Here are just a few of the “coping mechanisms” and ingredient substitutes I’ve developed for my SIBO recipes. Feel free to comment and share yours!

Salt

No coping mechanism here, just some good advice:  regular table salt is much more salty than kosher salt; I always use (and recommend you do too) Diamond Brand kosher salt (in the big red box).

Also worth noting, not all kosher salt brands are alike: Morton’s kosher salt (in the blue box) tastes much more salty; using it in the amounts specified in my recipes could make your dishes a LOT more salty-tasting.

Last but not least, if you’re using canned tomatoes, always check the label carefully for sodium content—the same can size may range from 30 mg up to a whopping 480 mg depending on the brand (the imported ones from Italy are some of the highest).

Coconut Milk

Yes, you can keep coconut milk in your pantry. But make sure you choose a brand without any thickeners (in the form of guar gum). Doing that isn’t always easy. We’ve come to rely on two brands, both shown at right:

• Natural Value Organic 13.5 ounce can:  look for the bright, lime-green label. We’ve found it at our local PCC Co-Op, at Whole Foods, and even on Amazon and Ebay from time to time.

•Arroy-D 8.5 ounce box: its dark green label can usually be found on the shelves of Asian grocery stores. This is a handy size when cooking meals for two.

Sour Cream / Yogurt

While I have yet to get this validated by a licensed nutritionist, several SIBO websites claim that home-made yogurt, which is fermented for 24 hours instead of the “standard commercial yogurt’s 12 hours,” has lost its lactose due to the longer fermentation time. We’ve included a recipe for it here >

Old Red Wine

Don’t throw out red wine! If by some strange chance you end up with some leftover red wine at the end of the dinner party, use one of those “Vacu-Vin Wine Saver Pumps,” put the bottle back in the pantry, and forget about it for a while. Not only does red wine contain very little of the sugar that is a risk in SIBO diets, but aging it reduces that risk even more.

Why save it? Old / “spoiled” red wine (aka high end red wine vinegar) adds depth of flavor to all sorts of dishes, including the sauce in our Eggplant Parmesan.

Soy Sauce –> Coconut Aminos or Fish Sauce

We love Asian food, so losing soy sauce was a problem… until we discovered the joys of Coconut Aminos. This concoction is made by salt-fermenting the nutrient-rich “sap” of coconut blossoms—which is very low glycemic, contains 17 amino acids, minerals, vitamins, and has a nearly neutral pH. It tastes sweeter than soy sauce, so I frequently add lime juice for balance.

Another option is a high quality fish sauce… depending on the brand, it typically contains just three ingredients: some form of fish, salt, and water. Fish sauce is similar to soy sauce in its salty intensity, without the sweetness of coconut aminos. However be sure to check the ingredients label, because some, like the popular Three Crabs brand, include additional ingredients like fructose, hydrolyzed wheat or vegetable protein, and even MSG.

Onions and Garlic –> Fennel

If your body doesn’t mind them, the safest forms of onions are the green tops of scallions, the green tops of Egyptian walking onions (my favorite), or fresh chives. However if you want to be absolutely safe, skip onions altogether during the first phase of your gut healing.

As for garlic, the SIBO Specific Diet Food Guide lists garlic in three ways: powdered garlic is red-zone illegal, fresh garlic is orange-zone-high, and garlic-infused oil is green-zone-safe. However in our experience, all forms of garlic—including garlic-infused oil—caused significant bloating, so that is the one exception we take to this food guide: we don’t use garlic in any of our recipes.

If your digestive system is similar to our household, take heart: rather than developing flavor with sautéed onions or garlic, give fennel a try. Fennel is green-column-SIBO-safe, and develops a lovely caramelized flavor when sautéed that, at least in our house, doesn’t make us miss onions at all. Just mince, dice, or slice and sauté it like you would onions and/or garlic.

