemic antibiotic (meaning it does get into your blood and circulate through your body) Metronidazole
is prescribed.66 Generally, doctors will prescribe these antibiotics for 10 to 14 day courses.67 These antibiotics
are expensive (about $1000 for a 14 day course of Rifaximin in the US) and often not covered by insurance.
At siboinfo.com, Dr. Siebecker (a leading expert on SIBO) gives these as some examples of SIBO dosage
options. Keep in mind that there aren’t any established protocols for SIBO antibiotic dosages, so your doctor
may prescribe something different:66
•• Rifaximin 1600mg daily × 10 days
•• Rifaximin 1200mg daily × 14 days
•• Rifaximin 1600mg daily + Neomycin 1000mg daily × 10 days
•• Rifaximin 1600mg daily + Metronidazole 750mg daily × 10 days
Oftentimes, a single round with one of these antibiotics doesn’t cure SIBO, especially in severe cas-
es.1 When the first course doesn’t work, doctors will often prescribe another antibiotic or add another anti-
biotic to the treatment for another course. For me, one 14 day course of Rifaximin + Neomycin didn’t even
come close to eradicating SIBO. Although I didn’t retest immediately after so I can’t tell you how much prog-
ress it did make or how fast recurrence was, I can tell you my symptoms were not relieved and over the
following months continued to get worse. I later learned that based on my severe case it likely would have
taken at least FOUR rounds! If I’d known that, I wouldn’t even have done the first round, saving me time,
money (not only on treatment but testing and doctors visits) and the anguish associated with all of that.

But Don’t Antibiotics Cause SIBO?
It is ironic that antibiotics are used to treat SIBO, because antibiotics are also one of the main causes of SIBO.
Antibiotics can’t tell the difference between the “healthy” bacteria in your body and the “harmful” bacte-
ria. They also can’t determine healthy levels of bacteria (remember, SIBO can sometimes be caused by too
much of the healthy bacteria which should be in your gut!). When you take an antibiotic, whether for SIBO or
another condition, it will indiscriminately kill off all bacteria—including the good guys.
The good bacteria in our guts have many roles, including keeping the “bad guys” in check. Without enough
good guys, the bad guys can quickly get out of control. So, those antibiotics for SIBO might temporarily get
rid of the harmful bacteria, but it will probably just come back since you also killed off the good guys too!
Hence why SIBO has such a high recurrence rate.
The (In)Effectiveness of Antibiotics for Treating SIBO

Depending on which reports you go by, antibiotics are 40% to 91% effective in treating SIBO.66, 67
However, if we look at the long-term effectiveness of antibiotics for treating SIBO, the results are poor.
Studies show that recurrence occurs in almost HALF of all patients within one year!1
Considering that antibiotics kill off the healthy bacteria in your gut, the high recurrence rate of SIBO after
antibiotic treatment shouldn’t be surprising. More importantly, antibiotics do not address the underlying
conditions which caused bacteria overgrowth in the first place. This is why it is so important to take
a comprehensive approach to SIBO treatment which includes taking a prokinetic (which we talk about later
in chapter 13), and making changes to your diet and lifestyle. You can’t just expect that a hardcore round
of antibiotics is going to solve your problems! There is no magic pill for SIBO and that includes antibiotics.
*You must wait 14 days after finishing a round of antibiotics (even herbal antibiotics) before
retesting. This is critical for the accuracy of test! However, don’t wait more than 16 days to
retest; you want to retest before regrowth of bacteria (recurrence) has time to occur.
Remember: these antibiotics require a prescription and I’m not a doctor. In the US, these antibiotics are
often costly, even with insurance. Since I’m uninsured I bought them (legally) from an online pharmacy in
Canada for 1�10th the cost. Going that route will still require you to have a prescription and might require some
patience on the shipping front.

11
Herbal Antibiotics for SIBO
There is no denying that antibiotics are one of the most beneficial medical
innovations of modern history. They have helped eradicate many communicable
diseases and saved countless lives. But antibiotics have also brought with
them a number of unforeseen problems and health risks.
Before we go any further, I want to say that I’m not anti doctor nor anti traditional medicine, but each
has its time and a place. Antibiotics are often over prescribed and shouldn’t be our default first choice for
treating everything. For numerous reasons, many people are turning to herbal antibiotics for treating SIBO.
What is an Antibiotic?
According to MedicineNet.com, an antibiotic is:
A drug used to treat bacterial infections. Originally, an antibiotic was
a substance produced by one microorganism that selectively inhibits
the growth of another. Synthetic antibiotics, usually chemically related
to natural antibiotics, have since been produced that accomplish com-
parable tasks.
As humans, we have been using natural antibiotics for centuries,
even before we knew what bacteria was. For example, garlic has been
used since at least 2600BC for its healing properties. Today, we now
know that garlic has natural antibacterial properties.
Why Choose Herbal Antibiotics for Treating SIBO?

There are already several pharmaceutical antibiotics which are commonly prescribed for SIBO. So why
would you choose herbal antibiotics over these? There are three main reasons:
I Antibiotic resistance
II Fewer potential side effects
III Herbal antibiotics may be more effective

1. Herbs Don’t Cause Antibiotic Resistance
In 1929, Alexander Fleming discovered penicillin and changed modern medicine completely. Doctors were
convinced that antibiotics would cure all bacterial diseases. In 1963, the Australian physician and Nobel
Prize winner Sir Macfarlane Burnet even said that by the end of the 20th century humanity would see the
“virtual elimination of infectious disease as a significant factor in societal life.” In 1970, the Surgeon General
William Stewart said that antibiotics would soon “close the book on infectious diseases.” They couldn’t
have been more wrong!
What they didn’t realize was that bacteria are capable of adapting to antibiotics and becoming resistant
to them. This is a VERY serious problem, and one which shouldn’t be taken lightly. Thanks to antibiotic resis-
tance, diseases which were once treatable—such as tuberculosis—are now often fatal. We may soon see the
re-emergence of diseases like typhoid, diphtheria, and many others.68
Keep in mind that antibiotics are not always effective in treating SIBO. Even when the first round of an-
tibiotics works, the SIBO often comes back after just a short time. As researchers point out in an article in
Gastroenterology,69 SIBO patients often require multiple rounds or continuous courses of antibiotic therapy.
To prevent resistance, they recommend rotating antibiotic regimens to prevent resistance.
Herbal antibiotics work on multiple levels in the body, so resistance is less likely to occur. Further, by us-
ing herbal remedies instead of turning to pharmaceuticals every time you get sick, you slow the spread of
antibiotic resistance.70, 71
2. Fewer Side effects with Herbal Antibiotics for SIBO

There are three main drugs which are used for treating SIBO: Rifaximin, Neomycin, and Metronidazole. Each of
these has some pretty nasty potential side effects. I’ve listed some of them below—but bear in mind that these
are just some of the potential side effects.
Drug Common Side Effect Less Common Side Effect
Bloating, Gas, Stomach pain, Nausea, Constipation, Muscle spasms, Fainting,

Rifaximin
Headache, Dizziness, Feeling tired, Trouble sleeping Ulcers in the mouth, Chest pain
Irritation in mouth or rectal area, Dizziness, Low of hearing,

Neomycin
Nausea and Vomiting Ringing sound in ears, Skin rash
Feeling agitated, Back pain, Confusion, Vomiting, Blood in stools, Body aches and pains, Severe stomach
Metronidazole
Weakness and Unsteadiness, Depression pain, Nasal congestion, Couching, Bleeding gums
As if dealing with SIBO symptoms isn’t bad enough, you’ve also got to worry about antibiotic side effects!
With herbal antibiotics, there is still a risk of side effects. However, the side effects generally aren’t going
to be as severe as with prescription antibiotics.70
One point worth mentioning is that even herbal antibiotics can kill off good bacteria. So, even you
use herbal antibiotics instead of prescription ones, you still must make diet and lifestyle changes to help
restore gut symbiosis.

3. Herbal Antibiotics Are Effective
Need another reason to choose herbal antibiotics for SIBO? How about the fact that they may be more effec-
tive in treating SIBO than prescription antibiotics!
Now, bear in mind that there have been really few studies on pharmaceutical antibiotics for SIBO. There
have been even fewer for herbal antibiotics for SIBO. In fact, there are only two (yes, TWO!) studies to date
which look at how herbal antibiotics can treat SIBO. And one of these studies was on just one person! 72
However, the lack of research doesn’t mean that herbal antibiotics aren’t a good solution. In the larger
study, which was published in the journal Global Advances in Health and Medicine73 , the results are pretty
impressive. They took 104 people who had been diagnosed with SIBO through lactulose breath testing. Of
these, 37 of the patients were treated with herbal antibiotics and the remaining were given Rifaximin.
The results? 46% of the patients who took herbal antibiotics had a negative breath test upon fol-
low-up, compared to just 34% of the Rifaximin users. The researchers concluded that herbal thera-
pies are “at least as effective as Rifaximin for resolution of SIBO.”
Doctor Siebecker, who is a leading expert on treating SIBO, says that she and her associates have reg-
ularly used herbal antibiotics for SIBO since 2011 and “have consistently found them to be as effective as
pharmaceutical antibiotics in relieving symptoms and reducing gas levels on breath testing.”72
What Makes Herbal Antibiotics So Effective?

Why would a natural substance be more effective than the prescription drugs which scientists worked for
years to develop? The book Herbal Antibiotics by Stephan Harrod Buhner describes it well (find the book
on our resource page at www.hollywoodhomestead.com/sibo-ebook-resources). He talks about how phar-
maceutical antibiotics are isolated chemicals—meaning they are one chemical. Because they are only one
thing, it is easier for bacteria to adapt to them and develop a resistance.
By contrast, herbs are made up of many compounds. For example, garlic (which is one of the best known
natural antibiotics) contains dozens of compounds. All of these compounds work together and can attack
bacteria on multiple levels. It is much harder for bacteria to adapt to herbal antibiotics because of how com-
plex the herbs’ structures are.70
Even the individual compounds in herbs can work in complex ways. Allicin, which is one of the main anti-
bacterial compounds found in garlic, is a particularly good example of the complexity of herbal antibiotics.
Interestingly, allicin isn’t present in undamaged garlic. But, when the garlic becomes damaged, a chemical
reaction occurs and allicin is produced to protect the plant from disease and other damage (that is why
garlic becomes pungent once you cut it open). Once in the body, allicin undergoes a redox-reaction with
proteins, which is thought to be the source of its biological activity.74
*Allicin does not contain the FODMAPs part of garlic (which means it won’t ferment), so it is
okay to take for SIBO.

Here is some food for thought. Animals can
move, and this allows them to come up with evolu-
tionary survival mechanisms like being able to run
fast or have sharp claws to fight predators. Plants
don’t have the ability to move, so they’ve had to
come up with other ways of protecting themselves.
They’ve evolved chemical structures to protect
themselves—like how poison ivy will make you itch
or kale tastes bitter so animals won’t want to eat it.
These mechanisms have been perfected in millions
of years of evolution (definitely longer than we’ve
been creating chemicals in labs!).
With a bit of research, we could utilize these natural plant compounds for our own benefit. Consider the
fact that about 40% of all prescription medicines are plant-derived. About 25% of these come from the rain-
forest, and we’ve only tested fewer than 1% of all the tropical trees and plants in the rainforest!74, 75
The bottom line? Plants are pretty amazing and their healing powers shouldn’t be underestimated.
Which Herbal Antibiotics Treat SIBO?

Unfortunately, there hasn’t been much research into herbal antibiotics, and even less research about herbal
antibiotics specifically for treating SIBO (it seems that drug companies would rather fund research for expen-
sive chemical pharmaceuticals than cheap, natural remedies!).
Here is the herbal antibiotic regimen I used for treating SIBO:
•• Allimed (Allicin) 450mg: Allicin is a component of garlic. Take 1–2 caps 3× per day for a total of 14 days
(start with 1 cap 3× per day and on day 3 increase to 2 caps 3× per day). It is important that you take 450mg!
Find out where to buy it on our resource page here: www.hollywoodhomestead.com/sibo-ebook-resources.
You will need 2 bottles for a 14 day course.
•• Berberine Complex: Berberine is a compound found in Oregon grape, barberry, goldenseal, and other
herbs. Take 2–3 caps 3× per day for a total of 14 days (start with 2 caps 3× per day and on day 3 increase
to 3 caps 3× per day; can cause headaches). Find out where to buy it on our resource page here: www.
hollywoodhomestead.com/sibo-ebook-resources. You will need to buy 2 bottles for a 14 day course.
•• Neem Plus: Neem is a tropical evergreen tree. Take 1 cap 3× per day for a total of 14 days. Find out
where to buy it on our resource page here: www.hollywoodhomestead.com/sibo-ebook-resources.
You will need 1 bottle for a 14 day course.
I took all 3 of these herbal antibiotics for a 14 day course. Many people take herbal antibiotics for SIBO
even longer though—such as 1 month courses. I took these herbal antibiotics while I was doing the elemental
diet. You don’t have to do elemental though. In fact, many people do either/or.

There are two schools of thought about using antibiotics or herbal antibiotics while on the
elemental diet (which starves the bacteria). Some doctors say you need to feed the bacteria
while taking antibiotics so they’re active while you kill them instead of lying dormant
while they’re dying off on elemental. I can tell you that doing both elemental and herbal
simultaneously worked for me.
I also took:
•• Interfase Plus (Klaire Labs): This is a biofilm disruptor. It is unclear how much it actually helps, but it
certainly doesn’t hurt and I was at the “let’s toss the kitchen sink at this” approach. Take 2 caps 3× per
day. If doing elemental, take away from the elemental formula as much as possible. Find out where to
buy it on our resource page here: www.hollywoodhomestead.com/sibo-ebook-resources. You will need
1 bottle for a 14 day course.
•• MotilPro (Pure Encapsulations): This one is for the long term. It’s a prokinetic. It’s mostly ginger and does
cause a bit of burning so some dislike it but I’ve found it effective. Take with lots of water to minimize that
burning sensation in the esophagus. Take 3 caps before bed and 3 caps 1–2 times a day between meals.
Find out where to buy it on our resource page here: www.hollywoodhomestead.com/sibo-ebook-resources.
Go ahead and buy 2 bottles, 1 for the herbal antibiotics course and another bottle for post-treatment.
*While I totally understand why someone would choose herbal antibiotics over prescription antibiotics, it
is important to note that herbal antibiotics courses are often much longer. It is like using a handgun instead
of a grenade :)
Important Notes about Herbal Antibiotics for SIBO

Whether you are taking herbal or pharmaceutical antibiotics for SIBO, you must wait 14 days after finishing
a round before retesting. This is critical for the accuracy of test! However, don’t wait more than 16 days to
retest; you want to retest before regrowth of bacteria (recurrence) has time to occur.
After finishing with herbal or pharmaceutical antibiotics, you will need to take a prokinetic agent (I took
MotilPro during the herbal antibiotics course and added 2 more prokinetics post-treatment). You can start
with the prokinetic immediately after antibiotics, even before you’ve retested. Read more about prokinetics
in chapter 13 about Motility.
Remember, herbal antibiotics may be a better alternative to pharmaceutical antibiotics—but even
these aren’t the sole solution to treating SIBO. To get rid of SIBO and keep it away, you’ve got to treat the
underlying issues which caused the bacterial overgrowth in the first place. That means making changes to
your diet and life. ■

12
Elemental Diet
After having limited success with traditional antibiotics, I decided to take the
treatment to a whole ‘nother level. One important step that I did to treat my
severe case of SIBO was do an elemental diet.
What is an Elemental Diet?

An elemental diet, also often called a bowel reset diet, isn’t actually a diet in the traditional sense at all. It
is a short-term protocol in which you eat nothing. The goal of elemental is to starve off the bacteria in your
small intestine. To prevent your body from starving, you take a special liquid formula (formulated for tube
feeding patients) which contains predigested nutrients. The nutrients are easily assimilated into the body so
bacteria can’t feed off of them and proliferate. Elemental diets are also often used to treat Crohn’s Disease,
a condition in which the gastrointestinal tract is severely inflamed. By taking the liquid Elemental Diet in-
stead of eating, the gut is able to start healing.
How Does an Elemental Diet Treat SIBO?

Remember that bacteria are living things. Like all living things, bacteria have to eat something. The bacteria
in our small intestines primarily live off of certain carbohydrates that we eat. When you eat these fermentable
sugars, you aren’t just feeding yourself but the bacteria too!
This doesn’t mean you shouldn’t ever eat carbs. Remember, it is normal and healthy to have some level of
bacteria in our guts. The problem occurs when you’ve got too many of certain carbs in your gut. The bacteria
have a smorgasbord and start to proliferate out of control. This leads to SIBO, which in turn can lead to other
serious problems like leaky gut. Bear in mind that some carbs are a lot worse than others, and there are a lot
of reasons why you might have excess carbs in your small intestine.
When you are on an Elemental Diet, you eat nothing. Instead, you take a liquid formula which contains
predigested nutrients so they are absorbed into your bloodstream quickly and the bacteria can’t use them
for food. So, the bacteria have nothing to feed off of and die off.

