What Sugars Should You Avoid With SIBO?

November 12, 2025 •

4 min read

According to research, excessive fermentation of carbohydrates is a key driver of SIBO symptoms. Understanding what sugars you should avoid with SIBO is therefore a crucial step in managing and reducing symptoms like bloating, gas, and abdominal pain by starving the bacterial overgrowth.

Quick Summary

A proper SIBO diet is essential for symptom management by limiting fermentable sugars that feed small intestinal bacteria. Key offenders include high-fructose corn syrup, lactose, certain fruits, and all sugar alcohols. Following a low-FODMAP diet or similar elimination plan helps identify and restrict these problematic carbohydrates.

Key Points

Avoid High-Fructose Sugars: Limit or eliminate foods high in fructose, including high-fructose corn syrup, agave, and certain fruits like apples and pears.
Restrict Sugar Alcohols: Sugar alcohols like sorbitol, xylitol, and mannitol are highly fermentable and should be avoided, especially in sugar-free products.
Limit Lactose: Many SIBO patients react poorly to lactose in dairy products due to bacterial fermentation. Opt for lactose-free alternatives or limit intake.
Be Wary of Natural Sweeteners: Even 'natural' sweeteners like honey and maple syrup contain fermentable sugars that can worsen symptoms if consumed in large quantities.
Prioritize Low-FODMAP Diet: The low-FODMAP diet serves as a foundation for identifying and restricting problematic sugars and other fermentable carbohydrates.
Consider Non-Caloric Alternatives: Well-tolerated sweeteners like stevia and monk fruit extract can be good substitutes for sugar.
Read Labels Carefully: Sugars are often 'hidden' in processed foods, sauces, and snacks. Always check ingredient lists to avoid hidden triggers.

The Problem with Sugars and SIBO

For individuals with Small Intestinal Bacterial Overgrowth (SIBO), the small intestine contains an excessive amount of bacteria that should typically reside in the large intestine. These misplaced bacteria feast on undigested carbohydrates, or fermentable sugars, which are often classified as FODMAPs. The fermentation process produces gas (either hydrogen or methane, depending on the type of bacteria), which leads to the hallmark symptoms of SIBO: bloating, gas, abdominal pain, and altered bowel movements. Avoiding high-sugar foods, particularly those that are poorly absorbed, is a core strategy for starving these bacteria and alleviating discomfort.

Fermentable Carbohydrates (FODMAPs) to Restrict

A low-FODMAP diet is one of the most recognized and effective approaches for managing SIBO symptoms. The acronym FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These are the specific types of carbohydrates that can cause issues. Here’s a breakdown of the sugar-related FODMAPs you should be mindful of:

Monosaccharides (Excess Fructose): Fructose, the sugar found in many fruits and honey, is a major trigger for many SIBO patients, especially those with pre-existing fructose malabsorption. High-fructose corn syrup (HFCS) is particularly problematic due to its high concentration of this sugar.
Disaccharides (Lactose): Lactose, the sugar in dairy products, is a common fermentable disaccharide. Many people with SIBO also have lactose intolerance, or the condition itself can create a temporary lactose sensitivity. Cow's milk, soft cheeses, and yogurt are often poorly tolerated.
Polyols (Sugar Alcohols): These are a type of sugar alcohol found naturally in some fruits and vegetables and are also widely used as low-calorie, artificial sweeteners. They are poorly absorbed and highly fermentable. Common polyols include sorbitol, mannitol, xylitol, and erythritol.

Refined and Natural Sugars to Avoid

Beyond the specific FODMAP categories, other sugars and sweeteners are known to exacerbate SIBO symptoms. The key is to limit any sugar that can provide a food source for the overgrown bacteria.

Refined Sugar (Sucrose): Found in table sugar, candy, baked goods, and many processed foods, sucrose is a disaccharide made of glucose and fructose. While glucose is generally well-absorbed, the fructose component can feed the bacteria, making excessive intake problematic.
High-Fructose Corn Syrup: As mentioned, HFCS is a major offender due to its high fructose content. It is ubiquitous in processed foods, soda, and sweetened beverages, so checking labels is essential.
Agave Syrup: Often marketed as a healthy alternative, agave is extremely high in fructose and should be avoided on a SIBO diet.
Natural Sweeteners (in excess): Even natural sweeteners like honey, molasses, and maple syrup contain fructose and other fermentable carbohydrates that can trigger symptoms, especially in large quantities.
Artificial Sweeteners to Question: Some studies suggest that artificial sweeteners like sucralose can alter the gut microbiome, though more research is needed. It's often recommended to avoid them during the elimination phase of a SIBO diet to be cautious.