Last but not least, my friend Zeema’s East Indian mama says that people who can’t eat garlic and onions in India simply add more cumin and mustard seeds to their recipes… give it a try and see what you think!

mashed-rutabagaPhoto of mashed rutabaga and carrots from the Home Schooling Doctor website

Potatoes –> Rutabagas

Rutabagas are allowed, and they aren’t too shabby a substitute for potatoes: they pan fry, hash, and mash with the best of them. The flavor is somewhere between a sweet potato and a radish. Don’t knock it ’til you’ve tried it. 🙂

My advice? Don’t cook just one or two… boil or bake a few extras, mash them, and freeze in 1 cup portions: mashed rutabaga is an excellent binder for other uses, including our recipe for meat loaf / meatballs, or as a topping for shepherd’s pie.

Zucchini-Noodles
Photo of zucchini noodles courtesy of the Moderate Indulgence blog

Pasta –> Zucchini Noodles or Spaghetti Squash

Zucchini noodles (aka “zoodles”) are a great substitute—in moderation: the lowest FODMAP “green” column recommends no more than 3/4 cup per serving. If you’ve got mad knife skills, you can make your own with a fine julienne (or thin slabs for things like zucchini lasagna); or you can invest in a mandolin slicer, or a hand-held julienne tool.

Your other “noodle” option is spaghetti squash. It’s absolutely delicious, and you can sauce it in the same way you sauce pasta (check out Riley’s recipes here).

Secret Tip:  yes, you can cook a spaghetti squash quickly in a microwave or pressure cooker. But once you bake it in your oven, and taste the deeply caramelized flavor that comes from baking, you’ll never go back. Here’s how:

Cut the squash in half (easier to cut through the middle section, rather than trying to cut it lengthwise), scoop out the seeds, place the halves cut-side down on a Silpat-covered baking pan, and roast at 350° F for approximately 1 hour. (While you’re at it, roast some butternut squash on the side for soup later this week!) You’ll know it’s done when the outer shell sounds more hollow and starts to look a little toasted / golden in places.

Rice

When the husband first began addressing his SIBO issues, he wanted to play it safe and avoid all white foods that might convert to some amount of sugar during digestion. About a year into his journey, he’d sneak some rice into a meal now and then, and didn’t seem to have any real ramifications, yet we still tried to avoid starches wherever possible (our normal meal is one protein + 2 different vegetables).

Although Dr. Siebecker’s SIBO Specific Diet Guide doesn’t mention rice anywhere (except as prohibited under rice syrup and starch), most SIBO nutritionists DO give the green light to rice:

http://www.gidoctor.net/diet-ibs-sibo.php – see point #5; although they also approve potatoes, which Dr. Siebecker does not.

https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2014/04/SBBO-Diet-10-27-16.pdf – rice is listed on page 2, under the “keep eating” column

https://www.thesibodoctor.com/wp-content/uploads/woocommerce_uploads/2017/04/SIBO_Bi-Phasic_Diet_Online_28042017.pdf – found on page 3, right column, under the Phase I bullets; this site also allows potatoes, which Dr. Siebecker does not

https://www.siboinfo.com/uploads/5/4/8/4/5484269/low_fermentation_diet.pdf – rice is listed at the top of page 5, along with potatoes and sweet potatoes, both of which Dr. Siebecker warns against.

The takeaway? Every body is a different blend of chemistry and tolerances. When in doubt, eliminate whatever starches that cause you problems. You can always try to re-introduce them later, once your digestion begins to heal.

Jicama

Jicama reminds us of a radish, and radishes are green-zone-safe… however Dr. Siebecker’s ingredient guide doesn’t mention jicama anywhere. After a fair bit of internet research, I came across this information from an MD:

“Jicama is not suitable for the GAPS and SCD diets. People with FODMAPS and SIBO should take caution, too. But each person’s GI tract is different! Although I have to lay low (even “no”) on cauliflower and asparagus because of FODMAPS, jicama and I get along okay! Jicama’s sweetness comes from inulin, which is a FOS [Fructo-oligosaccharide]–and FOS can be problematic to GAPS/SCD/FODMAPS/SIBO patients. However, I think that jicama’s inulin can be a great addition to GI health once symptoms are improving and foods are being reintroduced! But no matter, be patient, patient, patient, and eventually things slowly do improve! Although, I adhered to GAPS for 18 months, I have transitioned into allowing more foods (while keeping all the other premises) and paying close attention to any symptoms. I am much happier with the diversity. But it took a couple of years, and I’m still working on it!” – Terri Fites, MD / The Home Schooling Doctor