Does it Work?
An elemental diet is no doubt a hardcore way to deal with SIBO—but it is an effective one. In one study,
93 subjects with IBS and SIBO (diagnosed with a high lactulose breath test) were put on an elemental diet.
After 15 days, 80% of them had negative breath tests.76 According to RD Kelsey Marksteiner, elemental diet
has a cure rate of 80–85% for SIBO.77 Compare this to the cure rate of antibiotics for SIBO (which is as low as
40%), and the elemental diet is definitely worth considering, especially in severe cases.
Because your gut is able to rest and heal itself while on the elemental diet, it might help cure some of
the underlying causes of SIBO and thus reduce recurrence rate. However, there aren’t any studies (that I am
aware of at least) which show what the SIBO recurrence rate is for elemental vs. other forms of treatment.
Pros and Cons of the Elemental Diet

The main pro of an elemental diet for treating SIBO is that it is a fast and effective treatment which doesn’t
require a prescription. However, this effectiveness doesn’t come without drawbacks. The main one is that
doing an elemental diet is NOT at all a pleasant experience! You can’t have any solid food and those pow-
ered elemental formulas aren’t exactly the best tasting thing. Elemental diets usually should last around 2 or
3 weeks to be effective, so you’ve got to be able to tough it out that long.
Another drawback of the elemental diet is that it can be pricey. Readymade store bought elemental for-
mulas for SIBO cost about $1000 for 2 weeks. You can save money by making your own elemental formulas.
However, even homemade elemental formulas are still going to be a bit pricy because you’ve got to pur-
chase all of the nutrients individually. Expect to pay about $300–$400 for 2 weeks.
Should You Do Elemental?

Even though the elemental diet has a higher cure rate than traditional antibiotics, it is understandable that
most people wouldn’t want to turn to it as a first-choice treatment option. Doing elemental is not at all
a pleasant experience, and you will have to make some serious lifestyle changes while doing it.
I would recommend doing elemental for SIBO under these circumstances:
•• Your SIBO case is severe (methane and/or •• Losing a few pounds would not be detrimental
hydrogen numbers over 80 at any point in the to your health (i.e. if you’re already underweight,
3 hour test) you may want to rethink it)
•• You’ve tried traditional or herbal antibiotics for •• You have SIBO along with another gut disease
SIBO but haven’t had much success where severe inflammation is in place, such as
Crohn’s or IBS
•• You are ready for the extreme measure of going
without food (you’ve got to do it 2–3 weeks for it •• You’re so very over it and ready to just be done
to be effective) with SIBO once and for all

Elemental Diet Options
You’ve got two options when it comes to the elemental diet for SIBO: you can buy a readymade formula (Vi-
vonex Plus) or do a homemade formula. I did both of these options (Vivonex the first round, and homemade
the second). Overall, I like homemade better. It was easier to mix up than I anticipated and I just mixed it
once a day and portioned out 3 jars in the fridge.
Let’s talk about each of the elemental diet options so you can decide if either is right for you.
Vivonex Plus:
It is definitely pricey at about $1000 for two weeks, but it’s the easiest. You just add water and take it. This
formula has also actually been studied and proven effective. Find out where to buy Vivonex on our resource
page here: www.hollywoodhomestead.com/sibo-ebook-resources. You will need to buy enough for about
6 packets per day. A drawback with the Vivonex Plus option is that it does contain some not-ideal ingredients
(mainly corn derived) which are actually contraindicated in SIBO (yes, this means it could still feed the bacteria
a tiny bit, slowing down the die-off). It is high carbohydrate /low fat, so this also won’t be ideal for everyone.78
Another point worth mentioning about Vivonex is that it tastes horrible. The smell alone is enough to
make you gag. It’s meant to be a tube feeding formula so I guess they never took smell and flavor into
account when formulating it. I could not get past 2–3 sips of it without gagging. The only way I could get it
down was by adding Crystal Light. Yes, I know the ingredients in Crystal Light are terrible (soy, dyes, artifi-
cial sweeteners, etc.), but it was the best solution I found
and recommended by my doctor, and I had to prioritize
starving the bacteria for this short treatment time. That
said, because I added the Crystal Light most of the time
I couldn’t tell if a headache or other symptom was a die off
reaction or just a reaction to the daily dosing of soy and ar-
tificial dyes which my body isn’t used to. I decided it didn’t
matter and plowed ahead for 17.5 days.
Homemade Elemental Formula:
If you want to save money, gag a little less and consume

ingredients that are slightly closer to real food, this is the
way to go. Expect to pay about $300–$400 for 2 weeks.
The ingredients are a lot cleaner since you’re able to
choose each one individually. Another plus of going with
the homemade route is that you will be able to adjust the
amount of carbs and fats a bit to your needs. Bear in mind
that you will have to buy each ingredient separately and
mix them together each day. The oil doesn’t mix well so
I ended up sipping this separately, which isn’t exactly tasty.

Recipes for Homemade Elemental Formula
These recipes come from Dr. Siebecker (reprinted with her permission). There are two options: high fat/
low carb and low fat/high carb. I did the high fat option. Make sure to use quality ingredients because this is
what you are going to be living off of for the next 2 weeks. You can find out where to buy the ingredients on
our resource page here: www.hollywoodhomestead.com/sibo-ebook-resources.
Ingredients (for 2 weeks)
•• 2.2 lbs Jo Mar Labs Amino Acids (Original, No-MSM)
•• 10 lbs Dextrose
•• Half gallon high-quality oil: I used a combo of organic coconut and olive oil.
You can also use cod liver oil or macadamia oil. Make sure it is great quality.
•• 1 bottle Pure Encapsulations Nutrient 950 Multivitamin
•• Unrefined Celtic Sea Salt
•• Optional flavorings (such as vanilla) in small amounts per dose
Low Carb/High Fat Option: Low Fat/High Carb Option:

These instructions are per dose/meal. If you These instructions are per dose/meal. If you
are going to mix everything up at the start/ are going to mix everything up at the start/
end of the day, then multiply everything by end of the day, then multiply everything by
3 and divide it into 3 cups to put in the fridge. 3 and divide it into 3 cups to put in the fridge.
•• 2 Tbsp amino acids (24 grams) •• 2 Tbsp + 1 tsp amino acids (28 grams)

•• 3.5–5 Tbsp dextrose •• ⅔ cup dextrose (106g carbs)
(3.5T = 35g carbs, 5T = 50g carbs)
•• 1 tsp oil (4.6g fat)
•• 3–3.5 Tbsp oil
•• 2 capsules of the multivitamin,
(3T = 41g fat, 3.5T = 49g fat)*
emptied out
•• 2 capsules of the multivitamin,
•• ¼ to ½ tsp salt
emptied out
•• ¼ to ½ tsp salt
*If using higher dextrose amount, use lower oil amount, or

use higher oil amount if using lower dextrose amount.
Just mix everything together in a blender with water. You can use as much or little water as you want to get a de-
sired thickness. You can add ice too. Never use juice, milk or any other liquid but water to blend the ingredients!

Alternatively, you can take each of the ingredients individually. However, it is probably better to sip it through-
out the day, even if it doesn’t taste so fabulous. Using small amounts of vanilla extract as flavorings is allowed but
honestly I found it made it taste even worse. I think this is because I found it obnoxiously sweet from the dextrose
and the vanilla seemed to accentuate that. It was nowhere near as terrible tasting as the Vivonex however.
Find out where to buy each of these ingredients on our resource page here: www.hollywoodhomestead.
com/sibo-ebook-resources.
Elemental Diet Dosage

An elemental diet needs to last 2–3 weeks to be effective. With Vivonex Plus, you use 6 packets per day (you
can double them up and take 2 packets, 3 times a day or take the 6 packets separately, as you wish), which
comes out to 1800 calories per day. With the homemade elemental, the dosage is 3× per day, which comes
out to about 2000 calories.
Keep in mind you don’t have to take the formula 3× or 6× per day. You really have a lot of flexibility with how
you take it and can adjust it to your activity and caloric needs. For example, while doing the Vivonex elemental
formula, there were days when I just laid around in bed and rested. I didn’t need a full 1800 calories during those
days, so I took 5 or sometimes even just 4 drinks per day. Consult with your doc to see what is best for you!
Retesting After Elemental Diet

After completing the Elemental Diet, you need to wait at least 4 days before retesting. This gives things time
to settle down—but don’t wait more than 2 weeks or you might not get accurate results. The idea is for the
test to tell you how effective the treatment was, even if some mild re-feeding happens when you start rein-
troducing food again.
On my first round, I retested after 4 days. On my second round, I did it at 2 weeks after because it also co-
incided with the retesting schedule of the herbal antibiotics I took simultaneously with elemental. (Retesting
after antibiotics requires a 2 week waiting period as we discuss in chapter 10 on page 42).
My Personal Experience with the Elemental Diet

Before doing the first round of elemental diet, I was both excited and scared. Excited at the thought that this
would be the quickest way to get results (it was). Scared because I’d heard stories of people not being able
to make it past day 4 because they felt so terrible.
Because my case was so severe, I did Elemental for 17.5 days the first round. I hoped the extra days
would mean I would never have to do this again. Close, but not quite. The results from that breath test
were better, but I still had work to do. So I did another round of Elemental, this time using the homemade
formula and for 13.5 days.
Important! I also took herbal antibiotics and a prokinetic while doing the second round of elemental.
Read about the importance of prokinetics in chapter 13.

How I Felt While on Elemental Diet
Vivonex Plus (Round 1):

I started on a Monday (isn’t that how diets are supposed to roll? ;) and I was armed with my drinks made up
for the following day, plenty of ice in the freezer to pour them over and, aside from loads of movies to watch,
an almost blank to-do list. I also started a diary on Evernote to keep track of how I felt.
I was worried when day 4 rolled around since I had heard that days 4–8 were the worst in regards to
bacterial die-off. But, for me, it was actually days 8–12 that were the worst, probably because my case was
so severe. During those days, I had diarrhea and terrible bloating and cramping. I relied on detox protocols
during this time (especially Epsom salt baths and castor oil packs) to help me through.
Symptoms throughout:
I had headaches which started pretty much on day 1. It might not have been related to SIBO but to the corn
and soy ingredients which I don’t react well to. I also often felt itchy and had lots of phlegm. Again, it could
have been the ingredients. My breath was terrible and there was some moderate body odor, which is unusual
when I’m eating a clean diet. There was some cramping and insane amounts of burping—even in the middle
of the night! The bloating was so bad that I looked like was 6–8 months pregnant depending on the time of
day. It was interesting to see this after 10 days of not eating! Clearly, the party in my gut was starting to get
disrupted. And one more weird side effect: my teeth started to hurt.
My energy levels were okay for the first few days and then I started to feel lethargic. It could have been the
bacterial die-off, but I think inadvertently I wasn’t consuming enough calories because I hated the taste of
the drinks so much that I was limiting them to just enough to keep me alive. If I had to do Vivonex Plus again,
I’d add some high quality oil like olive oil to sip in addition to the drinks since their profile is pretty low fat.
Here is a post from my diary (Day 11):
The brain fog is unreal. My writing looks dyslexic. And I’m not
trying to be funny. Simple math in my head seems impossible.
And finding words is very difficult. It’s like my mom when
she’s trying to speak English except it happens to me in both
languages and at any time of day even after a good night’s
sleep. It’s like the synapses just aren’t happening.
How I Felt After Vivonex:

The truth is I was expecting to feel instantly better the minute
I got off elemental. I mean, that’s as low as my breath test results
would ever be, I wasn’t eating anything for pete’s sake! But, the
truth is, although I felt instantly better just having some real food
(albeit sticking to very simple, bland things like ground beef and
small amounts of cooked SIBO friendly vegetables), the SIBO
symptoms were not immediately completely gone. Both times
my body was a bit shocked and confused to be eating again and
digestion seemed slow. I was also a bit scared to eat which may
seem silly but I’m just trying to be honest.

Results:
Original Test Results
Test Results After Vivonex Elemental for 17.5 days
As you can see my methane numbers (which were previously very high) were zero across the board. This
is great! But what was surprising was that my hydrogen numbers, previously nominal, had increased enough
to still technically be a positive result. I later found out this is actually quite typical. I was on the right track
but more work needed to be done.

Homemade Elemental (Round 2)
The second round of elemental was much easier. This is most likely because I had made a ton of progress on
the first round so there was less die-off and thus fewer symptoms. However, it was still emotionally tough to
feel deprived of food. After that round of elemental was over I noticed that, while again I didn’t have life-chang-
ing nirvana immediately after finishing, I felt better with each day that passed by. I was more energized and
less bloated. It was like the healing was still happening even though I wasn’t doing anything for it anymore.
Sort of like when you step off a treadmill and your heart is still pounding and sweating for quite a bit longer.
The reason I decided to do a second round of elemental, with the thumbs up from my doctor, is that I felt
so close and knew it would take much longer to make progress with something like diet alone. I just wanted to
eliminate so I would only need to focus on prevention which is a much easier, yet just as important undertaking.
Results of second round of Elemental—this time homemade:
SIBO clear! The results on this one was just about zero.
As you can see this time both hydrogen and methane numbers where down to zero/almost zero. Finally
SIBO clear!

On a Personal Note …
The whole experience was a like a flashback to my “dieting” days. Yes, it made me feel deprived at times. An
interesting thing though is that I found Elemental easier than those weight loss diets I used to do. For some
reason, it was easier to swear off all food completely than the superhuman willpower it takes to have “just one”
bite of cake. Gretchen Rubin in her book Better Than Before refers to this type of habit former as The Abstainer.
You can find the book on our resource page here: www.hollywoodhomestead.com/sibo-ebook-resources.
Elemental also had an unexpected benefit for me. As a mother of three kids aged 4 to 16 and a business
owner, I don’t get too much down time and I have to manage a lot of things. This was an opportunity to
ask my husband and older daughter to pick up some of the slack for a couple of weeks so I could focus
on resting. Plus, I hired a housekeeper to help out as well. I didn’t deal with cooking or grocery shopping
(which would have been torture while not eating!), so this freed up a lot of time which I could use to focus
on relaxing and de-stressing. Again, stress is the biggest cause of SIBO! Many of those tasks I didn’t take
back on after my elemental diet was over ;)
My Best Advice for you during your Elemental Diet:
1. Get Support!
Without the help that I had during both rounds of elemental, I guarantee I wouldn’t have made it through
it. And I don’t just mean help around the house, with the kids, or time off work. I also mean emotional sup-
port. The toughest times for me were evenings and weekends, during my family’s meal times. I stayed in my
bedroom, turned on my essential oil diffuser (the peppermint seemed particularly soothing) so I wouldn’t
smell the delicious food and/or I took an Epsom salt bath. Having my husband to talk me off the ledge when
I could have killed someone for a piece of chicken was incredibly helpful. He offered to bring me tea and took
the kids out for dinner a few times so I wouldn’t smell food.
2. Get Time Off Work

Ideally take 2 weeks off and make it your full time
job to get well. If you have limited time off, try to
schedule it to start after day 4 since that’s when it
starts to get difficult, emotionally and also with die-
off symptoms. If necessary, ask your doctor about
disability insurance. This condition is no joke.
3. Clothing
Do yourself a favor and forget jeans or anything
restrictive in the waist. Yoga pants are your friend.
I lived in maxi dresses, yoga pants with long shirts
and pajamas.

4. Go Easy with Food when Coming Off Elemental
Your body will be in a for a big shock when you suddenly start eating again, so take it easy on the food front.
Stick to small portions of well-cooked, simple food for the first few days. It might sound boring but, after not
eating for a couple of weeks, a few bites of ground beef will sound like a holiday feast.
5. Managing Symptoms and Food Cravings
Diffuse peppermint essential oil in the room; it helps with

gas and also helps you not go berserk when you smell
the food your family is eating in the other room. A hot
water bottle on your belly (bonus points for a castor oil
pack) helps reduce nausea and belly pains, as does gin-
ger tea. Use visceral manipulation (just massage your
abdomen, even if you don’t know exactly what you’re
doing) to help things get moving along.
6. The Gross Film on Your Teeth
The elemental diet (especially Vivonex Plus) leaves

this weird gross film on your teeth. Brushing with bak-
ing soda and a couple drops of Orawellness oil blend
was the easiest way to handle this. Also, try oil pull-
ing for the teeth pain. Orawellness is listed on our re-
source page here: www.hollywoodhomestead.com/
sibo-ebook-resources.
7. Make the time pass
During the first round of elemental, I had a pity party for myself and the 17 ½ days seemed like an eternity.
During the second round, I tried to keep busy by writing, working, and organizing my files and photos (all
mostly from my bed) and the time went by a lot quicker.
If you’re in the middle of your elemental diet as you’re reading this, just remember time doesn’t stand still,
although it can sometimes feel that way. You’re making progress every single day, getting closer to the end of
your treatment, and the end of your SIBO journey. Hang in there. Get a countdown timer app on your phone
for when you need the occassional reminder of just how far you’ve come. ■

13
Improving Motility
One of the things I regret most about my first attempt at treating SIBO is not
understanding the importance of motility. Dismotility alone could be the cause
of your SIBO! Simply speaking, motility means how well things are moving along
in the digestive tract. The longer your food sits in the digestive tract, the
longer bacteria will be able to feed off of it, causing overgrowth. Motility is
not as simple as taking a laxative.
The Migrating Motor Complex

The Migrating Motor Complex is a wave-like series of muscle contractions (a sweeping action) which help
move food and waste through the digestive tract. There are actually two different MMC.
The first MMC starts in your stomach and travels through the small intestine.
The second MMC starts duodenum and travels up to the ileocecal valve in the large intestine.
Researchers believe that the MMC acts like a “housekeeping” function. The wave-like movements push
undigested food and waste out of our small intestines. When the small intestines are clear of food and waste,
then bacteria won’t be able to feed off of it. The waves can also clean out excess bacteria too.
During MMC, there are also increases in gastric, biliary, and pancreatic secretions. These secretions prob-
ably also help clean out the small intestine of bacteria buildup.79
To treat SIBO, you’ve got to stimulate the MMC and make sure waste is getting out of the small intestine.
If you have diarrhea, the idea of stimulating your MMC might seem scary—you don’t want more move-
ment happening! But it is important to realize that the MMC doesn’t go past the large intestine. It will not
worsen your diarrhea.80
Though medical researchers have known about the MMC for a long time now, there is a lot we don’t know
about it and many doctors don’t even realize how important it is for gut health and preventing/treating GI
diseases like SIBO. Dr. Siebecker says that the MMC is “a key underlying cause which allows SIBO to happen.”80
It is important to note that the MMC is different than peristalsis. Peristalsis is also a wave-like motion through
the digestive tract, but it is more like a churning and squeezing action. It occurs after you’ve eaten food and
helps move the food through the GI tract. In the small intestine, peristalsis also sloshes food around so the villi
can absorb it. So, we can summarize as peristalsis moves food and MMC makes sure no food waste remains.81

