What is an Elemental Diet and How Does It Treat SIBO?
The elemental diet is a medical food consisting of pre-digested powdered nutrients in an easily absorbed form. It contains all of the nutrients humans require broken down into their simplest form so that they are absorbed higher up in the small intestine.
In the case of SIBO, by drinking only elemental liquid it works to starve off the overgrowth of bacteria and allows the gut to rest.
A few components make up an elemental formula:
Proteins which are broken down into amino acids
Carbohydrates as glucose or maltodextrin
Fat as different oils
Essential vitamins & minerals
NOTE: There should not be any fiber, full proteins, or complex carbohydrates in an elemental diet.
The researched protocol for SIBO is for 14 days using the elemental formula in place of regular food. It is proven to be one of the most effective treatment options with an 80-84% success rate.
Patients usually do a repeat breath test after the protocol to measure the changes from the lactulose breath test.
Fun Fact: Elemental shakes were first developed by NASA when they wondered how to feed astronauts on long space journeys. Other researchers considered the elemental formula for food allergies, malabsorption, and other digestive tract malfunctions.
What is The Difference Between Elemental & Semi-Elemental Diet?
It’s easy to confuse the difference between an elemental and semi-elemental diet.
The elemental diet is used specifically as a medical food as the sole source of nutrition.
The semi-elemental diet is used as a supplemental product along with whole foods.
The main difference between them is that a full elemental diet contains each nutrient broken down into the smallest form, while the semi-elemental diet can contain whole proteins, fiber, or complex carbohydrates in conjunction with broken down nutrients.
It’s important to remember that if you are using an elemental diet to treat SIBO it must be a full elemental formula without whole proteins or fiber and in place of all food.
Bacteria feed on fiber and full proteins, so using a semi-elemental diet to treat SIBO will not have the same effect.
However, a semi-elemental diet can be a helpful supplement for those with chronic SIBO who want a simple source of nutrition that allows the gut to rest.
Elemental Diet Does Not Contain:
Full proteins or peptides
Complex Carbohydrates or fiber
Other food ingredients
When to Use an Elemental Diet for SIBO?
The elemental formula can be an effective option even if a patient doesn’t respond to other antimicrobial therapies. If a patient has the willpower to go through with this treatment option it is highly recommended.
In specific cases it is especially recommended:
Very high gas levels
Methane positive (methane can be tougher to treat)
Sensitive to herbs and medications
Super restricted diet
Has been resistant to other treatments and antibiotics
Patient prefers natural option
Pros & Cons of Using Elemental Diet for SIBO
80-84% success rate
Can order yourself online
Can dramatically reduce gas levels and symptoms in a 2-week course
Can reduce the need for antibiotics and their side effects
Allows the person to take a break from preparing meals
Buying the product can be expensive
Not allowed to eat food for 14 days
Die-Off Symptoms can be severe
Some people cannot tolerate the taste as well
What to Expect During Elemental Diet Treatment
It is very important to understand the possible side effects when treating with an elemental diet. This will help ease the transition into the all liquid diet and help you weather the storm when you do experience any side effects.
The first week of the diet is usually the most challenging and I can personally confirm that to be true in my own experience.
Typical Side Effects People Experience:
Headaches (allowed to take some Tylenol or Advil)
Diarrhea (May become explosive at times so make sure there is a bathroom nearby)
Body aches & pains as well as fatigue
Aggravation of symptoms
Lightheadedness if you wait too long to drink the food because of blood sugar swings
The mouth can get nasty because of the simple sugars you drink all the time. Brush teeth more frequently
My Personal Experience:
The elemental diet has been very helpful for me and totally worth it.
I definitely experienced some annoying symptoms while undertaking the diet and it took total commitment getting through it.
But, even though it can be a challenge, I recommend it because after I was done my gut felt so much better.
I created a PDF that details my journey with the 14-day elemental diet so that you can do it with clear expectations.
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SIBO Elemental Diet Buying Guide
There are 3 main elemental formula options for SIBO treatment.
I have experience using the ready-made packets and also making my own formula as I did the elemental diet protocol a couple times.
I have also taste tested the Physicians Elemental Formula and thought the taste was really good. Below is my breakdown of the 3 elemental diet drinks used.
Can pick your own ingredient sources
Anyone can order online
Requires much more planning and calculating
I think the easiest option would be to order the Vivonex Plus for 14 days if you don’t have a problem getting used to the taste. Most people find that at the beginning of the diet they think the taste is unpleasant but they can get used to it.
If you have the time and are willing to calculate the amounts of specific ingredients you need to make your own elemental diet, the homemaking option can be good. This option is just more of a hassle to organize. I have made my own before and found it to be a good option if you have the time.
Elemental Diet Dosage
You need to make sure to get sufficient calories while doing an elemental diet for 2-3 weeks. You do not want to lose too much weight on this diet so be sure to drink all of your formula.
Below are the number of packets per day for Vivonex Plus. If you go with Physicians Elemental Diet you will need to go to their website and total up the number of scoops you need for the duration of the diet.
To figure out the total amount of physicians elemental formula you need to order from their site you first find out how many calories you need per day, then find out how many scoops that equals, then multiply the number of scoops per day by 14 for the duration of the treatment.
When living on the elemental diet you have the option to space out your shakes or drink them consistently throughout the day. From my experience, I would recommend drinking the liquid nutrients evenly throughout the day instead of waiting too long to drink the formula. When I waited too long I experienced some dizziness due to the blood sugar swings.
I recommend working with your doctor to determine your caloric needs.
Vivonex Plus Product Amount
Packages Per Day
Calories Per Day
Total Packages to Order for 14 Days:
5 a day=70 packages
6 a day=84 packages
7 a day=98 packages
Semi-Elemental Formula Uses & Products
There are a few different semi-elemental formulas on the market. Although these products are not used specifically for treating SIBO they offer a good source of nutrition following the elemental diet or alongside a healthy whole food diet when you deal with digestive issues.
Sometimes if you have a really tricky case of SIBO you may find supplementing with a semi-elemental diet really helps.
There are a couple great product options to try:
Absorb Plus from Listen to Your Gut- This is a very high-quality semi-elemental diet product made without artificial ingredients or preservatives. It is made with casein and lactose free whey protein which a lot of people can tolerate. They also have vegan elemental shake options in their shop to try out if you cannot tolerate whey protein.
Making your own drinks by purchasing individual ingredients from LYTG shop or Amazon (below).