All 885 tips from all chapters, sorted by topic and confidence score. See what is well supported and what is still experimental.
| Topic | Established | Well supported | Promising | Plausible | Experimental |
|---|---|---|---|---|---|
| Gut barrier | 3 | 14 | 13 | 2 | |
| Opportunistic pathogens | 1 | 11 | 10 | 17 | 1 |
| Bacteriophages | 1 | 1 | 3 | ||
| Microbial diversity | 1 | 8 | 29 | 41 | 2 |
| Gut-brain axis | 1 | 19 | 24 | ||
| Digestive function | 3 | 9 | 25 | 46 | |
| Small intestine colonisation | 3 | 8 | 11 | ||
| Immune system and inflammation | 2 | 5 | 21 | 23 | |
| Total | 7 | 41 | 127 | 175 | 8 |
Tap a number to see the tips below. Darker cells contain more tips.
Small intestine colonisation · Clear selection
Trust score 4 of 5:Well supported Lifestyle
Consistently reduce high-FODMAP foods and observe whether the symptoms ease. If there is no improvement after four to six weeks, end the diet and do not extend it; it probably will not help. A symptom diary before and during the diet makes the effect visible.
Doing low-FODMAP right 1 sources
Trust score 4 of 5:Well supported Lifestyle
Psyllium, two kiwis a day or prunes demonstrably help chronic constipation, regardless of the methane level. Whether methane falls is secondary; what counts is your bowel movements.
Hydrogen sulfide and methane: the other gases in the gut 2 sources
Trust score 4 of 5:Well supported Lifestyle
A temporary diet low in rapidly fermentable carbohydrates relieves symptoms in people who also have IBS. The guideline recommends it there, not as a permanent solution, and it does not treat the overgrowth itself.
Trust score 3 of 5:Promising Lifestyle
Test one group after another to find your personal triggers. Each group over a few days in rising amounts with breaks in between, so that you can link reaction and cause.
Doing low-FODMAP right 1 sources
Trust score 3 of 5:Promising Lifestyle
Only avoid what really causes symptoms. Put everything else back on your plate. Many tolerate smaller amounts of a trigger; the limit is often a question of portion.
Doing low-FODMAP right no source of its own, score based on judgement
Trust score 3 of 5:Promising Lifestyle
Effects add up: better small portions spread over the day than several triggers in one meal. Sugar alcohols in “sugar-free” products count too.
Doing low-FODMAP right no source of its own, score based on judgement
Trust score 3 of 5:Promising Lifestyle
Before eliminating strictly, regular meals, slow eating, less coffee and alcohol, fluid intake and exercise often help already. That is a gentle first step, especially if you tend towards fear of food.
Doing low-FODMAP right no source of its own, score based on judgement
Trust score 3 of 5:Promising Lifestyle
After the test phase, rebuild variety on purpose, step by step, so the gut microbiota can recover. The chapter on prebiotics in small steps explains how.
Doing low-FODMAP right 1 sources
Trust score 3 of 5:Promising Lifestyle
Good sources are cooled potatoes, rice or pasta, oats and green bananas. Even small amounts are a good start. In foods the fibres sit in their natural packaging and are usually fermented more slowly than in a powder.
Prebiotics that build up gently 1 sources
Trust score 3 of 5:Promising Lifestyle
A normal breath test is not the same as being well. Note bloating, pain and bowel movements before, during and after a treatment. Then you can see whether it really helps you, and you have a good basis for your next doctor’s appointment.
SIBO treatments compared: rifaximin, herbs, elemental diet and faecal transplant 1 sources
Trust score 3 of 5:Promising Lifestyle
Every treatment lowers the bacteria only temporarily if the cause remains. Use the time after a course to address medicines, thyroid, blood sugar and breaks between meals.
SIBO treatments compared: rifaximin, herbs, elemental diet and faecal transplant 1 sources
Trust score 2 of 5:Plausible Lifestyle
A lot of meat increases sulfur compounds in stool, and an all-animal diet promotes sulfur-using bacteria. Cutting out vegetables such as cabbage, onions and garlic, by contrast, has not been studied and costs diversity. If single foods bother you, check them in a diary and leave them out selectively.
Hydrogen sulfide and methane: the other gases in the gut 2 sources
Trust score 2 of 5:Plausible Lifestyle
Start with 2 to 3 g a day and increase over two to four weeks. The gut microbiota adapts, and bloating often eases. Spread the amount over meals instead of taking it all at once.
Prebiotics that build up gently no source of its own, score based on judgement
Trust score 2 of 5:Plausible Lifestyle
Introduce one new fibre or powder and wait about a week before the next. Only then can you tell what suits you. Note the amount, time and symptoms, most easily in the symptom diary.
Prebiotics that build up gently no source of its own, score based on judgement
Trust score 2 of 5:Plausible Lifestyle
A walk after eating and enough water help move gut contents and gas along. Both are cheap and do no harm. There are no good studies on this specifically for prebiotics.
Prebiotics that build up gently no source of its own, score based on judgement
Trust score 2 of 5:Plausible Lifestyle
Three to four hours between meals give the cleansing wave time. It only runs when the stomach is empty. Constant snacking through the day interrupts it again and again.
Trust score 2 of 5:Plausible Lifestyle
The cleansing wave runs especially undisturbed at night. If you move your last meal a bit earlier and eat nothing after dinner, you give it room. There is no good evidence for this in SIBO; it follows the mechanism.
Trust score 2 of 5:Plausible Lifestyle
If out of fear of bloating you leave out more and more foods, you starve the diversity of the large-intestine flora and risk nutrient deficiencies. Better: restrict briefly, then reintroduce step by step and note in a diary what you tolerate.
When the small intestine is too densely colonised no source of its own, score based on judgement
Trust score 2 of 5:Plausible Lifestyle
The cleansing wave of the small intestine only runs during breaks from eating, about every 90 to 120 minutes. Three meals with breaks instead of constant snacking give it the opportunity to push leftovers and bacteria towards the colon.
Where the small intestine meets the colon: ileum, valve and caecum 1 sources
Trust score 2 of 5:Plausible Lifestyle
With diarrhoea caused by bile acids, a very fatty meal triggers particularly much bile release. Several smaller meals with a moderate fat share can ease symptoms. Avoiding fat completely makes no sense, because you need it for fat-soluble vitamins.
Where the small intestine meets the colon: ileum, valve and caecum no source of its own, score based on judgement
Trust score 2 of 5:Plausible Lifestyle
The cleaning wave only runs when the stomach is empty. Three meals with breaks and a night-time break of about 12 hours give it a chance. Whether this prevents relapses has not been tested in studies; it is based on physiology and is safe for most people. If you use insulin or are underweight, discuss it first.
Why SIBO comes back: the cleaning wave, underlying causes and prokinetics 1 sources
Trust score 2 of 5:Plausible Lifestyle
No study shows that a permanently strict diet prevents relapses. It can, however, lead to deficiencies, less diversity in the gut flora and fear of eating. Low-FODMAP is meant as a limited phase followed by reintroduction, not as a permanent solution.
Why SIBO comes back: the cleaning wave, underlying causes and prokinetics 1 sources