Cycles of the MMC
Peristalsis occurs when you eat food. By contrast, the MMC only starts when you haven’t eaten food for
a while. Again, this has to do with the apparent role of the MMC as a housekeeper to get out all that undigest-
ed food which is why prokinetics before bed are a good idea.
Cycles of the MMC can vary a lot depending on the person. However, research generally shows that the
MMC starts about 1 ½ to 2 hours after not eating. If you are the type of person who “grazes” on food through-
out the day, you could be preventing your MMC from starting! Registered Dietician Tamara Duker Freuman
says that you should lay off snacking if you’ve got SIBO or other GI problems related to motility.82
Once it begins, the MMC is divided into 4 phases:
•• A calm period lasting about 45 to 60 minutes
•• A period of peristaltic contractions which increase in frequency and last for about 30 minutes
•• A period of rapid, evenly-spaced peristaltic contractions lasting about 5 to 15 minutes
•• A short transition period until phase 1 starts again79

One interesting thing to note is that there appears to be a link between MMC cycles and sleep cycles. They
appear in similar frequency, have cyclic patterns, and are disrupted by sensory stimuli (such as food with the
MMC). There are theories that they are linked, which makes one wonder if lack of sleep could be related to
SIBO in this way.83

Testing for MMC Problems
Want to know if your MMC is functioning? There is a test you can take. The test is called IBS Chek and was
formulated by Dr. Pimentel, a leading SIBO specialist and author of A New IBS Solution. The test is described
as a way to diagnose irritable bowel syndrome. However, it is really a test to see whether the MMC is func-
tioning, as an impaired MMC will lead to IBS-like symptoms.
IBS Chek is a quick blood test which looks for the presence of two antibodies: anti-CdtB and anti-vinculin.
The presence of these antibodies is a sign that the MMC isn’t functioning (because of damage to a protein
called vinculin which signals the gut to contract during the MMC). At the time of writing, the test is still very
new and is a big breakthrough for diagnosing gut disorders. You can learn more about the test at their
website www.ibschek.com.
Wait At Least 4–5 Hours Between Meals

Do the math: It takes about 1 ½ to 2 hours for the MMC to begin. Then it takes about 1 hour 45 minutes for
the MMC to go through all its phases. If you eat during this time, then the MMC will stop. To make sure the
MMC is able to do its housekeeping job, you’ve really got to wait at least 3 hours 45 minutes between meals,
without grazing or snacking.
Dr. Pimentel, who is a leading expert on SIBO, originally said in his book A New IBS Solution that you
should wait 3–5 hours between meals. Then he changed his recommendation to 4–5 hours. Everyone’s MMC
seems to be a bit different. To play it safe, I’d wait for at least 5 hours between meals. That means no snacks,
coffee, tea, or anything except water.80
Can’t I Just Take a Laxative?

The problem with laxatives is that they do not trigger the MMC. Some types of laxatives act as stimulants
which do trigger peristalsis, so food is moved throughout the GI tract faster—but it won’t help clean out any
leftover undigested particles which linger about, nor any excess bacteria. Laxatives also don’t trigger gastric,
biliary, or pancreatic secretions like the MMC does to clean out bacteria.
Other types of laxatives are not stimulants, but rather “stool softeners.” They work by drawing water from
the intestines and into stool, so your constipation essentially turns to diarrhea. Aside from dehydrating you,
these laxatives are made from fiber which could be fermentable—which is a major no-no for SIBO!
Of course, if constipation is a big issue for you, the occasional use of glycerine suppositories is absolutely
fine but just know this won’t do a thing for your MMC.

Using Prokinetics to Stimulate the MMC
After you finish SIBO treatment (whether traditional antibiotics, herbal antibiotics or Elemental Diet), you
should immediately start taking a prokinetic agent to stimulate the MMC.
I took a prokinetic while doing Elemental Diet and taking herbal antibiotics. Once I finished with Elemen-
tal and the herbal antibiotics, I added two more prokinetics. This is the combo which really seemed to do
the trick and what ultimately helped me stay clear of SIBO. Check with your doctor to see which combo
might be best in your case. These are not the only options.
•• MotilPro: Take 3 caps before bed and 3 caps 1–2 times a day between meals. (For long term use,
3 before bed may be enough).
•• Iberogast: Take 20 drops before bed or with meals.
•• Erithromycin—50mg: This is actually an antibiotic but a really low dose is shown to be highly effective
as a prokinetic to stimulate the MMC. You’ll need a prescription for it. It comes in 250 mg dose and I cut
in 4 so end up with like 67 mg or so which is fine. Take before bed.
Find out where to buy MotilPro and Iberogast on our resource page here www.hollywoodhomestead.
com/sibo-ebook-resources ■

14
Diet Protocols for Treating
SIBO
As we talked about in the previous chapters, antibiotics alone are terribly
ineffective at treating SIBO. Patients often require multiple rounds of antibiotics
in order to get their gut bacterial levels under control (my doctor told me it
probably would have taken 4 rounds!).
Even after taking multiple courses of antibiotics, SIBO often still comes back. Bacteria can repopulate the
small intestine in as little as 2 weeks after completing antibiotics,84 which is why recurrence rates are around
44% after 9 months.85 To make sure that SIBO goes away and stays away, you’ve got to address the underly-
ing problems which caused it in the first place. This often means making serious changes to your diet.
Is Your Diet Causing SIBO?

Remember that bacteria is part of the natural structure of our
guts, and it actually serves many important roles in our bodies
which range from aiding in digestion to regulating mood. Just
like all other living organisms, bacteria have to eat something.
And what do bacteria primarily eat? Carbohydrates.
When you eat a low quality diet which is mostly carbohy-
drates (especially simple carbs like the sugary and starchy foods
found in the typical Standard American Diet), bacteria will have
a field day. They eat up those excess carbs, proliferate, and then
you’ve got an overgrowth problem on your hand. It certainly
doesn’t help that the SAD diet also is full of inflammatory foods
like gluten and seed oils which can damage the lining of the
stomach and decrease stomach acid production. As we talked
about in chapter 03 about the Causes of SIBO, stomach acid is
important for regulating and killing bacteria in the gut. Without
enough stomach acid, you will also have undigested particles
of food in your small intestine, which the bacteria can then eat.

Dietary Protocols for Treating SIBO
There are 4 main dietary approaches to treating SIBO. They vary significantly, but are all based on one
common principle: starve the bacteria and/or don’t re-feed it.
Low FODMAP Diet for SIBO

FODMAP stands for Fermentable Oligosaccharides,
Disaccharides, Monosaccharides, and Polyols,
which are the four classes of fermentable sugars/
sugar alcohols. The Low FODMAP diet was original-
ly derived as a dietary treatment for IBS but can be
adapted for treating SIBO.
The idea behind the Low FODMAP diet is that
you get rid of foods which contribute to intestinal
fermentation. Low FODMAP diet is very effective
in treating gastrointestinal conditions like IBD and
IBS. However, it is important to note that the Low
FODMAP diet does not restrict polysaccharide and
disaccharide sources of carbs such as grains, starch,
starchy vegetables, and sucrose. These carbs are
normally well-absorbed, but with SIBO they aren’t
absorbed well and bacteria can feed off of them
and worsen the problem. So, to treat SIBO, these
carbs must also be removed.86, 87
Note: It’s LOW FODMAP, not NO FODMAP, so try
not to drive yourself too insane.
SCD Diet for SIBO

SCD stands for Specific Carbohydrate Diet. It was originally developed by a pediatrician for treating Celiac
Disease and was later popularized by Elaine Gottschall in her book Breaking the Vicious Cycle, which you can
find listed on our resource page here www.hollywoodhomestead.com/sibo-ebook-resources. SCD limits
complex carbs (disaccharides and polysaccharides), lactose, sucrose and other man-made (read: crappy)
ingredients. These ingredients are harmful to the digestive system and lead to yeast overgrowth, bacteria
overgrowth, and inflammation. According to data from surveys, SCD has a 75% to 84% success rate.88

Here are some examples of SCD foods:
Allowed: Not Allowed:
•• Meat •• Cereal grains (wheat, corn, oats, rye, etc.)
•• Kale, lettuce, peas, peppers, mushrooms •• Processed meat
•• Ghee •• Canned fruits and vegetables
•• Some legumes •• Soy, chickpeas, fava beans, bean sprouts
•• Most spices •• Commercial milk and dairy products
•• Potatoes, yams, sweet potatoes
GAPS Diet for SIBO

GAPS stands for Gut and Psychology Syndrome. The diet was created by Dr. Natasha Campbell-McBride. It is
based on the idea that all disease starts in the gut—which is supported by the fact that 90% of all cells and ge-
netic material in the human body belongs to gut flora. Campbell-McBride says that modern life damages the
gut flora and leads to diseases including autism, ADD, epilepsy, depression, as well as many other diseases.
GAPS diet is similar to SCD diet, but allows/excludes a few different items and also has a very clear out-
line. There are seven phases to the GAPS diet. The introductory stage is basically a fast which allows very
little food, room temperature water, and probiotics. As you move through the phases, you are allowed to
add more foods to the diet—such as egg yolks, avocado, and squash. There are some foods which are not
allowed at any phase of the diet. GAPS diet also heavily focuses on detoxing.89
Not Allowed During Any Phase:
•• Sugars (other than fruit)
•• Potatoes, rice, flour
•• Wheat
•• Dairy
While many have experienced great results such as reversing food allergies and improving symptoms of
behavioral and mood disorders with GAPS, there isn’t any scientific evidence supporting GAPS diet for SIBO.
Because the diet removes starches and certain sugars, as well as difficult-to-digest foods like beans, it can help
reduce inflammation and intestinal fermentation. However, the diet does not remove high FODMAP foods.
These foods act much like sugars and starches, meaning that you could still be feeding the bacteria in the gut.
For this reason, even GAPS diet will have to be adapted if it is going to be used to effectively treat SIBO.90

Cedars-Sinai Diet for Preventing SIBO
The other diets mentioned above are used for treating SIBO. By contrast, the Cedar-Sinai Diet is designed
to prevent SIBO. It was devised Dr. Mark Pimentel, Director of the Gastrointestinal Motility Program at Ce-
dars-Sinai Medical Center. The diet isn’t as strict as the ones listed above, but follows the same general prin-
ciples: you’ve got to reduce foods which are hard for your body to digest so bacteria don’t end up using them
as food. Pimentel’s diet also advises against frequent eating because this can affect the migrating motor
complex which helps empty and clean the bowels.91 He outlines the details in his book A New IBS Solution,
which you can find on our resource page here www.hollywoodhomestead.com/sibo-ebook-resources.
Key Points of the Cedars-Sinai Diet:
•• Avoid sweeteners like corn syrup, mannitol,

sorbitol, lactose, and sucralose
•• Avoid dairy
•• Limit beans, lentils and peas
•• Drink 8 cups of water per day
•• Eat protein like beef, fish, poultry, and eggs

in body-appropriate portion sizes
•• Some carbohydrates are okay, but must

experiment with how your body reacts to them
•• Eat fruits in moderation
•• Eat non-starchy vegetables
•• Coffee and tea are okay in moderation;

soda should be avoided
The protocol also involves taking a prokinetic
drug to improve motility and supplementing with
hydrochloric acid, if deficient. ■

15
The SIBO Diet
When treating and preventing SIBO with diet, the most important thing to
remember is to avoid any food which bacteria love to eat. This basically means
avoiding most carbohydrates, which are referred to as “fermentables.” The only
carbs which bacteria don’t really eat are insoluble fiber.
A combination of the Low FODMAPs diet and SCD Diet is considered best for treating SIBO. On their own,
each of these diets has its flaws. For example, SCD (which was originally created for treating Celiac) allows
garlic—which is highly fermentable. Low FODMAP (which is primarily used for treating IBS) allows ingredients
like dairy, soy, and grains—which will also wreak havoc on your gut. By combining SCD and Low FODMAP,
you get rid of most of the fermentables. The combo is called “The SIBO-Specific Diet”.
However, even SIBO Specific isn’t exactly ideal because it allows a some things which aren’t great for your
health—such as the artificial sweeteners aspartame and saccharine. These are things I wouldn’t recom-
mend for anyone to eat, with or without SIBO. The diet also allows legumes which are not ideal for someone
trying to heal their gut lining.
When you have SIBO, your gut is under severe inflammation and might even already have holes in it (leaky
gut). You want to make sure you aren’t consuming anything which is going to irritate your gut. Even better,
you want to consume food which is going to heal your gut.
For these reasons, the best diet for treating sibo is a combination of:
Low FODMAP + SCD + Paleo/Primal
The Low FODMAP and SCD diets take care of the fermentable and pro-inflammatory foods which will
feed bacteria. The Paleo diet will take care of all those unnatural foods which wreak havoc on your gut health
(not to mention the rest of your health).
The SIBO Diet Protocol

The moment you confirm you’ve got SIBO, you will want to put yourself on The SIBO Diet. Even if you are
taking antibiotics for SIBO, you will still want to attack it with a dietary approach. Again, the goal isn’t just to
get rid of bacteria, but to keep it away and heal your gut.

How Long Do You Need to Be On The SIBO Diet?
Follow The SIBO Diet all during treatment (unless you are doing Elemental during which you won’t be eating
anything). Yes, I know it is hard to make major dietary changes to your life, but your health is SO worth it. And
after you get over the initial transition period, you will probably never want to go back to eating the foods
that give you symptoms, or at the very least proceed with caution.
After you cure SIBO, I’d recommend sticking to The SIBO Diet for about 3 months. You can gradually try
small amounts of fermentable foods but certain foods that have no nutritional value I’d advise staying away
from for the long haul (we really don’t need junk like corn syrup and hydrogenated oil when we can just use
more nutrient dense foods like honey and olive oil). When adding a fermentable food back to your diet, try to
make it one that is nourishing and/or a food that you miss and really makes you happy. Your mental health is
just as important as your physical health, and you don’t want to feel like you are depriving yourself.
Over time, you will customize your best diet. This “best” diet will likely evolve over the upcoming months
or even years. You’ll find out which foods are worth eating for you, and which foods you are happy to give up.
For example, I’ve noticed that milk (lactose) does not agree with me right now. I had to suffer through sev-
eral cappuccinos at my favorite café before I was ready to accept this hard truth. It isn’t likely a life sentence
but, for now, I’m laying off the cappuccinos to avoid those tummy troubles. On the other hand, I’ve learned
that I can order a glass of wine without experiencing any symptoms so that’s a treat that I’m happy to be able
to have on occasion. Find what flexibility works best for you. Chances are no two SIBO diets will look alike.
How Strict Do You Need to Be on The SIBO Diet?

During treatment, I would try to follow The SIBO Diet as closely as you can. Antibiotics (both pharmaceutical
and herbal) have a really low success rate for treating SIBO, and you don’t want to decrease your chances of
success by eating foods which will feed the bacteria in your gut. This might require more time than you are
used to in the kitchen and shopping and prepping for foods. For helpful advice on how to upgrade your diet
and make it work for your lifestyle when you are busy with kids, travel, work, etc, read Paleo Made Easy. You
can find it on the resource page here: www.hollywoodhomestead.com/sibo-ebook-resources.
After your breath tests finally come back as negative for SIBO, you will still want to stick to The SIBO Diet
for 3 months. This will allow your gut to heal and your bacteria levels to normalize.
Ideally, you would stick to The SIBO Diet perfectly for the 3 months following treatment. But here’s the
thing: as mentioned before, stress is the leading cause of SIBO and a huge cause of recurrence. Stress is
probably what got you here in the first place, so stressing about food isn’t going to help you fight SIBO!
Further, The SIBO Diet isn’t like other elimination diets (such as the Paleo Autoimmune Protocol) where
you really need to follow the diet 100% in order to make it effective. It is not necessary to avoid all FOD-
MAPs—the poison is really in the amount. A scoop of avocado might be fine, but an entire avocado might
destroy you.

