A Zero Carbohydrate, Carnivore Diet can Normalize Hydrogen Positive Small Intestinal Bacterial Overgrowth Lactulose Breath Tests: A Case Report

Abstract Background: Small intestinal bacterial overgrowth (SIBO) is a clinical condition characterized by an excessive bacterial growth in the small intestine. Clinical symptoms might be non-specific (dyspepsia, bloating or abdominal discomfort). Nevertheless, SIBO can cause severe malabsorption, serious malnutrition, immune reactions, and deficiency syndromes. This retrospective case report introduces six patients with positive lactulose hydrogen SIBO breath tests. The patients chose between different therapeutic options and willingly consented to a nutritional intervention, based on a zero carbohydrate, zero fibre, carnivore diet, extended over two to six weeks of time. The rationale for this dietary approach was based on the idea that opportunistic, carbohydrate favouring bacteria and methanogens proliferate in the small intestines if the natural barriers in the digestive tract have been weakened due to stress, illness, medication, etc. A zero carbohydrate, carnivore diet, consisting of animal fats and protein, could essentially eliminate these carbohydrate favouring bacteria through starvation while still providing plenty of both calories and nutrients.Methods: six patients from our functional medicine clinic followed a strict zero carb, zero fiber, carnivore diet for 2-6 weeks. A lactulose breath test was performed immediately before and after the dietary change as well as extensive medical testing. Results: five patients that followed the carnivore diet for four weeks or longer tested negative for SIBO, and the one patient that only endured the diet for two weeks had a near complete eradication of her hydrogen elevation. Methane values were generally low both before and after the dietary treatment, but there was a significant decrease in patients 3 and 5.Conclusions: The carbohydrate, zero fibre, carnivore diet shows great potential for being a readily available, cost-effective, and equally effective alternative treatment for SIBO. According to our observations it also results in better satisfaction after meals, decreases cravings for sweets and generate weight-loss in patients where it is needed.