Thank you so much, Kate! This is very helpful. To know starch reverts back when heated… I am wondering if starch should be avoided because of symptoms it may cause or because it feeds the bacteria… I never get the SIBO really away and I am best when very restricted. As soon as I start to reintroduce I am getting much worse. I know it is a question of portion size. If I eat 10 almonds and 1/4 cup broccoli is this already to much or is it ok. to stay at the upper end of the still green amount for several foods (according to Monach App)?

Starch is a bit complicated. Starchy foods can become resistant starch when cooled (think cold potato salad vs. hot baked potato)–but starches will revert back when re-heated. The amylose-amylopectin content varies from one starch to another–another interesting part of the science of starch. The amylopectin is easier and faster to break down in the gut—making it a potentially better option for someone w/ SIBO. Unfortunately, there is so little research about diet and SIBO—and I think most people are too restrictive with the diet post SIBO diagnosis that many become malnourished! This is unfortunate–and not necessary in my opinion. I typically allow starch for most of my SIBO patients—unless they become very symptomatic when they eat it. And do find in my clinical practice that the low FODMAP diet helps many with SIBO—but I try to liberalize the diet soon after they are treated–as tolerated. Trying to determine the underlying cause of why you developed SIBO is important too—so work with a good GI doctor to try to test for overlapping conditions that may have predisposed you to developing SIBO in the first place.

thank you so much for this post! I never got the idea that we might be able to encourage restaurants to adapt to our FODMAP needs. And it makes sense for them as well as so many people suffer under IBS.

I have SIBO and need to avoid starches as well. I just read that “starches’ physical-chemical properties evolve when they come in contact with water, undergo temperature variations and as time passes”. I cook usually big portions and eat them for several days as only small amounts are allowed. Are veggies like carrots, spagetti squash and zucchini and rice more difficult to digest after one or two days in the fridge and reheated? I would be very happy to see some light in the dark! Many thanks, for your excellent work!
Christine