Honestly, my diet was not perfect after finishing the second round of Elemental and the concurrent course
of herbal antibiotics, which is why I was shocked when my test results came back negative.
The most important thing to remember is to not drive yourself crazy trying to follow The SIBO Diet 100%
accurately, 100% of the time. Just do the best you can. Avoiding something as common as garlic when eat-
ing out is almost impossible. But, as much as I enjoy it, garlic was my kryptonite and something I haven’t
been brave enough to try reintroducing yet.
The only time I’d say you should be super strict is if you’ve got a confirmed autoimmune disease and
really need to watch your diet. Otherwise, I’d say do your best to stick to the foods in the chart and slowly
introduce other foods when you are ready.
What Do You Eat on

The SIBO Diet?
The following table shows you foods which
are okay to eat on The SIBO Diet and ones
which are fermentable and should be avoid-
ed or eaten with caution. Remember, with
SIBO, it isn’t the food itself which is the prob-
lem but rather the dosage. You don’t have to
drive yourself crazy avoiding all of the foods
on the “no” list—just consume them in mod-
eration and see how your body reacts.
Not sure what to cook on The SIBO Diet?
In the recipes section on page 91, you can
find all sorts of easy meal ideas which won’t
feed the bacteria in your gut and can even
help gut healing. ■

SIBO Food Lists
Meats
Yes (note amounts) No
Bacon with honey Bacon with sugar or HFCS
Broth—homemade meat or marrow bones (no cartilage) Broth: homemade bone/cartilage
Beef Deli/processed meat with sugar, carrageenan, high FODMAP or
Eggs SCD illegal additives
Fish
Game
Lamb
Organ meats
Pork
Poultry
Seafood

Vegetables
Artichoke hearts ⅛ c Asparagus
Arugula Artichoke hearts > ⅛ c
Bamboo shoots Avocado
Beet 2 slices Bok Choy > 1c
Bok Choy 1 c /85g Bean sprouts
Broccoli ½ c/1.6oz Broccoli > ½ c
Brussels Sprouts 2 ea Butternut Squash
Cabbage 1 c/98g Beet > 2 slices
Cabbage: Savoy ½ c Brussels Sprouts > 2 ea
Carrot Cauliflower
Celery root/Celeriac Cabbage: Savoy ¾ c
Chives Celery
Cucumber Corn
Eggplant Fennel bulb > ½ c, leaves 1 c
Endive Garlic
Fennel bulb ½ c, leaves 1 c Jerusalem artichoke
Green beans 10 ea/2.5oz Mushrooms
Greens: lettuce, collard, chard, kale, spinach Onions
Olives Peas, green > ¼ c
Peas, green ¼ c Snow peas > 5 pods
Peppers: bell/sweet Scallions: white part
Peppers: chili 11cm/28g Shallot
Radicchio 12 leaves Sugar Snap Peas
Radish Yellow Zucchini > ¾ c
Rutabaga Okra
Scallion: green part Parsnip
Snow peas 5 pods Pepper: chili 40g
Squash: butternut ¼ c Potato: white/all colors
Kobocha, Sunburst, Yellow, Zucchini ¾ c Potato: sweet
Tomato Starch powder: all (arrowroot, corn, potato, rice, tapioca)
Seaweeds
Spinach > 15 leaves/150g
Tomato: soup/juice, sundried
Turnip
Taro
Water Chestnut
Yam
Yucca
Canned vegetables

Fruits
Banana—fresh, dried Apple
Berries: blueberry < 80 ea, boysenberry, strawberry, raspberry Apricot
10 ea/19g Avocado
Carambola Berries: cranberry, blueberry > 80/100g,
Citrus: lemon, lime, oranges, tangelos, tangerine blackberry, raspberry > 10ea
Current, dried 1Tbsp Citrus: grapefruit
Dragon fruit Current, dried > 1 Tbsp
Durian Custard Apple
Grapes Date, dried
Guava Fig, dried
Kiwifruit Longon > 5ea
Longon 5 ea/15g Lychee
Melon: cantaloupe/rock, honeydew ½ c/100g Mango
Papaya/Paw Paw Melon: honeydew > ½c
Passion fruit 4 pulps/100g Nectarine
Pineapple Papaya, dried
Pomegranate ½ ea/38g, ¼ c seeds Passion fruit > 4 pulps
Prickly Pear Pineapple, dried
Rambutan 2 ea/31g Peach
Rhubarb Pear
Jam/Jelly—homemade from allowable fruits—see fruit list Pear: nashi
(no pectin, sugar) Persimmon
Tomato Plum
Pomegranat > ½ ea, > ¼ c seeds
Prunes
Plantain
Raisins
Rambutan > 2 ea
Tamarillo
Watermelon
Canned fruit in High FODMAP fruit juice
Jam/Jelly—commercial

Nuts & Seeds
Almonds 10 ea/0.42oz, Almonds > 10 ea, > 2 Tbsp flour
flour 2 Tbsp Chestnuts
Coconut: flour/shredded ¼ c, milk (w/no thickeners) Cashews
Hazelnuts 10 ea/15g Coconut milk with thickeners (guar gum, carageenan)
Macadamia 20 ea/40g Chia seeds
Pecans 10 ea/22g Flaxseeds
Pine nuts 1 Tbsp/14g Hazelnuts > 10 ea
Pumpkin seeds 2 Tbsp/23g Macadamia > 20 ea
Sesame seeds 1 Tbsp/11g Pecans > 10 ea
Sunflower seeds 2 tsp/6g Pine nuts > 1 Tbsp
Walnuts 10 ea/30g Pistachios
Pumpkin seeds > 2 Tbsp
Sesame seeds > 1Tbsp
Seed flour
Sunflower seeds > 2 Tbsp
Walnuts > 10 ea

Beverages and Alcohol
Common Drinks Common Drinks
Coffee 1 c/day (weak) Coffee > 1 c/day (weak)
Cranberry juice-pure Fruit juice from Low FODMAP fruits > ⅓ c/100ml
Orange juice, fresh ½ c/125ml Fruit juice from High FODMAP fruits
Fruit juice from Low FODMAP fruits ⅓ c/100ml Coffee substitutes
Tea: black (weak), camomile, ginger, green, hibiscus, Soda (fructose, sucrose)
lemongrass, mate, mint, oolong (weak), Tea: chicory root, licorice, pau d'arco
rooibos/rooibos chai, rose hip
Tea: green > 2 c/day
Water
Seltzer/Carbonated beverages (CO2/gas)
Alcohol
Alcohol
Occasionally in moderate amounts: Bourbon, Gin, Vodka,
Whiskey/Scotch, Wine Rum: light/gold, dark
Brandy
Hard Cider
Liqueurs/Cordials
Sherry
Tequila
Wine: dessert/sweet, sake, sparkling, port

Dairy
Butter Cream—lactasetreated
Cheese: aged 1mo+, Cheese: cream cheese, cottage cheese, fresh cheese (feta,
dry curd cottage cheese, cheve, fresh mozzarella), ricotta
yogurt cheese/labneh Kefir—commercial, homemade 24 hour
Ghee Cream
Sour cream—homemade 24 hour Milk
Yogurt—homemade 24 hour Sour cream—commercial
Yogurt—commercial

Fats & Oils
Bacon fat Soybean oil
Butter Seed oils: canola, walnut, grapeseed, sesame seed,
Coconut oil safflower, sunflower, corn
Cod liver oil & Fish oil Vegetable shortening
Duck fat Margarine
Garlic-infused oil
Ghee
Lard & Tallow
Medium chain triglyceride/MCT oil
Macadamia oil
Olive oil
Palm oil

Condiments and Seasonings
All spices (except onion & garlic) Asafoetida powder
Garlic-infused oil Chicory root (leaves ok)
Ginger (fresh & dried) Cocoa/chocolate unsweetened
Mayonnaise, homemade or commercial w/honey Gums/Carrageenan/Thickeners
Mustard—without garlic Sauces or Marinades with High FODMAP/SCD illegal items
Pickles/Relish—no sweetener or garlic Soy Sauce/Tamari
Tabasco (McIlhennyCo) Spices: onion & garlic powder
Wasabi—pure Venegar: balsamic
Vinegar: apple cider, distilled/white, red & white wine Baking powder

Sweeteners
Glucose/Dextrose Agave syrup
Honey: alfalfa, cotton, clover, raspberry 2 Tbsp Barley Malt syrup
Stevia—pure (no inulin) in small amounts, occasionally Cane sugar (Rapadura, Sucanat)
Coconut sugar
Fructose, powdered
Honey: blackberry, buckwheat, citrus/orange blossom, acacia,
sage, tupelo
Honey: raspberry > 2 Tbsp
High-fructose corn syrup
Maple syrup
Molasses
Sugar/Sucrose
Sucralose
Polyols/Sugar alcohol: isomalt, erythritol, lactitol, maltitol,
mannitol, sorbitol, xylitol

16
Preventing Recurrence
If you are reading this book, I wouldn’t be surprised if you have already
undergone multiple bouts of antibiotics, with dosages or regimens changing
each time. Symptoms might clear up temporarily, only to return in a few weeks
or months. SIBO has an incredibly high recurrence rate, and it is very important
that you understand this before you set about treating the disease.
SIBO Recurrence Rates

Treating SIBO isn’t about getting rid of all the
bacteria in your small intestine (you need bacte-
ria there!). It is about getting your gut bacteria at
a healthy balance. You will always have bacteria
in your gut, and bacteria is a living thing. It will re-
produce. If the conditions of your gut are healthy
after finishing a bout of antibiotics, then the bac-
teria will stay at healthy levels. If not, then bacte-
ria can begin to repopulate again in as little as
two weeks.92 Since antibiotics don’t address the
underlying problems which caused the bacteria
to get out of control in the first place, recurrence
is almost inevitable.
According to one study85 in which patients were
treated with rifaximin, patients experienced these
rates of recurrence:
•• 12.6% after 3 months

Keep in mind that a single round of antibiotics is only effective in about half of cases, so your chances of
beating SIBO with just one round of antibiotics is really low.1

Why is this so important?
Because it very important to realize that you’ve got
to treat the underlying causes of SIBO, not just the
bacterial overgrowth!
Taking antibiotics every single time your SIBO
comes back is NOT the solution! Aside from be-
ing a major annoyance which includes unpleasant
symptoms, frequent doctors’ visits and continual
testing, the bacteria in your gut could become re-
sistant to the SIBO antibiotics. When this happens,
you are going to have to take even higher dosages
of antibiotics and/or different types of antibiotics.69
Who wants to be a guinea pig for every pharma-
ceutical in the book? I know I don’t.
Steps to Prevent SIBO Recurrence
1. Reduce Stress
The most important thing you can do to prevent SIBO recurrence is reduce stress. Stress isn’t just the #1 cause
of SIBO, it is also a leading cause of conditions which contribute to SIBO—like how stress causes gut inflam-
mation, which can set the stage for bacterial overgrowth. I suggest you re-read through the Causes of SIBO
chapter of this book on page 19 to see how everything comes back to stress.
2. Eat a Real Foods Diet

Along with reducing stress, you will need to maintain a healthy diet. You don’t have to stick to the SIBO diet
forever, but you will want to adhere to its core principles: avoid excess carbs and avoid foods which harm the gut.
The worst thing you can do for your gut (and body and mind) is to eat the Standard American Diet (appro-
priately called SAD). This diet is high in foods which irritate the lining of the gut, reduce stomach acid (which
you need to keep bacteria levels in check), and are low in nutrients.
Diet is too big of an issue to discuss in detail here. For starters, I’d recommend getting rid of ALL pro-
cessed foods and gluten. My family and I follow a paleo diet and I credit it directly to solving numerous health
problems we’ve had, including weight problems, acne and eczema, low immunity, and digestion problems.
If you are interested in upgrading your diet, read Paleo Made Easy. The ebook has useful information on
which foods to eat and avoid, shopping advice, cooking tips, and more. You can find the ebook listed on our
resource page here: www.hollywoodhomestead.com/sibo-ebook-resources

3. Take Probiotics
As Nutritionist Angela Pifer points out, SIBO treatment usually doesn’t include probiotics. The rationale for
this is that probiotics are bacteria, so you don’t want to add more bacteria to your gut when you have SIBO.
Pifer advocates taking probiotics because, in most cases of SIBO, probiotics are not the type of bacteria
causing problems. They are the “good bacteria” which help reduce inflammation, maintain proper gut pH,
and even help kill off the “bad guys” which shouldn’t be there. Further, she notes that if you are taking anti-
biotics for SIBO, then you are going to kill off the good bacteria in your gut along with the bad. You will need
to replenish this, or else your gut flora will remain unbalanced and SIBO is bound to recur.
Bear in mind that there haven’t been much research on probiotics for treating and preventing SIBO, but
the few studies which are out there are promising.93 You can add probiotic supplements to your daily regi-
men. We list some on the resource page here: www.hollywoodhomestead.com/sibo-ebook-resources
But make sure your probiotics don’t include PREbiotics!
If you just grab any probiotics off the shelf in hopes they will help keep SIBO at bay, you might be sur-
prised to find your symptoms get worse. The reason for this is because many probiotics contain prebiotics.
Prebiotics are the fiber which probiotics eat. But the bad bacteria also happen to love prebiotics! The bac-
teria eat this fiber and overgrowth can occur/recur. So, if you are going to take probiotics for SIBO, you must
make sure they do not include any prebiotics, fillers, or other junk.94
4. Increase Stomach Acid
If you remember from the Causes of SIBO chapter, one of the leading causes of SIBO is not having enough
stomach acid. That’s right—we want stomach acid! Stomach acid is responsible for breaking down food. No,
too much stomach acid does not cause heartburn or acid reflux. It is too little stomach acid which causes
heartburn and acid reflux.
If you don’t have enough stomach acid, then you will have a lot of undigested food particles in your small
intestine. Bacteria will feed off of these food particles and overgrowth will occur. That means inflammation,
gas, and a lot of pressure on your gut. All that pressure causes your stomach acid to push up into your esoph-
agus, i.e. heartburn.
How do you know if you have low stomach acid (hypochlorhydria)?
According to certified nutritionist Dr. Joseph Debe the Heidelberg Stomach Acid test is the best, most
reliable way of testing for low stomach acid. Unfortunately, the test costs about $350 to perform. If you don’t
want to spring for this test, then you can try these two cheaper options.
•• The Baking Soda Test: Mix ¼ tsp of baking soda in 4–6oz of cold water. Drink it first thing in the
morning before eating or drinking anything. Time how long it takes you to belch. Stop after 5 minutes. If
you have enough stomach acid, you should belch within 2 or 3 minutes. This isn’t very accurate, but it is
cheap and easy.

•• The Betaine HCL Challenge Test: Buy some Betaine HCL tablets with pepsin. Eat at least 6oz of meat.
In the middle of the meal, take 1 of the Betaine HCL tablets. Finish the meal and pay attention to your
body throughout the rest of the day. If you don’t notice any changes, then you probably have low
stomach acid levels. If you notice stomach distress, then your stomach acid levels are probably fine.
While you are at it, you are going to want to stop using all those antacids so your stomach acid levels can
get back to normal and bacteria can stabilize.
5. Stimulate the Migrating Motor Complex
As we talked about in chapter 13, the Migrating Motor Complex is the wave-like motions that sweep through
the intestines and help clean the gut of excess bacteria and undigested food particles. One of the leading
causes of SIBO is an improperly working MMC. When your MMC isn’t doing its job, then food is going to sit
inside your small intestine too long (constipation!) and bacteria will have a field day on it.
There are a few ways to stimulate the MMC. The most important one is to avoid stress, as stress will shut
off the MMC. You will also want to follow these tips:
•• Don’t eat snacks between meals (to allow plenty of time for your intestines to flush out food)
•• Get plenty of sleep
•• Try acupuncture for MMC
•• Take prokinetic drugs (such as those recommended on the resource page here:
www.hollywoodhomestead.com/sibo-ebook-resources)
6. Heal the Intestinal Lining
SIBO can do a lot of damage to your intestinal lining, which in turn can cause severe problems like leaky gut.
So, to cure SIBO for good, you will also need to repair your intestinal lining. This is a hefty subject which we
will get into the next chapter but half, if not more, of the work of repairing the gut is done by simply eliminat-
ing the offender, which in this case is the overgrowth! ■

17
Healing the Gut
When you have SIBO, the bacterial overgrowth creates an inflammatory response
in the intestinal mucosa. The inflammation not only makes symptoms worse, but
can lead to leaky gut syndrome. 29 To cure SIBO, you need to make sure that you
are also taking steps to heal your gut from the damage which has been done.
What is Leaky Gut Syndrome?

When you eat food, your digestive system breaks the food down into tiny parts. These digested particles
pass through the lining of the stomach and into our bloodstream. The gut is designed in a way so only fully
broken down food particles can pass through. Think of it like a window screen. The screen lets air through
but stops bugs from getting inside. Our gut linings are like this screen, allowing nutrients through but stop-
ping undigested food particles from getting past.
If the lining of the gut gets damaged, then holes can form. Particles of undigested food are able to escape
through those holes (hence the name leaky gut) and into our bloodstream.
Anything which causes inflammation can lead to leaky gut. This includes chronic stress, certain medica-
tions, antibiotics, GMOs, birth control pills, and excessive alcohol consumption. The big culprit of leaky gut
though is usually food sensitivities.95
If you only exposed yourself to these pro-inflammatory conditions occasionally, your gut might be able
to heal itself, but many of us lead lifestyles in which our guts are constantly subjected to inflammation. Just
think how many people eat cereal for breakfast, a sandwich for lunch, and then top off all that gluten with
some spaghetti for dinner! Now think how many people are constantly stressed out by work and rushing
around. Then factor in all the chemical additives in “foodstuff”, prescription medications, GMOs …
Obviously, having holes in your gut is no bueno. But it is worse than you might realize. When bits of undi-
gested food escape through the gut, they get into the bloodstream. Our immune systems then attack these
food particles. The problem is that some of these food particles resemble substances in our bodies, so the
immune system gets confused and starts attacking itself. That means autoimmune diseases. Yes, all auto-
immune disease starts with leaky gut syndrome—and SIBO leads to leaky gut!
And things get even worse from here.
When your gut is damaged, your stomach membranes don’t produce gastric acid efficiently.96 Without
enough acid, you can develop bacterial overgrowth (or, if you already have it, the overgrowth gets worse).

