What is the Prep Diet?
The SIBO breath test involves a 24-48 hour prep diet (the length depends on your doctor’s recommendation), a 12 hour fast prior to the test, and a 3 hour breath test (once every 20 minutes) after drinking a solution of lactulose. Download the SIBO Prep Guidelines.
This includes the 24 hours prior to your test. Some doctors will suggest a longer preparation depending on how fast your intestinal tract is, however that is something you would have to discuss with your doctor. During this prep, stop taking all non-essential medications, supplements, and pro-biotics. This includes over the counter pain medications, allergy medications, and antacids. If you don’t know what medication is considered essential, consult your prescribing physician. The goal is to starve the bacteria for a day in order to produce the best results when doing the test. SIBO bacteria love plant products and sugars, so the only foods that you can have on the prep diet are listed here – if it is not on this list DO NOT eat it:
- Any meat/poultry/fish/seafood that is not cured or brined
- Plain, steamed white rice
- Clear meat broth (made only from the meat, no bone/cartilage or vegetables)
- Fats/oils (coconut/olive/vegetable oils, butter, or lard)
- Salt and Pepper (no other herbs/spices)
- Weak black coffee and/or weak black tea (plain, no sweeteners or cream, NO green or herbal teas)
- Plain water (no mineral water or water with additives)
The prep diet is incredibly restrictive. I really can’t replace things on it?
No. Any changes to the diet can affect the results of the test. The manufacturer of the SIBO test created the prep diet based on their research and testing. Only the things on the prep diet are allowed to get the cleanest results for the SIBO test.
Do I have to eat everything on the prep diet?
No. If you do not eat grains, for example, do not consume the rice. If you do not eat eggs, then do not start just for this diet. Eat things on this list, but only of what you would normally eat.
Can I eat cheese on the prep diet?
Certain doctors will modify the diet to what they feel is the best test for them. At NUNM Health Centers, as a reference lab, we can only go by what the manufacturer of the SIBO test has worked with to create the guidelines for the test. If you doctor has a specific modification (such as hard cheeses) then you must discuss it with them, as we cannot give advice about foods outside of the manufacturer’s guidelines.
Can I eat brown rice/quinoa/etc?
The only grain acceptable on the prep diet is plain, white rice. Other rice/grains have a higher level of fiber and macromolecules that SIBO bacteria like to eat. Any substitutions can give inaccurate test results. If you normally do not eat rice, do not eat any during the prep diet.
What if I’m a vegetarian/vegan?
The SIBO prep diet specifically cuts out plant products and sugars in order to starve the bacteria for a day prior to taking the test, which will give you the most accurate results. If you do not adhere to the diet, the bacteria may not react during the test, leading to possible false negative results. If you do not normally consume meat/eggs, please consult with your doctor to determine your options.
Why is the meat broth so specific on the prep diet?
Regular bone broth is often cooked with cartilaginous bones or meat. When cooked, polysaccharides (specifically glucosaminoglycans or GAGs) from the cartilage leech into the bone broth and can feed a bacterial overgrowth and therefore be problematic for people with SIBO.
It is important that if you consume meat broth for the prep diet, it must be made from ONLY the meat. There cannot be any bone or cartilage included, and it cannot have any vegetables or herbs (aside from salt and pepper) in it. Most store bought broths have ingredients that are not appropriate for this prep diet, so homemade broth is the best decision.
Can I eat cured meats/lox/sausage?
Any meat ingested must be made without any added sugars/brines/cures/etc. to avoid contaminating the prep diet. Avoid meats like deli-meat, lox, and pre-prepared meats that have any other herbs and spices besides salt and pepper. Meats like sausage usually have other herbs or sugars in them and should be avoided during the prep diet.
Can I eat sushi?
The sashimi fish is fine on the prep diet, when eaten alone and without sauce. The rice in Nigiri is usually made with sugar-based binders to make it stick together better, and thus should be avoided on the prep diet. The only exception is home-made Nigiri with steamed white rice and no sauces. Sushi rolls are very much to be avoided.
What about smoking/alcohol?
If you are a smoker, of tobacco or cannabis, there is no recommendation to stop use during the prep diet. However, do not smoke anything for at least one hour prior to taking the breath test, or during the time of the test (4 hours total). If you ingest cannabis in edible form, it must be avoided during the prep diet. Smokeless tobacco (chew) should be avoided during the prep diet and prior to the test as well. Avoid all alcohol during the prep diet.