Sugars and Sweeteners for SIBO Patients

Not all sweetening agents are off-limits for SIBO patients. Certain options are generally better tolerated due to their low fermentability or different metabolic pathways. Here’s a brief comparison:


Sugar Type	Examples	SIBO-Friendly?	Reason
Sugar Alcohols (Polyols)	Sorbitol, Mannitol, Xylitol	No	Poorly absorbed; highly fermentable by gut bacteria, causing gas and bloating.
High-Fructose Sugars	High-fructose corn syrup, Agave, Honey	No	Fructose is often poorly absorbed and feeds bacteria in the small intestine.
Lactose	Milk, Soft Cheeses	No	Many with SIBO have trouble digesting lactose, leading to fermentation.
Sucrose (Table Sugar)	Sugar, Candy	Limit	Contains fructose. Small amounts may be tolerated, but large quantities are problematic.
Stevia	Stevia extract	Yes	Not a sugar; generally considered a well-tolerated, non-caloric sweetener.
Monk Fruit	Monk fruit extract	Yes	Similar to stevia, it's a non-caloric option that does not feed bacteria.
Glucose	Glucose powder	Maybe	A simple sugar that is well-absorbed, but excessive intake is not advised.

Strategies for Managing Sugar Cravings and Intake

Beyond simply avoiding certain foods, developing strategic habits can be very helpful for those with SIBO.

Start a food journal: Tracking what you eat and how you feel afterward can help you pinpoint specific sugar triggers that affect you individually.

Mindful eating: Pay attention to portion sizes, particularly for fruits, to avoid overwhelming your digestive system with a high load of fructose at once.

Meal spacing: Some protocols recommend waiting 4-5 hours between meals to allow the Migrating Motor Complex (MMC), the gut's natural cleansing wave, to clear bacteria from the small intestine. Constant snacking, especially on sugary foods, inhibits this process.

Focus on whole foods: Prioritizing lean proteins, healthy fats, and low-FODMAP vegetables and fruits provides energy without feeding the overgrowth. This helps reset cravings and promotes overall gut healing.

Work with a professional: The guidance of a gastroenterologist or registered dietitian specializing in SIBO is invaluable. They can help navigate the complexities of elimination and reintroduction phases, ensuring proper nutrition and effective symptom management.

Conclusion: Starving the Overgrowth for Relief

Effectively managing SIBO requires careful attention to diet, particularly the types and quantity of sugars consumed. Avoiding fermentable carbohydrates such as high-fructose corn syrup, lactose, and sugar alcohols is crucial for reducing the fuel supply for overgrown intestinal bacteria. While many sweets and processed foods must be temporarily eliminated, focusing on low-FODMAP fruits, natural sweeteners like stevia or monk fruit, and whole foods can help manage cravings and symptoms. By adhering to a therapeutic diet under professional guidance, individuals can significantly alleviate their discomfort and work towards long-term digestive health.

Disclaimer: The information provided is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Consult with a qualified healthcare provider for personalized guidance.

Frequently Asked Questions

Sugars, specifically fermentable carbohydrates known as FODMAPs, serve as fuel for the overgrown bacteria in the small intestine. As the bacteria ferment these sugars, they produce gas, leading to symptoms such as bloating, gas, and abdominal pain.

Generally, it's best to avoid or strictly limit natural sugars like honey and maple syrup during a SIBO protocol. These contain fermentable sugars, including fructose, that can feed the overgrowth and trigger symptoms.

No, sugar alcohols are a type of fermentable carbohydrate (Polyol) and are notoriously difficult for the small intestine to absorb. They are highly fermentable by gut bacteria and are a common trigger for bloating and discomfort.

The low-FODMAP diet is an elimination diet that restricts certain fermentable carbohydrates, including specific sugars like fructose and lactose. It’s a common strategy for managing SIBO by reducing the bacteria's food source and alleviating symptoms.

Some research suggests artificial sweeteners can alter the gut microbiome. While their impact on SIBO is still being studied, many experts recommend avoiding them during the elimination phase to reduce any potential disruptive effects.

Generally, non-caloric sweeteners like stevia and monk fruit are considered safe for SIBO patients. Unlike fermentable sugars, they do not feed the bacterial overgrowth and are typically well-tolerated.

High-fructose fruits like apples, pears, mangoes, and watermelon are often limited or avoided during a SIBO diet. However, low-FODMAP fruits such as strawberries, blueberries, and grapes may be tolerated in moderation.