Bacterial overgrowth can then make leaky gut worse. In this sense, SIBO and Leaky Gut aren’t just an “A leads
to B” thing; they are part of a vicious cycle.
Reduced Excess Bacteria Causes Worsened

Inflammation → Leaky gut → Stomach Acid
→ More Inflammation
→ Leaky Gut
No matter what you do to get SIBO bacteria levels in check, you aren’t going to fully overcome from those
digestive problems if you’ve got a damaged gut lining. Healing your gut is a big topic, and I discuss it a lot more
deeply in my eBook The Gelatin Secret (which you can find on the resource page here: www.hollywoodhome-
stead.com/sibo-ebook-resources) but here are the basic steps you need to take to heal your intestinal lining.
1. Eliminate Pro-Inflammatory Foods
A food sensitivity is any food which irritates your gut and leads to inflammation. Food allergies also cause
irritation and inflammation. However, the difference between the two is that, with an allergy, your body mis-
takenly thinks something is a harmful invader. The body releases its soldiers (histamines) to fight the invader,
causing symptoms.
Food sensitivities don’t cause the immediate reaction as allergies. This makes them harder to pinpoint.
One day, for example, you might be fine eating corn. But, as you continue to eat corn, all the irritation adds
up to the point where you experience symptoms and yet you still might not know what food is causing it
because it crept up on you over time. The best way to pinpoint food sensitivities is to do an elimination
diet for 30 days. To do this, you remove suspected food sensitivities (the most common ones are gluten,
corn, eggs, and dairy). After 30 days, you introduce them one at a time to see if you experience a reaction.
In her book The Paleo Approach, Dr. Sarah Ballantyne talks in depth about how to do an elimination diet.
The book is mostly in reference to autoimmune diseases, but I recommend it to anyone with health issues
as a must-have encyclopedia of sorts. You can find the book on our resource page here www.hollywood-
homestead.com/sibo-ebook-resources
Many of us on the Standard American Diet eat nothing but gut irritants all day. There are a LOT of gut
irritants, but the big ones are:53
•• Gluten •• Legumes •• Nightshades

•• Grains (including, but •• Eggs •• Processed sugar
not limited to those
•• Caffeine •• Processed foods
containing gluten)
•• Alcohol •• GMOs (genetically
•• Nuts
modified organisms)
The first step in repairing your gut lining and solving SIBO for good is to ELIMINATE ALL PROCESSED FOOD.
It shouldn’t even be considered food but rather food stuff. So no more TV dinners, boxes of cookies, or gro-
cery store items with ingredients you can’t even pronounce. Your gut doesn’t need these items. Your body
certainly doesn’t need them either!

2. D ecrease Omega-6 to Omega-3 Ratio
You’ve probably heard about Omega-3 and all of its health benefits. What a lot of those health articles gloss
over is the fact that it isn’t enough to just increase Omega-3. You’ve got to simultaneously decrease the
amount of Omega-6 in your diet.
This is a huge topic that requires a discussion about how the body converts Omega-3 into the fatty acids
EPA and DHA, and how Omega-3 and Omega-6 compete for the same pathways. Here are some key points
that you need to know about Omega-3 : Omega-6 ratios.
•• Anthropological research shows that our hunter-gatherer ancestors ate Omega-3 and Omega-6 in a 1:1 ratio
•• Today, people eat Omega-3 and Omega-6 in ratios of about 1:10 to 1:20!
•• A diet high in Omega-3 and low in Omega-6 will reduce inflammation
•• A diet low in Omega-3 and high in Omega-6 will increase inflammation
•• Ideally aim for a 1:4 Omega-3 to Omega-6 ratio (1:1 would be better, but that is probably not achievable
unless you are Eskimo and eating wild salmon all day!)
People following a typical American diet are getting about 20% of their calories from a single
source: soybean oil. Guess what soybean oil is high in? Yep, Omega-6. The same is true of other common
oils, such as sunflower oil or corn oil. To make things worse, these oils oxidize quickly, which can turn them
into harmful trans fats! Heart disease anyone?97, 98
One of the best things you can do for your gut and overall health is to cut out all those pro-inflammatory
cooking oils. What should you cook with instead? My personal favorite is tallow, which has an Omega-3:6 ra-
tio of about 1:6, which is a huge improvement over sunflower oil which has a ratio of about 1:200 or safflower
oil which has no Omega-3 at all.Ghee (clarified butter) is also a great alternative to cooking oil.99, 100, 101, 102
Another important thing you can do to reduce Omega-6 is switch to grass-fed beef and wild-caught
salmon. Cows eating their natural diet of grass instead of corn have much higher levels of Omega-3. How
much higher? Grain-fed beef can have Omega-6:3 ratios exceeding 20:1 whereas grass-fed beef is around
3:1. With salmon, farmed salmon
may contain just half of the omega
3s as wild-caught salmon. I get that
most people probably aren’t going
to eat wild salmon all day long to
optimize their Omega-3:6 ratios. It
may be worth considering a sup-
plement, such as Thorne brand’s
Super EPA.103, 104 You can find it
listed on the resource page here:
www.hollywoodhomestead.com/
sibo-ebook-resources

1. N ourish the Gut Lining
Getting rid of gut irritants and optimizing Omega-3 to Omega-6 ratios is a start. If you want to speed up gut
healing though, you’ve got to provide your gut with nutrients it needs to heal. One of the absolute best su-
perfoods you can consume for gut healing is bone broth.
Real bone broth is made from boiled down bones and connective tissues. With SIBO, it is important that
you only make bone broth with marrow and meat bones. Cartilage bones (such as knuckle bones) rate
high on FODMAP and need to be avoided. You can find a recipe for SIBO-friendly bone broth on page 93.105
Once you’ve boiled down the bones, you are left with a liquid which is very rich in nutrients. Most impor-
tantly, bone broth is also rich in gelatin. It turns out that gelatin acts like spackle to fill the holes in your gut.
No wonder bone broth has long been considered the go-to remedy for digestive ailments! Steven Horne
(AHG and IIPA) and Thomas Easton (AHG) recommend drinking about 1–4 cups of bone broth daily to repair
your gut from SIBO. You’ll probably want to start slowly though and gradually increase your dosage, letting
your body guide you and starting with marrow bone broth before you gradually introduce gelatinous broth
made from cartilage.106
If you really hate the taste of bone broth, you can consume real gelatin instead (I’m not talking about the
Jello packets you buy at the supermarket which are made from byproducts and chemical additives—avoid
those like the plague!) Real gelatin is FODMAPs safe. Some people still find it difficult to digest so take it slow
and increase the dose as your body allows.107
There are only a couple of brands of real gelatin that I know of. You can use it to make tasty treats
like gummies, smoothies, and much more. You can find loads of easy gelatin recipes in my ebook
The Gelatin Secret.108 You can find the the book and my favorite brands of gelatin listed on the resource page
here www.hollywoodhomestead.com/sibo-ebook-resources ■

18
Supplements
SIBO wreaks havoc on your entire body, not just your gut. To help your body
beat off the bacteria, overcome symptoms, and heal your gut, supplements can
go a long way. Here are some of the supplements you may want to consider as
part of your SIBO treatment. You can find where to buy them on our resource
page here www.hollywoodhomestead.com/sibo-ebook-resources
Remember that I am not a doctor and this information isn’t intended to be used as medical advice. Always
consult with your doctor before taking any supplements.
Supplements for Treating SIBO

When traditional antibiotics failed me, I decided to attack SIBO with a hardcore course of herbal antibiotics.
I took ALL of these antibiotics while also doing the elemental diet. Read the chapter about herbal antibiotics
on page 44 to learn more about how they work.
•• Allimed (Allicin) 450mg (herbal antibiotic):

1–2 capsule 3× per day for a total of 14 days;
start with 1 cap 3× per day and on day 3 increase
to 2 caps 3× per day
•• Berberine Complex (herbal antibiotic):

2–3 capsules 3× per day for a total of 14 days;
start with 2 caps 3× per day and on day
3 increase to 3 caps 3× per day
•• Neem Plus (herbal antibiotic): 1 capsule 3×

per day for a total of 14 days
•• Interfase plus from Klaire Labs (biofilm disruptor): 2 capsules 3× per day for a total of 14 days
You can find where to buy these supplements on our resource page here www.hollywoodhomestead.com/
sibo-ebook-resources. There is also a discount code for Allimed there too!

Supplements for Fixing Nutrient Deficiencies
Your small intestine is the part of your GI system which is responsible for absorbing nutrients into your body. If
your small intestine is damaged from SIBO, then you won’t be able to absorb nutrients well and can suffer from
deficiencies. The bacteria in your gut can also interfere with bile salts, which are important for fat absorption. If
you can’t absorb fat, then you can end up deficient in the fat soluble vitamins A, D, and E. Finally, bacteria in your
gut can consume B12. For these reasons, you might want to consider supplementing during SIBO treatment.
The truth is, until you eliminate SIBO it will be difficult to reverse micronutrient deficiencies. If resources
are limited, I would focus on SIBO first and then worry about what deficiencies you have and how to best
address them under the care of your doctor.
If money is no object and/or you suspect your micronutrient deficiencies are severe, please see a naturo-
pathic doctor and request that they run a micronutrient panel (I love the Spectracell Labs one) to see what
your deficiencies are. This lab test along with a comprehensive CBC (complete blood count) will give you an
excellent big picture as to what needs to be addressed more urgently.
If your gut is having trouble absorbing nutrients (which is a given in the case of SIBO), your naturopathic
doctor will likely prescribe some custom intramuscular vitamin shots that you can give yourself each week
with the specific vitamins you need so you can bypass the gut and still get them in. Note that this is an ex-
pensive route to go and unlikely to be covered by insurance, but it’s a great option even if you decide to use
it as a jump start for only the first few weeks.
Another way to bypass the gut is to use the amazing absorption of your skin! You can ask your doctor
about using gut healing supplements that are highly absorbable, such as glutathione.
Prokinetic Supplements for Improving Motility

Read the chapter about motility on page 59 to understand why it is so important for preventing and treat-
ing SIBO. You should start taking a prokinetic immediately after you finish your SIBO treatment and continue
taking it for 3 months (or as directed by your doctor). If you have an MMC problem, then you may need take
prokinetics for the long term to prevent SIBO recurrence. I also took one prokinetic (MotilPro) during treat-
ment, and then added the other two prokinetics after treatment.
•• MotilPro (Pure Encapsulations): 3 capsules before bed and 3 capsules 1–2 times a day between meals
•• Iberogast: Take 20 drops before bed or you can use this one with meals
•• Erithromycin: 50mg before bed (will probably need a prescription for this one as it’s a low dose of an antibiotic)

Supplements for Healing the Gut
There are many things that people can do to heal their gut. However, when you have SIBO, some of the
things which are traditionally used for gut healing are way off limits. You have to proceed with caution and
check in with your body (or with your lab tests and doctor) to see what works for you and what doesn’t. We
all have individual tolerances and what works for one might not work for another. A great example of this is
gelatin-rich bone broth (which is such an incredible gut healer that I wrote an entire book about it which you
can find on the resource page here www.hollywoodhomestead.com/sibo-ebook-resources). But for some
SIBO patients, the cartilage (which is high FODMAP) in gelatin can be bothersome. To prevent problems, it is
best to make bone broth from marrow bones as they don’t contain much cartilage. You can find a recipe for
SIBO-friendly bone broth on page 93 ■

Parting Thoughts
It’s no doubt that SIBO, its treatment, and its prevention can seem overwhelming.
My biggest piece of advice is to make a plan of attack, commit to following it,
and stay vigilant for prevention but don’t let it consume your life.
Your life is about so much more than this condition. Invest in a good doctor, testing, and medicine like
your life depends on it (because the quality of your life most definitely does). Use this manual to help guide
you along the way. Spend the rest of your time doing things which have nothing to do with SIBO.
Mindset is everything. SIBO is a temporary, acute condition that you absolutely can and will recover
from. Set your mind to it, do the work and move on to happier things.
Be sure to bookmark this page where I will share updates that come up after the release of The
SIBO Solution as well as download your FREE SIBO detox support guide mini ebook with all the dif-
ferent gentle detoxes I recommend to help support your body as it tackles SIBO! ■
www.hollywoodhomestead.com/sibo-bonus/

Recipes
Before I was diagnosed with SIBO, I had already been following a real food diet
for several years. I had thought that transition was tough at times! The SIBO
Diet was different than anything I was used to because even a lot of healthy
things aren’t good for people with SIBO, such as garlic and high amounts of
broccoli and cauliflower.
At first, it may seem like The SIBO Diet is super-restrictive and impossible, but I urge you to approach it pos-
itively. Don’t focus on the things you can’t eat, but think of all the things you can eat. Not only are you help-
ing your body beat and heal from SIBO, but you will probably learn a thing or two about food. If you aren’t
already used to checking the ingredients on everything you eat, you’ll soon be surprised to learn how much
sugar, gluten, additives, and other harmful ingredients are lurking in everything from mustard to salad dress-
ings. After a few weeks of vigorous reading of labels, you will really start to rethink all that processed food!

One thing I really want emphasize when it comes to eating on The SIBO Diet is that ingredient quality matters.
With meat, you should really strive for pastured, free-range, or wild-caught meat and fish whenever possi-
ble. No, this isn’t just for the welfare of the animals. When animals have access to the outdoors, they are much
healthier than those animals which are cooped up, which means more nutritious meat for us. I am especially
a huge advocate of choosing Grass-Fed Pastured beef products because, when cows eat their natural diet of
grass instead of being fed grains, their Omega-3:6 ratios are much better. As we talked about on page 83
about healing the gut, Omega-3:6 ratios are really important for people with SIBO in order to reduce inflam-
mation in the gut. You will also want to choose organic and hormone-free meat whenever possible.
Remember to always read the ingredients on food labels before you buy to make sure there aren’t any
off-limit ingredients or additives in the product. Also keep in mind that small changes can make a big differ-
ence to your overall health, like how sea salt is more nutritious than regular table salt.
Most importantly, don’t stress. Just do the best you can. The SIBO Diet isn’t about perfection. You don’t
have to completely eliminate all foods which contain FODMAPs. It is about reducing harmful foods to safe
limits so bacteria stays under control and your gut can start to heal.
You’ll notice that some of the recipes do contain foods on the limited list. Those ingredients are marked
with an asterisk (*). The quantities of these foods have been carefully measured so FODMAPs are within safe
limits for people with SIBO. However, these are foods that you won’t want to have more than one serving of
until you know what your body can handle.
I hope these SIBO recipes will serve as a good starting point and you can use them as inspiration to come
up with your own recipes. At first it seems restrictive but, once you get the hang of it, it’ll be second nature. ■

Basic Staples
Having SIBO means making some big changes to your meals. No more mashed potatoes
for dinner, lattes with lunch, and even most of that healthy salad for lunch is
now off limits. You can kind of wrap your head around these big changes, but SIBO
also means changes to the small things too. How, for example, do you give flavor
to your food when you can’t eat garlic? And what about broths for your soup—
which are safe to use? Here are a few of the staples which helped me get through
The SIBO Diet without feeling deprived and also make meal prep a lot easier.
Beef Bone Broth

When I talk about broth, I’m not talking
about the broth you buy in the supermar-
ket which comes in a box or can. I’m talking
about real bone broth which is made from
boiling down bones. When you boil down
the bones, it releases many nutrients and
you get an incredibly healthy, healing liq-
uid which also happens to taste great. I’m
such a fan of broth and the gelatin it con-
tains that I wrote a whole book about it,
called The Gelatin Secret.
For most people, traditional bone
broth is one of the best things you can
consume and is a great gut healer. For
people with SIBO though, broth can be
problematic because real broth is typi-
cally made from cartilage bones, which are high FODMAP. You can circumvent this problem by using marrow
bones (which are low FODMAP) instead of bones containing cartilage. Unfortunately that does mean you will
have to specifically buy marrow bones for broth instead of using leftover bones from your roasted chicken
dinner. You can get marrow bones at your butcher. Shank bones are particularly good. By the way, you can
roast the bones and eat the marrow before using the bones for broth. Roasted marrow tastes awesome.

Bone quality
The quality of the bones you use is really important when making broth. Whenever possible, choose beef
bones which were Grass-fed and Finished. This means the animals were able to eat their natural diet of grass
and not grains like corn. Grass-fed beef has a much better Omega-3:6 ratio and is higher in nutrients. With pork
and sheep bones, you will want to look for Free Range products. Always choose Organic and Hormone-Free
when you have the chance.
Making Bone Broth
Bone broth is super easy to make. You can use a pressure cooker, slow cooker or just a regular stock pot with
the instructions below. You can make a big batch and keep it in the fridge or freezer. You can either simply sip
on a cup of warm broth or use as a base for soups or to use in place of water in any savory recipe. If you’re in
a hurry, you can just make it with the bones, vinegar and water and save the seasoning for later when you’re
ready to drink the broth or use it in a recipe for more flexibility.
You may be wondering why vinegar is included in this recipe. It’s an essential ingredient that will help pull
the minerals out of the bones while your stock is simmering in the pot over a long period of time. This recipe
for beef bone broth can easily be doubled or even tripled if your soup pot is big enough!

