Hi Friends,
We’re often told to “eat more fiber” because it’s considered universally good for our health. It’s true that the Standard American Diet (SAD Diet) is notoriously low in fiber, with most people falling far short of the recommended daily intake—25 grams for women and 35 grams for men. Fiber is essential for bulking up stool, stabilizing blood sugar, and nourishing beneficial gut bacteria that produce short-chain fatty acids (SCFAs), powerful postbiotics that influence our energy, metabolism, and immune function.
But here’s the twist…
As a doctor specializing in gut health, I see patients every day who feel worse when they eat fiber—more bloating, more discomfort, sometimes even nausea. If I were to recommend fiber to most of my IBS patients right away, I’d likely exacerbate their symptoms rather than improve them.
So, why do so many people struggle with fiber? It’s a great question—and one that explains the growing popularity of extreme diets like carnivore, which eliminates fiber entirely just to avoid symptoms.
While fiber can absolutely be part of the healing process, it’s not where I start. In fact, it’s one of the last things I reintroduce—after the gut is functioning well.
Here Are Common Reasons Why Fiber May Not Be Tolerated:
🔸 SIBO (Small Intestine Bacterial Overgrowth): One of the most common root causes of IBS—up to 70% of IBS is linked to SIBO. In this condition, bacteria ferment fiber in the wrong place (the small intestine), producing gas, bloating, and pain.
🔸 Chronic Constipation: If you’re not moving your bowels regularly, adding more fiber can backfire and make bloating worse.
🔸 Active Inflammation: During acute gut issues like appendicitis or diverticulitis, a low-fiber or even fiber-free diet may be necessary to reduce strain on the digestive tract.
🔸 Inflammatory Bowel Disease (IBD): In Crohn’s or ulcerative colitis flare-ups, we often temporarily reduce fiber intake to minimize irritation.
In extreme cases of bloating or gut inflammation, I recommend a temporary period of bowel rest—a zero-fiber approach that allows the gut to calm down and reset.
Just recently, one of my patients with severe bloating did a two-day bowel rest with homemade broth, the Elemental Diet (a medical-grade, pre-digested nutrition powder mixed with water), chicken, and white basmati rice. By day three, her bloating had vanished, and she felt amazing— noticing more energy and better mental focus!
My 2-Step Gut Healing Framework:
Step 1: Clear overgrowth from the small intestine by restoring gut motility and using herbal antimicrobials (as outlined in my 4-Phase SIBO Protocol).
Step 2: Slowly reintroduce prebiotic, fiber-rich foods to rebuild microbial diversity and encourage the production of SCFAs like butyrate. Click here to watch this short video to learn about SCFA.
🥩 What About the Carnivore Diet?
The rise of the carnivore diet—where individuals eliminate all plant foods—is a reflection of just how prevalent fiber intolerance has become. Many patients feel temporarily better on this diet, but it’s important to understand: this doesn’t address the root cause. A fiber-free diet may reduce symptoms, but it doesn’t heal the microbiome. Without gut repair, these individuals will continue to struggle when reintroducing vegetables.
I recently tested the gut microbiome of a young woman who had been on the carnivore diet for a year. Her results confirmed what we now understand scientifically—low bacterial diversity, low SCFA production, and high inflammation markers consistent with poor gut health.
🥬 Fiber: Still Essential for Long-Term Gut Health
Once your gut is healed, fiber can become your friend again. Fiber is fuel for your gut bacteria, who turn it into SCFAs that support energy, metabolism, immune health, and even cancer prevention.
With the right gut support, I’ve seen patients go from fearing fiber to comfortably enjoying a variety of fiber-rich foods—without symptoms.
Pro Tips for Fiber Reintroduction:
🕒 Timing Matters: For sensitive IBS patients, try introducing fiber at dinner rather than breakfast to avoid discomfort during your workday. A high-fiber smoothie in the morning may be too much initially.
⚖️ Trial & Error Is Normal: Not all fibers work for everyone. Some patients do well with:
- Green banana flour (found in our Prebiotic Fiber)
- Acacia fiber
- Psyllium husk
- Whole food sources like chia, flax, or hemp seeds
The key is to go slow and listen to your gut!
🍝 Palmini Bolognese
(Low-Carb, Gut-Friendly, and Delicious!)
This is a quick and easy weeknight dish the whole family will love. Palmini noodles—made from the vegetable known as hearts of palm—are a low-carb, high-fiber alternative to traditional pasta. They have a satisfying spaghetti-like texture and are generally well tolerated, even by those with fiber sensitivity. Plus, they’re naturally low FODMAP, meaning they are tolerated by those who bloat easily!
👉 Tip for SIBO Patients on a low FODMAP diet: You can still enjoy the flavor of garlic and onion by sautéing them in oil and then removing the solids before adding other ingredients.
Ingredients:
2 lbs organic ground chicken (or ground meat of your choice)
1 jar of your favorite organic pasta sauce
1/2 onion, diced (optional for low FODMAP)
4 cloves garlic, minced (optional for low FODMAP)
2 tablespoons Italian seasoning
1 teaspoon dried basil
1 teaspoon dried oregano
2 teaspoons salt
1/2 teaspoon black pepper
3 tablespoons extra virgin olive oil (plus more for drizzling)
Fresh basil for garnish
Instructions:
In a large sauté pan, heat olive oil over medium heat. Sauté the diced onion until translucent, then add garlic and stir for 1 minute. (If following low FODMAP, remove onion and garlic after infusing the oil.)
Add ground chicken to the pan, drizzle with more olive oil, and season with Italian seasoning, basil, oregano, salt, and pepper.
Use a spoon or spatula to break up the meat and cook thoroughly. If excess liquid pools in the pan, spoon it out and discard.
Pour in the jar of pasta sauce, cover, and let it simmer covered on low for 5 minutes.
Meanwhile, open and rinse the Palmini noodles in a colander under cold water.
Add the rinsed noodles to the sauce and stir gently to coat. Cook for 3–5 minutes until the noodles reach your preferred tenderness.
Garnish with fresh basil, serve warm, and enjoy!
Thanks for reading this week’s newsletter. If you’ve ever felt like fiber makes your gut worse, you’re not alone—and it doesn’t mean you have to live on a restricted diet. It means your gut needs healing. With the right approach, fiber can shift from foe to friend—and become a powerful ally in your health journey.
Warm regards,
Rajsree Nambudripad, MD
Dr. Rajsree is a caring and compassionate physician, who is board-certified in both Internal Medicine and Integrative/Holistic medicine. She is passionate about helping patients optimize their health through a preventative approach involving healthy lifestyle, dietary changes, targeted nutritional supplementation, and optimizing hormones. Her practice is unique in the personalized attention she devotes to each and every patient.