1. Stock Pot Method
If you don’t have a slow cooker or pressure cooker, you can make bone broth with this method.
Yield: 1 ½ quarts | Total Time: 6 hours
Ingredients 5 Cut the tough green leafy part off of each leek.
1 ½ lbs beef marrow bones (about 3 bone sections This will leave you with a white section at the root
that are each 4″ in length) end of the leek and a light green section that was
the mid-part of the leek. Cut the white part away
2 ½ qt. water
and reserve it for later use. Slice the light green
2 leeks, the soft green tops, cut into chunks* sections in half lengthwise.
2 carrots, cut into large chunks 6 Add the cut leek sections, 2 whole carrots
¼ cup apple cider vinegar (unpeeled and chopped into 3 or 4 pieces), bay
leaf, dried thyme, 6 whole peppercorns and sea
1 Tbsp butter
salt to the stock and continue to simmer for
2 tsp salt another 2 hours. No longer top up the liquid.
1 tsp dried thyme You want to have the stock reduced to about
6 whole black peppercorns 1–1 ½ quarts when you are done for a well-flavored
and concentrated beef broth. At this point, some
1 large Bay leaf
people choose to transfer the stock, bones, etc.
Directions over to a large crock pot set on high for the rest
of the process. You can even let it simmer in the
1 Preheat oven to 350°F
crock-pot overnight if you want.
2 Put the beef marrow bones on a small rimmed
7 After a minimum of 2 more hours remove the
cookie sheet covered with foil and place on the
pot from the heat and let the contents cool down
middle rack of a preheated oven. Roast the bones
for a bit. When cool enough to handle, discard the
for 45 minutes until somewhat browned.
bones and strain the liquid through a fine sieve to
3 In a large soup pot add the water and the apple remove the small bits, veggies and peppercorns.
cider vinegar along with the soup bones. Place When the strained beef stock has cooled to room
the pot on high heat until the liquid comes to temperature, cover and refrigerate it overnight.
a boil and then immediately turn the heat down The fat will solidify on top of the stock by the next
to the point where the liquid is just simmering morning and you can easily skim it off before using
(somewhere between medium and medium-low). this tasty stock in your favorite soup recipe.
4 Let the soup stock simmer for 3 hours, adding * denotes limited amount—please see yes/no list on page 70
small amounts of water as necessary to keep the
bones covered with liquid. Skim off any foam or fat
that rises to the surface.

3. Pressure Cooker Method
This is the fastest method of making broth but is

more hands-on.
1 Preheat oven to 350°F
2 Put the beef marrow bones on a small rimmed
cookie sheet covered with foil and place on the
middle rack of a preheated oven. Roast the bones
for 45 minutes until somewhat browned.
3 Put bones, vegetables, seasonings, and apple
2. Slow Cooker Method cider vinegar into the pressure cooker.
This is the easiest and lowest-maintenance method 4 Cover with filtered water to ⅔ of the
of making broth. recommended fill point.
5 Close the valve and turn on high and place on
1 Preheat oven to 350°F a burner on high heat.
2 Put the beef marrow bones on a small rimmed 6 As soon as the pressure cooker indicates high
cookie sheet covered with foil and place on the pressure, turn it to low and cook for 30–40 minutes
middle rack of a preheated oven. Roast the bones (not longer).
for 45 minutes until somewhat browned. 7 Remove from heat and let the pressure release
3 Turn the slow cooker on to High on its own (about 10 minutes).
4 Add the bones, vegetables, seasonings, and 8 Strain in a mesh strainer over a bowl or pot.
apple cider vinegar to the slow cooker. 9 Enjoy the broth! you can reuse your bones for
5 Add filtered water to the slow cooker until the another weaker batch of bone broth if you’d like.
bones and veggies are covered, leaving about an
inch of room at the top.
6 Let it cook for at least 24 hours, ideally 48 or
even longer!
7 Once you are ready to harvest your broth, pour
it through a strainer into a pot or bowl and allow to
cool.
8 Enjoy your broth or store it for later.
9 When the broth cools, you may have a layer of
fat on top. Just skim it off.

Garlic Infused Olive Oil
Giving up garlic, which is high FODMAP is a tough proposition. This recipe is a great way for you to still en-
joy the garlic flavor in your cooking without the negative effects. It will be worth the few minutes it takes to
make, I promise.
The reason garlic is off limits but garlic infused oil is ok for SIBO sufferers is this: the FODMAPs part of garlic
(fructans) is water soluble. They won’t leach into the oil. So long as you discard the garlic, garlic infused olive
oil is completely okay on The SIBO Diet.
Serves: makes 1 cup | Total Time: 40 minutes
Ingredients
1 cup olive oil

1 bulb of garlic separated into individual cloves
Directions
1 Peel the garlic by cutting off the ends of the
cloves and smashing each clove with the broad
side of a flat knife.
2 Heat ¼ cup of the olive oil in a saucepan to
the point where it is just simmering and add all
of the cloves. Let the cloves simmer in the oil for 5 Inspect the strained oil to make sure that
5 minutes. They may begin to turn a nice golden every spec of garlic has been removed. If you
color but watch them closely. You don’t want the see small particle of garlic in the oil repeat the
oil to become too hot as it will begin to burn the straining process using a few more layers of clean
cloves and this could make the end result bitter. cheesecloth.
Overheating the oil will also damage it as olive oil
6 Once the garlic infused olive oil has cooled,
has a lower smoke point so keep an eye on it.
store it in the fridge in a sterilized glass jar with
3 Now add the remaining oil and adjust the heat a tight fitting lid.
to bring the oil back up to the simmering point. You
want to see only a few small bubbles around the
cloves. Simmer this way for 15 minutes.
4 Remove from the heat and strain the oil through
a fine sieve lined with a few layers of cheesecloth.
Discard the garlic cloves.

Homemade Yogurt
Simple to make, homemade yogurt not only tastes better than store bought yogurt, it is also much more
economical. The list of uses for yogurt is lengthy. It can be the base of a healthy and nutritious breakfast,
served up with fresh fruit for a snack, whipped into a tangy salad dressing and a whole lot more.
Many people who eat a lot of yogurt own a yogurt maker, but don’t despair if you don’t have one. I de-
scribe a few, super-easy ways to make yogurt without a lot of fancy equipment. So here’s a list of the things
you’ll need to make your first batch of homemade yogurt (without a yogurt maker):
•• Candy thermometer •• Stainless steel whisk and a ladle
•• Stainless steel or cast iron enamelled pot or •• Cheesecloth for straining if you want a thicker
a thermos or a large glass jar (these will be used yogurt consistency—as in Greek-style yogurt
as an incubator for your yogurt)
•• Mason jars for storing yogurt in the fridge
Serves: makes 2 quarts yogurt | Total Time: 10 minutes, incubation period—24 hours
*Even though your yogurt may be done faster, always let it ferment
for 24–37 hours before putting it in the fridge. This is important for
SIBO patients so they get the right levels of healthy bacteria.
Ingredients
2 qt whole milk, (preferably raw, second best is grass fed, third best is simply organic)
½ cup yogurt or a package of dried yogurt culture (find out where to buy on our resource page here
www.hollywoodhomestead.com/sibo-ebook-resources)
Directions
1 Sterilize the equipment you will be using. You can 5 If you are using fresh yogurt as a culture, mix
do this by setting your dishwasher to the “sanitize” a little of the warm milk into the yogurt to thin it
setting or by using the boiling water bath method. out and then mix the thinned yogurt into the warm
2 Pour the milk into a pot with the candy milk in the large pot.
thermometer attached to the side making sure 6 If you are using a powdered culture, follow the
the bottom of the thermometer isn’t touching the manufacturer’s directions when adding the powder
bottom of the pot. to the warmed milk in the pot.
3 Heat the milk over a burner turned to medium- 7 The directions for making yogurt are identical
high until the milk reaches the boiling point (180°F), up to this point. Read on for descriptions of three
stirring constantly. different methods you can use at home (without
4 Immediately remove from heat and let the milk a yogurt maker).
cool down to 110–115°F.

Method 1 Method 2
If you own a heavy enameled cast iron pot this is the This is how I used to make yogurt before I owned
way to go. If you use it for the first part of the process a cast iron pot. Place the milk mixture in a large ster-
described above the cast iron will be nice and warm ilized glass jar with a tight fitting lid. Wrap a small
when you add the yogurt or powdered culture to the quilt, comforter or child’s sleeping bag around the
milk. Simply turn the light on in your unheated oven. jar and put it on top of your fridge. The motor of
Cover the pot with its cast iron lid and place the pot the plugged in fridge lets off a bit of heat and if you
in the oven close to the side where the oven light is place the wrapped up jar towards the back of top
located. The heat from the light bulb will keep the of the fridge your jar will stay nice and warm. Again,
oven warm. Leave the pot without disturbing it for leave it for 24–37 hours.
at least four hours or more. You can take it out of
the oven after that, but let it ferment for 24–37 hours
before you put it in the fridge. I usually do my yogurt Method 3
prep just before bedtime, leave everything in the
An insulated thermos makes a great incubator too.
oven overnight and always have a good result in the
Simply pre-heat the interior by filling the thermos
morning. What could be easier than that!
up with really hot tap water and set it aside until you
are ready for it.
*Note: If you find your yogurt is thinner than you like simply place
the yogurt in a fine sieve, lined with a few layers of cheesecloth and
place the sieve over a deep bowl. Let the yogurt drain out until it
thickens into the required consistency.

Sausage Spice Blends
Having a couple spice blends on hand that you can prep ahead of time is a great tool to have when you’re
on The SIBO Diet. That way you know you have a couple of spice blends you can use when cooking without
having to check your yes/no list. You can even make one up to carry in your purse if you plan to eat out and
ask the waiter to keep your food unseasoned (like a simple grilled meat) and season it yourself.
Spicy Italian Sausage Spice Blend

This is the spice blend used for the sausage recipe on page 117 but it’s also a great spice blend to have on
hand for other foods you’d like to season.
Serves: 4 | Total time: 3 minutes
Ingredients Directions
1 Tbsp dried oregano 1 Combine spices to create the spice blend.

1 tsp crushed red pepper flakes Double, triple or quadruple the recipe to make
bigger batches.
1 tsp fennel seed
2 Store in a glass jar or reuse a salt shaker.
1–2 tsp sea salt
3 Use on anything you want!
1 tsp fresh cracked black pepper
⅛ tsp cayenne pepper, or more to taste

Savory Sage Spice Blend
Serves: 4 | Total Time: 3 minutes
1 tsp rubbed sage 1 Combine spices to create the spice blend. Double, triple
1 tsp marjoram or quadruple the recipe to make bigger batches.
½ tsp sea salt

2 Store in a glass jar or reuse a salt shaker.
⅛ tsp ground cinnamon

3 Use on anything you want!
⅛ tsp ground nutmeg

Lemon Ginger Vinaigrette Dressing
Having a salad dressing on hand in the fridge, especially if you’re used to buying store bought salad dress-
ings, can be helpful for when you want to make a quick salad and have something interesting to dress it
with. This very simple dressing is one of my favorites. Keep in mind it won’t store as long as store bought
dressings loaded with preservatives so I’d recommend making this recipe once every 10 days or so and
keeping it refrigerated.
Serves: 6–8 | Total Time: 5 minutes
¼ cup olive oil 1 Combine all the ingredients in a small bowl or

¼ cup fresh lemon juice salad dressing container.
1 Tbsp fresh grated (or finely chopped) ginger

2 If in a bowl whisk the ingredients together until
they are well blended. If using a salad dressing
1 tsp dried oregano
container shake vigorously until the ingredients are
Pinch of salt blended together.
3 Serve over your favorite salad and enjoy.

Breakfast
If you’re used to having tons of grains like cereals and muffins for breakfast, then
breakfast on The SIBO Diet will be a bit of a change of pace. If you’re in a hurry
you can always do something simple like scrambled eggs and be on your way but,
if you have a little time, you can make a frittata or some sausage patties to eat
throughout the week or freeze for later. Here are some ideas to get you started.

Banana Nut Muffins
This is a perfect recipe for using up bananas that are overripe and passed their prime. Ready in twenty five
minutes, this version of banana bread serves one. You simply mix the ingredients up, pop it in the oven and
presto; a nice warm and moist banana bread to start the day.
½ Banana, mashed 1 Pre-heat oven to 350 degrees

1 Egg, beaten 2 Whisk egg in a small bowl.
2 Tbsp almond flour* 3 Combine with mashed banana, honey, coconut oil & vanilla in
1 Tbsp coconut flour* a small bowl.
1 Tbsp honey*
4 Add the almond flour, coconut flour, baking soda, cinnamon & salt.
Mix until all ingredients are well combined.
1 Tbsp almond butter
5 Spoon the batter into a large-sized, oiled muffin tin.
1 tsp coconut oil
6 Bake on the middle rack of the pre-heated oven for 20 minutes.
¼ tsp vanilla
You can double the recipe for two beautiful banana nut muffins.
¼ tsp baking soda
* denotes limited amount—please see yes/no list on page 70
Pinch of Cinnamon
Pinch of Salt

Banana Nut Smoothie
2 bananas, frozen 1 Place all the ingredients in a blender and

½ cup Homemade Yogurt (see recipe on page 98) process on high speed for one minute until
everything is well blended.
½ cup coconut milk*
2 Enjoy!
½ cup coconut water
2 Tbsp almond butter*
2 Tbsp honey*
2 or 3 ice cubes

Green Smoothie
1 banana, frozen and cut into chunks 1 Place all the ingredients in
2 cups baby kale leaves or spinach leaves a blender and process on high
speed for one minute until
½ cup strawberries, frozen
everything is well blended and
1 kiwi, peeled the kale leaves are completely
¾ cup cold water (or ½ cup water and 2 or 3 ice cubes) incorporated into the smoothie.
½ cup coconut milk* * denotes limited amount—please see
yes/no list on page 70
½ cup Homemade Yogurt (see recipe on page 98)
2–3 Tbsp. honey*

Breakfast Bowl
I make a breakfast bowl when I want to change it up a bit in the morning. I’ve used ground beef in this bowl
but you could easily substitute any ground meat you have on hand. There’s also a wide range of spice and
herb options that work equally well. You could opt for a curry flavored breakfast bowl or throw in oregano
and basil for an Italian version of this versatile dish. If I have leftover Roasted Root Vegetables (from the reci-
pe on page 125) from the night before I’ll use those instead of the cooked squash. Tasty and filling, a break-
fast bowl is the perfect way to fuel your body for the busy day that lies ahead.
½ lb Ground Beef 1 In a skillet heated to medium-, sauté the sliced

2 cups kale or spinach leaves, leek in olive oil until it softens.
shredded & tightly packed 2 Add the ground beef to the skillet and continue
½ Leek, sliced thinly* to stir and cook the beef/leek mixture until the beef
is browned and cooked through.
½ cup butternut squash, cooked*
3 While continuing to stir the mixture, add the
¼ cup almond milk
cooked squash, almond milk and thyme leaves.
1 Tbsp fresh thyme leaves 4 When all the ingredients are heated through,
2 tsp olive oil adjust the seasonings with salt & pepper, divide
Salt & pepper to taste into two bowls and serve.

Leek & Roasted Red Pepper Frittata
It’s hard to beat eggs in the morning. When served in a frittata with roasted red peppers, leeks and an aged ched-
dar cheese, the end result is a scrumptious combo your family will love even if they are not eating The SIBO Diet.
8 Eggs, whisked 1 Roast the pepper. To do 2 Sauté the sliced leeks in olive
1 Red pepper, roasted this, first remove the seeds and oil in a small sized skillet placed
and cut into small dice membrane and then cut it into flat over medium-high heat.
pieces. Put the pieces skin side up 3 Add the roasted red pepper
2 Leeks, white part
on a cookie sheet that has been and spread the leek and pepper
only—thinly sliced*
lightly oiled with your cooking fat mixture evenly over the bottom
½ cup aged cheddar cheese, of choice. Place the cookie sheet of the skillet.
grated (use white cheese)* under the broiler in your oven 4 Pour the whisked eggs into
1 Tbsp olive oil and leave the peppers pieces
the skillet slowly so the leek/
there until they are charred. Once
1 tsp basil (or 1 Tbsp fresh leaves pepper mixture remains evenly
blackened, remove them from the
chopped finely) dispersed around the bottom of
oven and let the peppers cool.
¼ tsp sea salt the skillet.
You will find the charred skins pull
Grinding of pepper off easily and the resulting roasted 5 Turn the heat down to
pepper pieces will have a deep medium and when the egg
and mellow flavor. begins to firm up on the bottom,
gently lift the sides of the
firming egg so that the liquid
egg on top runs underneath the
firmed up egg. Lift various areas
around the edge and repeat the
process. When the egg is almost
completely firm sprinkle the
cheddar cheese over the top and
pop the skillet under the broiler
in the oven to melt the cheese.
6 When the cheese is bubbling
and slightly browned remove the
frittata from the oven and serve.
* denotes limited amount—please see

Main Courses
The great thing about The SIBO Diet is that protein (other than processed stuff
with added sugars like many brands of bacon) isn’t limited. This gives you a ton
of flexibility when it comes to creating main courses.
Remember, as we discussed on page 92, the quality of the meat, poultry, eggs and fish is important. Choose
pasture-raised, free-range, wild-caught and organic whenever possible.
Beef

Beef Carnitas with Coconut Flour Tortillas
Serves: 2 | Total Time: 8 hours
Ingredients
Beef Carnitas For the Tortillas Optional Additional Toppings:

2 cups water 5 egg whites Shredded Cheese*
1 (1 lb) sirloin steak ¼ cup coconut flour* Broccoli*
1 bell pepper, sliced ¼ cup unsweetened almond Shredded Napa Cabbage
1 tsp paprika milk (without thickeners)*
1 tsp cumin 1 tsp cumin
½ tsp cayenne ½ tsp chili powder
1 tsp chili powder ¼ tsp sea salt
1 tsp salt coconut oil
Directions
1 Mix together the paprika, For the Tortillas (makes 4 tortillas) 8 Cook for 2–3 minutes on one
cumin, cayenne, chili powder, 1 Add the egg whites, coconut side, until the exposed side is no
and salt in small bowl to make flour, almond milk, cumin, chili longer shiny.
a spice rub for the beef. powder and salt to a blender or 9 Flip carefully, using a large
2 Rub the spice rub mixture all food processor. spatula.
over the sirloin steak, massaging 2 Process until well combined. Cook another 1–2 minutes, or
10
it into the meat. It will be thin. until browned.

3 Place the steak in the slow 3 Allow the batter to sit for 11 Remove, and set aside.
cooker then pour the water 5–7 minutes. 12 Repeat with remaining batter
around it. 4 Place a small nonstick skillet to make 4 tortillas.
4 Turn the slow cooker on low over medium heat. 13 Do not place them on top of
for 8 hours. 5 Add the coconut oil and move each other; they will stick! A paper
5 After 8 hours, remove and the pan around to make sure it towel lined plate works best.
shred the beef with two forks. covers the entire surface.
Remove the bones and place the To Assemble:
6 Using a ladle, add ¼ of the
meat back into the juices until 1 Spoon the beef into the
mixture to the hot skillet.
ready to serve. tortillas. Add the bell peppers,
7 Lift it up and move it around
and other veggies if desired.
to spread the batter around in
a circle in the skillet. yes/no list on page 70

Spaghetti & Meatballs: Paleo Style
Serves: 4 (32 small meatballs) | Total Time: 45 minutes
Ingredients
1 lb Italian Spiced Turkey Sausage

(see recipe on page 117)
12 ripe plum tomatoes
2 leeks (white part only), sliced thinly*
6 Tbsp fresh basil
4 Tbsp flat leaf parsley
4 Tbsp fresh oregano leaves
2 Tbsp butter
1 Tbsp olive oil
Salt & pepper to taste
Directions
1 Preheat oven to 350 degrees 6 Meanwhile, cut the end out of each tomato
2 Make small meatballs using the turkey sausage and chop them all coarsely. When the leeks have
by rolling about a tablespoon of the sausage meat softened and start becoming translucent, add the
between the palms of your hands. One pound of chopped tomatoes to them.
sausage meat should make 32 small meatballs. 7 Bring the leek and tomato mixture until they
Rubbing a scant amount of oil on your palms will start simmering and then lower the heat to a point
keep the meat from sticking. where the mixture continues to cook at a bare
3 Brush rimmed cookie sheet with a small amount simmer. Cook for 15 minutes, stirring occasionally.
of oil, or line it with parchment paper. Place 8 Add the parsley, oregano and 2 tbsp of the basil
meatballs on the cookie sheet. Bake meatballs for to the sauce and continue to simmer for another
20 minutes. 5 minutes.
4 Chop the flat leaf parsley, snip the oregano 9 The meatballs should be just coming out of the
leaves off of the stems, chiffonade the basil into oven now. You can add them right into the tomato
thin strips and set aside. sauce and simmer for another 5 minutes. Adjust
5 Heat the butter and the olive oil in a saucepan the seasoning by adding salt & pepper to suit your
over medium-high heat. When the oil/melted taste buds. Serve over zucchini noodles (recipe
butter mixture is very hot add the leeks. Sauté for follows) and garnish with reserved basil.
three or four minutes.

Quick Zucchini Noodles
4 small yellow zucchini* 1 Cut the zucchini lengthwise into very thin slices
1 Tbsp butter 2 Now carefully cut each slice into flat “noodles” lengthwise.
salt & pepper 3 Melt the butter in a medium sized frying pan place over a burner
set to medium high
4 When the butter has melted and is hot add the zucchini noodles all
at once. Sauté until the noodles become somewhat soft and are heated
through. This won’t take very long; about 4 or 5 minutes at most.
5 Adjust the seasoning with salt and pepper to taste.

Beef & Veggie Soup
I’ve used carrots, cabbage, leeks and broccoli in this recipe but really you can use whatever veggies you have
on hand. Just make sure you pay attention to the amounts you use according to the foods allowed list so
you can accurately figure out the number of portions you’ve made.
Serves: 4 | Total Time: 1.5 hours
1 lb marinating beef steak cut into 1 inch cubes 1 Heat butter and olive oil in
1 qt Beef Bone Broth (recipe on page 93) large soup pot over medium
high heat.
4 cups shredded cabbage*
2 Add leeks and sauté for
2 cups broccoli, cut into small pieces*
1 minute before adding the
2 Leeks, white part only, sliced thinly* cubed beef. Sauté the leek and
2 medium size carrots, finely diced beef mixture for 2 more minutes
until the meat begins to brown.
2 Tbsp fresh thyme leaves
3 Add the diced carrots and
1 Tbsp butter
shredded cabbage to the pot
1 Tbsp olive oil followed by the beef broth and
1 bay leaf bay leaf. Once the soup starts
to boil, turn down the heat and
let the soup simmer for about
45 minutes before adding the
broccoli and fresh thyme.
4 Simmer for another
15 minutes then correct the
seasoning by adding salt and
pepper if needed.

Beef and Broccoli
1 round steak, cut into strips 1 Add the coconut oil to a medium skillet and heat
1 cup broccoli, cut into florets (½ each serving)* on medium-high.
1 orange
2 Add the steak strips to the hot skillet and sauté
for 3–4 minutes.
1 Tbsp apple cider vinegar
3 Add the broccoli, juice from the orange, apple
½ inch ginger, minced
cider, and ginger.
sea salt and black pepper, to taste 4 Season with salt and pepper.
coconut oil 5 Continue to sauté until the steak is cooked to
desired doneness.

Poultry
Yellow Zucchini Pasta with Turkey Meatballs

Ingredients
½ lb ground turkey

2 yellow zucchini
3 tomatoes, quartered
1 egg
1 Tbsp almond meal*
1 Tbsp oregano
4–5 basil leaves
½ tsp salt
olive oil
salt and pepper, to taste
Directions
1 In a medium mixing bowl,
add the turkey, almond meal,
turkey, oregano, and ½ tsp. salt.
2 Use your hands to mix well.
3 Form meatballs (about 6)
and set aside.
4 Heat a medium skillet over
medium-high heat. Add a drizzle 6 Use a spiralizer to create the 9 Sauté the “noodles” until
of coconut or olive oil.
yellow zucchini pasta. Set aside. warmed through.
5 Place the meatballs in the 7 Add a drizzle of olive oil or 10 Serve with meatballs and
hot skillet and cook 3–5 minutes
coconut oil to the same pan the garnish of fresh basil.
on each side, turning frequently
meatballs were cooked in. * denotes limited amount—please see
to brown all sides until cooked
through. Remove to heat and
8 Add the yellow zucchini pasta
set aside. and quartered tomatoes. Season
with salt.

Lemon Dijon Chicken
This recipe comes together quickly and is a perfect choice when you need a meal in a hurry. You could also
double the recipe and use the leftovers for a chicken salad for the next day.
2 chicken breasts 1 Preheat oven to 350°F 6 Place the casserole on the

¼ cup chicken broth or white wine 2 Rub each chicken breast with middle rack of the preheated
1 Tbsp of dijon mustard on both oven and bake for 20 minutes or
2 Tbsp dijon mustard
sides and place side by side in until the internal temperature of
2 Tbsp mayonnaise the chicken reaches 165 degrees.
a small casserole dish. Grind
grinding of pepper pepper over them. 7 Remove the chicken. Put it on
5 or 6 sprigs of fresh thyme 3 Sprinkle the zest from the a plate and drain off the juices.
lemon over the chicken breast Collect the juices in a bowl. You
Juice and rind (grated)
and drizzle the juice from the may need to strain the juices to
from ½ lemon
lemon over top of everything get out the small bits of chicken.
4 Top the chicken breasts with
8 Add 2 tbsp. of mayonnaise
the sprigs of fresh thyme. to the strained juices and whisk
together to make a smooth
5 Carefully pour the chicken
sauce. Serve in a small dish
stock (or wine) around the outside
beside the chicken.
edges of the chicken breasts.

Homemade Italian Spiced Turkey Sausage
Yield: 3 lbs of sausage meat | Prep Time: 5 minutes
Ingredients You will notice I’ve provided measurements for both dried and fresh herbs.
Use three times the amount of fresh herb when substituting fresh herbs
3 lbs ground turkey
for dried herbs; that’s the general rule of thumb. I would recommend us-
3 Tbsp red wine vinegar ing the dried herbs if you are planning on freezing the sausage meat.
1 Tbsp black pepper
1 Tbsp dried parsley
(3 tbsp fresh parsley leaves)
1 Tbsp dried basil
(3 tbsp fresh basil leaves)
1 Tbsp oregano
(3 tbsp fresh oregano)
1 Tbsp ground fennel
2 tsp paprika
2 tsp crushed red pepper flakes
2 tsp salt
1 tsp dried thyme
( 1 tbsp fresh Thyme)
¼ tsp pure stevia (optional—
traditional Italian sausage Directions Serving Suggestion
has just a hint of sweetness 1 Place the ground turkey into 1 Pre-heat oven to 400°F.
and stevia in small amounts
a large bowl and simply add all 2 For a quick meal form egg-
is allowed on The SIBO Diet
of the ingredients listed above. shaped balls of meat and insert
but if you prefer to stick to
Mix everything together until a skewer into the centre of
100% whole foods you can
the spices are evenly distributed each. Place turkey skewers on
definitely leave it out)
throughout the ground meat. a parchment lined cookie sheet
2 Wrap the sausage mixture and bake in the pre-heated oven
up tightly in plastic wrap and for about half an hour. The meat
refrigerate for 12 hours. This should be nicely browned and
gives the flavors a chance to slightly crispy on the outside when
blend and develop before using the turkey skewers are done.
in your favorite recipes or you
can simply freeze for later use.

Coconut Crusted Chicken with Spinach Salad
1–2 chicken fillets 1 Allow the chicken fillets to 5 Place the coated fillets in
1 egg, beaten come to room temperature. the hot skillet and cook for
2 Place the coconut flour on one 4–5 minutes on each side or until
13 spinach leaves
plate, coconut flakes on a separate the fillets are golden brown and
1 tomato, quartered cooked through. Set aside.
plate, and egg in a bowl. This is
2 Tbsp apple cider vinegar your dredging station. 6 In a small bowl, mix the apple
1 Tbsp coconut flour* 3 Place the chicken fillet in the cider vinegar, and honey. Whisk in
coconut flour, coating the fillet. the olive oil until well combined.
1 Tbsp unsweetened
Next dip it into the eggs, turning Season with salt and pepper.
flaked coconut*
to coat the fillet. Finally, put it 7 Plate the chicken with the
½ tsp. clover honey*
in the coconut flakes, turning to spinach, tomato and dressing
drizzle of olive oil coat the fillet. on the side.
salt and pepper, to taste 4 Add the coconut oil to a skillet * denotes limited amount—please see
coconut oil over medium heat.

Seafood
Pecan Honey Mustard Crusted Salmon Salad

Ingredients
For Salmon
2 (5oz) salmon fillets
1 ½ Tbsp pecans, chopped finely*
1 Tbsp gluten-free mustard
1 Tbsp clover honey*
Olive oil, for greasing pan
Salt, to taste
For Salad
1 cup arugula, chopped
1 cup spinach, chopped
1 cup carrots, shredded Directions
½ cucumber, chopped 1 Preheat oven to 350°F. 5 While the salmon is cooking
2 Tbsp pomegranate seeds* 2 Place the salmon on an oiled combine all the ingredients for
1 Tbsp pumpkin seeds, roasted* baking sheet. Season with salt. the salad in a large mixing bowl.
3 In a small bowl combine the
6 In another small bowl whisk
For Dressing together the ingredients for the
chopped pecans, mustard, and
1 Tbsp mustard honey. Mix until a paste forms. Use dressing. Pour the dressing over
1 Tbsp white wine vinegar your hands to cover the top of the the salad ingredients and toss
salmon filets with the paste, being to coat.
1 Tbsp olive oil
sure to press down as you go. 7 Once the fish is done remove
4 Place the salmon in the oven it from the oven.
and bake for 12–16 minutes, 8 Divide the salad evenly
until cooked through and flakes between two plates. Top with
with a fork. the salmon fillets and serve.

Fish Tacos
2 4oz cod filets 1 Preheat oven to 400°F.

10 cherry tomatoes, quartered 2 In a small bowl mix together the cumin and smoked paprika.
4 lettuce leaves 3 Place the cod filets in a baking dish. Drizzle the fish with the olive
(These will be your tacos; oil. Season with salt to taste. Sprinkle the spice mix over the fish,
Boston Lettuce works well) dividing evenly.
1 Tbsp olive oil 4 Bake in the oven for 13–16 minutes, until the fish is cooked through
1 Tbsp fresh parsley, chopped and flakes with a fork.
1 tsp cumin
5 Remove the fish from the oven. Divide each of the fish filets
between the lettuce leaves, making 4 tacos total. Divide the chopped
1 tsp smoked paprika
tomatoes between the tacos. Serve with lemon wedges and sprinkle
Salt, to taste with fresh parsley for garnish.
4 lemon wedges, for garnish

Shrimp Kabob
About 20 shrimp shrimp, 1 Place the shrimp in a small bowl and add the lime juice, chili
peeled and deveined powder, cumin, and sea salt. Stir to coat. Set aside for 10 minutes.
3 bell pepper, cut into large chunks 2 Soak 4 bamboo skewers in water while the shrimp is marinating.
3 tomatoes, cut into large chunks 3 Spear a bell pepper, follow by a shrimp, then a tomato, and repeat
1 tsp chili powder until skewer is full. Repeat until all the ingredients are used.
1 tsp cumin
4 Heat the coconut oil in a grill pan over medium high heat.
½ tsp sea salt

5 Once the oil is melted, place the skewers into the hot pan. Grill
4–5 minutes on each side, or until the shrimp is pink and cooked
Juice from 1 lime
through.
Coconut Oil 6 Serve immediately. Enjoy!
4 small bamboo skewers
or 2 long skewers

Side Dishes
The main courses on The SIBO Diet are pretty easy, since you have so many
protein options to choose from. The side dishes are where things can sometimes
get tricky since the vegetable list is the one that is much more restrictive in
terms of which vegetables are allowed and which ones need to be limited.
Please note the asterisks on these recipes; those are ingredients which have been carefully measured out so
that they are compliant with the quantities allowed on The SIBO Diet. Use these side dish recipes as starting
points to create your own recipes as well!

Honey Ginger Carrots
½ lb carrots, peeled and cut into 1 Preheat oven to 400°F.

strips 2 In a large bowl whisk together the olive oil, honey, and fresh ginger.
1 Tbsp fresh ginger, grated Add the carrots and toss to coat.
1 Tbsp clover honey* 3 Spoon the carrots onto a baking sheet.
1 Tbsp olive oil 4 Bake in the oven for 20–25 minutes, until fork tender.
1 tsp sesame seeds* 5 Transfer the carrots to a plate. Sprinkle with sesame seeds and serve.
sea salt to taste * denotes limited amount—please see yes/no list on page 70

Sautéed Bok Choy
2 cups (170g) bok choy, washed* 1 Heat 1 Tbsp of olive oil in a skillet over medium heat.
2 scallions, green part only, 2 Cut the bok choy in half lengthwise.
chopped 3 Add the bok choy and grated ginger to the skillet. Sauté until the
1 Tbsp olive oil bok choy softens and the leaves turn dark green, about 4–6 minutes.
1 Tbsp fresh ginger, grated 4 Remove from the pan and place in a serving bowl. Garnish with
1 tsp sesame seeds* the chopped scallions and sesame seeds. Season with salt to taste
and serve.
sea salt to taste

Roasted Root Vegetables
Roasting root vegetables deepens their flavor and is a perfect way to cook them during the autumn and win-
ter months. Simply toss the cut veggies with a bit of oil and sprinkle on your favorite seasonings. Make sure
to cut the veggies into chunks of a similar size so they are all done at the same time. The smaller the chunks
the faster they’ll cook so, if you are in hurry, cut the veggies smaller.
Serves: 6 | Total Time: 50—55 minutes
1 cup rutabaga, cut into ½″ cubes 1 Preheat the oven to 350°F

1 cup parsnips, cut into ½″ cubes* 2 Place cut vegetables in a flat bottomed casserole dish.
1 cup carrots, cut into ½″ cubes 3 Drizzle the olive oil over the veggies and toss them around until
¾ cup butternut squash, they are evenly coated.
cut into ½″ cubes* 4 Distribute the thyme, herbs de provence, salt & pepper evenly over
2 Tbsp olive oil the vegetables.
1 tsp thyme
5 Place casserole dish on the middle rack of the preheated oven
6 Roast the vegetables for 35–40 minutes, stirring once or twice until
they are cooked through and beginning to brown slightly.

Indian Style Cabbage
For a veggie side dish that comes together quickly, consider this recipe for a spicy cabbage stir-fry with the
aroma and flavors of India. I use chili flakes and fresh ginger to add a bit of heat to this dish. Serve with a dol-
lop of Homemade Yogurt (see recipe on page 98) on the side if you want to temper the heat a bit.
Serves: 4 | Total Time: 18–20 minutes
Ingredients
4 cups cabbage, shredded*

1 Tbsp Garlic Infused Olive Oil
2 tsp fresh ginger, finely minced
1 tsp turmeric
½ tsp mustard seed
½ tsp garam masala
½ tsp herbs de provence
¼—½ tsp chili flakes, (depending
on how hot you like it)
¼ tsp sea salt
Grinding of pepper
Directions
1 Heat oil on medium high in a wok or large frying pan.
2 Add the mustard seed and swirl around in the hot oil for 1 minute
then add the garam masala, turmeric, chili flakes and minced ginger
and continue to sauté for another 2 minutes.
3 Add the shredded cabbage and cook, stirring continually for at
least 5 minutes. This will give you a somewhat crunchy cabbage so
simply continue to cook and stir the cabbage a bit longer if you prefer
a softer version of cooked cabbage.

Mock Potato Salad
You don’t have to give up potato salad! Well, actually you do but you won’t mind because you can still enjoy
the flavors you love by substituting rutabaga for potato. I know it sounds odd but give it a try. You’ll find your
mock potato salad tastes so much like the original version that your family and friends won’t even know the
difference; unless, of course, you tell them!
Ingredients
4 cups rutabaga, cut into ½″ cubes

2 hard boiled eggs
⅓ cup celery, diced small
green parts of 3 scallions,
sliced thin
½ cup mayonnaise
1 tsp dijon mustard
sea salt & pepper to taste
sprinkle of paprika
Directions
1 Cover rutabaga with water in a large pot and bring to the boil. Adjust
heat under the pot and continue to boil until the rutabaga is cooked
through but remains firm and is not mushy. Drain and set aside to cool.
Chill the cooled rutabaga in the fridge until you are ready to assemble
the salad.
2 When it’s time to assemble the salad, mash the hard boiled
eggs with a fork in a bowl large enough to accommodate all the
ingredients.
3 Add the rutabaga, diced celery, sliced scallion and combine with the
mayonnaise making sure everything is evenly coated.
4 Add salt and pepper to taste.
5 Serve on a platter or in a bowl garnished with a sprinkle of paprika.

Snacks
I’m honestly not much of a snacker. Ever since I switched from the Standard
American Diet of processed foods to a real food diet, I just don’t feel that
hungry between meals.
Okay, I will admit that it is also because I’m a bit lazy. If I do want a snack, I’ll usually just crack open a can
of wild caught sardines (awesome source of Omega-3s!) or a can of smoked oysters (great source of Zinc!),
sprinkle on some sea salt, and eat it straight out of the can. I know that’s probably not everyone’s cup of tea
so I’ve included this snack section to give you some ideas of what you can make if you’re in a munchy mood
or have a party you want to make snacks for.

Sesame Seed Crackers
Serves: 8 (makes 32 crackers—4 per portion) | Total Time: 23–25 minutes
1 cup almond meal* 1 Preheat oven to 325°F

4 Tbsp toasted sesame seeds* 2 Mix together the almond meal and toasted sesame seeds.
1 egg white 3 Mix the egg white, dijon mustard and softened butter into the dry
1 Tbsp soft butter ingredients. Do this by hand making sure the ingredients are all evenly
incorporated.
¼ tsp sea salt
4 Using a teaspoon, make small mounds of the mixture on cookie
¼ tsp dijon mustard
sheets that have been lined with parchment paper and then flatten
(gluten free, no extra additives)
gently using the back of a spoon until they’re about ¼ inch thick.
There should be enough of the cracker mixture to fill two 9″ × 13″
cookie sheets.

Labneh
Labneh is the Lebanese version of cream cheese that’s made using a full fat yogurt. It has a creamy, tangy
flavor that you’ll love.
Serves: makes 2 cups | Total Time: 12 hours + 5 minutes prep time
Ingredients
4 cups full fat Homemade Yogurt

(see recipe on p. 98)
¼ tsp sea salt
Directions
1 Line a large sieve with a few
layers of cheesecloth so that the
cheesecloth hangs over the top
edge of the sieve and set the
sieve over a deep bowl.
2 Mix together the yogurt and
sea salt until the salt is evenly
incorporated and place mixture
into the lined sieve.
3 Cover with a plate and let
the liquid from the yogurt/salt
mixture drip into the bowl for
a 24 hour period. You will be
left with a dense cream cheese
that has a mellowed yogurt-like
flavor. Refrigerate the Labneh in
a tightly covered container until
ready to be used.

Labneh Herb Dip & Veggie Platter
Customize this dip by using your favourite fresh herbs and serve with raw veggies of choice.
Serves: makes 1 cup | Total Time: 15 minutes
1 cup Labneh (see recipe on page 130) 1 Combine Labneh, mint,

½ Tbsp fresh mint leaves, chopped finely thyme, basil, and 1 tablespoon
of the garlic infused olive oil.
½ Tbsp fresh thyme, chopped finely
2 Place the mixture on a small,
½ Tbsp basil leaves, chopped finely
flat serving dish. Spread the dip
2 Tbsp Garlic Infused Olive Oil (see recipe on page 97) out somewhat, swirling it around
1 Tbsp toasted pine nuts* to form shallow grooves across
the surface.
1 sweet pepper, seeded and cut into strips
3 Drizzle the rest of the garlic
2 carrots, cut into small sticks
infused olive oil over the dip.
½ English cucumber, cut into thin wedges
4 Garnish with toasted pine nuts.
½ cup broccoli, cut into small florets*
5 Arrange the veggies on a plat-
ter and serve next to the dip.

Banana Egg Muffins
Makes: 8 muffins | Total Time: 15 minutes
2 ripe bananas, mashed 1 Preheat oven to 375°F.

4 eggs, beaten 2 In a large bowl mix together the bananas, eggs, almonds and
1 Tbsp chopped almonds* vanilla extract.
1 tsp vanilla extract

3 Pour the batter into 8 muffin cups lined with cupcake liners.
4 Bake in the oven for 12–15 minutes, until the muffins are cooked
through.
5 Remove from the oven and serve.

Honey Ginger Hot Wings
Chipotle powder adds heat so feel free to use less for a gentler effect.
1 lb chicken wings 1 Preheat oven to 350°F 4 Line the wings up on a foil-
½ cup honey* 2 Wash the chicken wings and lined rimmed cookie sheet and
pat them dry then place the sprinkle the toasted sesame
1 ½ Tbsp fresh ginger,
wings in a bowl large enough to seeds over top. Place the pan
peeled & minced
hold them all. on the middle rack of the pre-
1 Tbsp Garlic Infused Olive Oil heated oven.
3 Mix the honey, minced ginger,
chipotle powder and garlic
5 Bake for 15 minutes then
1 Tbsp lightly toasted remove from the oven and,
infused oil together and pour
sesame seeds using a brush, baste the wings
this mixture over the chicken
½ tsp chipotle powder wings, tossing them to make with some of the honey glaze
sure they are all evenly coated. that has dripped off of the wings
and onto the surface of the pan.
Be careful not to dislodge the
sesame seeds.
6 Return the wings to the
oven and bake for another
5–8 minutes until they are a nice
golden brown and cooked
through.

Desserts
Sometimes you just need a little treat. It may seem like desserts are impossible
on The SIBO Diet but with a few pieces of the allowable fruit, a few nuts and
a dash of the allowable sweeteners you can make the occasional treat that
you’ll enjoy.
Before my SIBO diagnosis stevia was not a sweetener I would turn to, opting for more natural sweeteners
like maple syrup or raw honey. Since maple syrup is not possible with SIBO and only certain types of honey
like clover are allowed (which can get a little repetitive), I’ve included a few recipes which use small amounts
of stevia. Of course, you’re welcome to skip those recipes or substitute the stevia for what works for you.
Green stevia like the one found on our resource page here at www.hollywoodhomestead.com/sibo-ebook-
resources is more natural than it’s white powdered counterpart so I would opt for the green one if you can.

Whipped Banana with Walnut
This is a great alternative to ice cream. It is quick and easy when you just need a little treat!
1 frozen banana 1 Add the walnuts to your food processors bowl.

10 walnuts* Pulse until nuts are broken into small pieces.
Do not over process or it will turn into nut butter.
Drizzle of clover honey* (about ½ tsp)
2 Add the frozen banana and honey.
Ground cinnamon, to taste
3 Process for about 30 seconds, until the banana
is creamy.
4 Serve immediately and garnish with a banana
slice and ground cinnamon, if desired.

Honey Meringue Kiss
Light and airy, these little melt-in-the-mouth meringue cookies are sweetened with honey. They go together
quickly as there are only two ingredients. However, you need to make these on a day when you will be home
for a few consecutive hours as they require a long, slow bake in an oven set at a low temperature. You will
notice that these Meringue Kisses made with honey have a more golden hue than traditional meringues,
which are usually completely white.
Serves: Makes about 35 little meringue kisses | Total Time: 2 hours + 5 minutes prep time
Ingredients 4 Adjust the heat so that the water maintains

2 egg whites a slow rolling boil. It’s best to wear an oven mitt
on the hand holding the bowl as escaping steam
¼ cup clover honey*
could easily scald your fingers.
Directions 5 Beat the honey and egg white mixture for five
1 Preheat oven to 200°F minutes. Turn the burner off. When you remove the
bowl from the heat, the mixture will be a slightly
2 Place egg whites and honey in a stainless steel
off-white golden color and holding stiff peaks.
bowl. Set the bowl over a saucepan filled with water
to a depth of about 3 inches. Place on the bowl and 6 If you have a piping bag, place the beaten egg
saucepan set-up on a stove-top burner and set it to white mixture into the bag and pipe out 1″ diameter
high. If you have a double boiler, use this! kiss-shaped mounds onto a parchment lined
cookie sheet. An alternate method is to use a food-
3 Using a hand-held mixer set to high speed, beat
safe plastic bag with a small hole cut out of one
the egg whites while the water beneath the bowl
corner for the piping process. Of course, simply
comes slowly to the boiling point.
mounding the egg white mixture onto the cookie
sheet using a teaspoon is also acceptable (and
definitely the easiest method).
7 Place the cookie sheet on the middle rack of
a pre-heated oven for 2 hours. When the time is up
you will notice that the cookies are still somewhat
moist and sticking to the parchment paper. Don’t
despair, the meringue kisses will dry out and
harden as they cool. You will find they are no longer
sticking to the parchment paper once they have
cooled completely. Store the meringues in an air-
tight container at room temperature.

Macaroon Cookies
When you are in the mood for a little something sweet, a macaroon cookie is hard to beat. I like to bump the
flavour up a notch by giving the coconut a light toasting in the oven before mixing up the macaroons. If you
decide to go this route, make sure you watch that coconut like a hawk while it’s toasting in the oven. It goes
from a lovely golden brown to being burnt black in a matter of seconds.
This recipe is for a small batch of cookies as the coconut flour and unsweetened coconut are items that
can only be consumed in measured amounts on The SIBO Diet. One cookie equals one serving.
Coconut, although allowed in small quantities on The SIBO Diet can be problematic for some. My recom-
mendation is to try it in small doses and see how it works for you. In other words, try 1 cookie, not a half dozen :)
Serves: 8, 2″ cookies; 1 cookie = one serving | Total Time: 30–33 minutes
1 cup unsweetened coconut, 1 Preheat oven to 350°F 4 Gently fold the egg whites
toasted* 2 Mix the coconut, coconut and the coconut mixture
2 egg whites flour, honey and vanilla together together.
⅓ cup honey* 3 In a separate bowl, whip the

5 Line a cookie sheet with
egg whites using a hand mixer parchment paper and divide
⅛ cup coconut flour*
on high, until they form stiff the batter into mounds with
½ tsp vanilla a diameter of about 2″.
peaks.
6 Bake on the middle rack of
the oven for 15–18 minutes or
until the cookies have turned
a golden brown on top. Remove
to a wire rack and when cool
store the cookies in an airtight
container.

Strawberry Preserves
1 cup frozen strawberries 1 In a stainless steel pot over medium-high heat, lightly boil
2 Tbsp honey* strawberries and honey for 5 minutes.
2 Mash strawberries with a potato masher.
3 Let cool and it’s done!

Coconut Ice Cream Banana Split
Makes: 8 servings (1 serving = 2 scoops)

Total Time: 15 minutes, cooling time in fridge—4 hours, freezing time will depend on the brand of your
ice cream maker!
4 cups coconut milk* 1 Gently warm the honey over low heat until it becomes more fluid.
4 egg yolks 2 Mix coconut milk, egg yolks, and vanilla together in a stainless steel
½ cup honey* bowl.
1 tsp vanilla
3 Slowly add the warm honey into the remaining ingredients while
mixing well.
Banana slices
(about ½ banana per split)
4 Refrigerate the mixture until it is cool (optional but recommended).
Strawberry preserves
5 Place two scoops of ice cream into a bowl, decorate with banana
(about 1 Tbsp per split; made slices and strawberry preserves. There will be enough ice cream for
with honey—see recipe on 8 servings. Don’t eat more than one serving as the amount of coconut
page 138) milk you can consume in one sitting on The SIBO Diet is limited.

Shortbread Cookies
Serves: 3 (2 cookies per serving) | Total Time: 15 minutes
6 Tbsp coconut flour* 1 Preheat oven to 350°F.

4 Tbsp butter (or coconut oil), 2 Add the ingredients to a large mixing bowl. Use a wooden spoon to
melted mix all the ingredients together until well incorporated.
2 Tbsp almond butter* 3 Divide the dough into 6 pieces. Roll each piece into a ball and place
2 Tbsp honey* on a baking sheet lined with parchment paper.
½ tsp vanilla extract

4 Press each cookie down with a fork, until the top is flattened.
5 Bake in the oven for 7–10 minutes, until the cookies begin to brown.
6 Remove from the oven and allow to cool before serving.

Homemade Yogurt Parfait with Honey and Blueberries
1 cup plain Homemade Yogurt (24 hour) 1 Add ¼ cup yogurt to a cup.

recipe on page 98 2 Top with 10 blueberries the blueberries.
40 blueberries* 3 Top with another ¼ cup yogurt.
2 Tbsp clover honey* 4 Top with another 10 blueberries.
2 Tbsp sliced almonds* 5 Add layer of 1 Tbsp. honey and 1 Tbsp. almonds.
6 Repeat for second serving.

Coconut Custard
4 eggs 1 Allow the eggs to rest on the 3 Vigorously whisk the eggs in
1 can (15oz) full fat coconut milk counter at room temperature for a medium-sized mixing bowl.
(no fillers)* 10–15 minutes prior to beginning Set aside.
the cooking process. Preheat the 4 Put coconut milk in saucepan
2–3 Tbsp clover honey, to taste*
oven to 350 degrees. and heat over low heat. Add the
1 Tbsp vanilla extract 2 Prepare 6 ramekins by placing honey, vanilla, cinnamon and
1 tsp ground cinnamon them all on a large baking sheet. nutmeg. Stir constantly, until just
¼ tsp ground nutmeg beginning to simmer.
5 Carefully, and slowly add the
milk mixture to the eggs, whisking
constantly until well combined
and beginning to froth.
6 Pour the mixture evenly into
each ramekin, filling them ¾ full.
7 Place in the oven and cook for
30–40 minutes, until the center
of the custard if no longer jiggly.
8 Remove and allow to cool
for 10–15 minutes. Place in the
refrigerator to chill for at least
1 hour.
9 Serve chilled with berries.
Enjoy!

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Introduction 7 11 Herbal Antibiotics for SIBO 44

1 What is SIBO? 9 12 Elemental Diet 49

2 Symptoms of SIBO 13 13 Improving Motility 59

3 Causes of SIBO 19 14 Diet Protocols for Treating SIBO 63

4 Prevalence of SIBO 25 15 The SIBO Diet 67

5 Associated Diseases 27 SIBO Food Lists 70

6 How to diagnose SIBO 30 16 Preventing Recurrence 79

7 Breath Tests for SIBO 33 17 Healing the Gut 83

8 Methane vs. Hydrogen SIBO 36 18 Supplements 87

9 Treating SIBO 40 Parting Thoughts 90

10 Antibiotics for SIBO 42

Basic Staples 93 Side Dishes 122

Garlic Infused Olive Oil 97 Honey Ginger Carrots 123

Breakfast 103 Snacks 128

Banana Nut Muffins 104 Sesame Seed Crackers 129

Main Courses 109

Poultry 115 Honey Meringue Kiss 136

Lemon Dijon Chicken 116 Strawberry Preserves 138

Fish Tacos 120

The SIBO Solution 7 HollywoodHomestead.com

The SIBO Solution 8 HollywoodHomestead.com

The SIBO Solution 9 HollywoodHomestead.com

•• Mouth: Chewing and saliva start breaking down starches.

•• Esophagus: Swallowing brings food to the stomach.

•• Stomach: Muscle movements mix food with stomach acid.

The small intestine is really quite fascinating. It is

The small intestine is arguably the most import-

The SIBO Solution 10 HollywoodHomestead.com

•• Breaking down carbohydrates so they can be absorbed;

•• Helping the gut’s immune system develop;

•• Protecting against disease-causing bacteria;

•• Stimulating the growth of the intestinal lining;

Concentration of bacterial flora in different parts of the gastrointestinal tract

The SIBO Solution 11 HollywoodHomestead.com

The SIBO Solution 12 HollywoodHomestead.com

The SIBO Solution 13 HollywoodHomestead.com

Malnutrition from SIBO

There are t wo ways that

The SIBO Solution 14 HollywoodHomestead.com

•• Vitamin E Deficiency = muscle weakness, vision problems, poor immunity 12

•• Fatigue •• Poor memory

•• Depression •• Nerve problems like numbness or tingling

•• Confusion •• Megaloblastic anemia15

Psychological Symptoms of SIBO

The SIBO Solution 15 HollywoodHomestead.com

The SIBO Solution 16 HollywoodHomestead.com

Remember, the gut-brain axis is a two-way street. Stress, neurological, and

The SIBO Solution 17 HollywoodHomestead.com

•• A study found that SIBO is 10 times

•• Correction of SIBO leads to marked

•• A Russian investigation reported that

•• A Chinese study involving patients

The SIBO Solution 18 HollywoodHomestead.com

•• Stress → Inflammation → Low Stomach Acid → SIBO

•• Stress → Weakened Immunity → Overgrowth of “Bad” Bacteria → SIBO

•• Stress → Weakened Immunity → Infection → Antibiotic Use → SIBO