Everything To Know About Elemental Diet For SIBO
For a long time, researchers and clinicians treating individuals with gastrointestinal diseases believed that good therapeutic responses were only possible if the bowel was completely at rest.
This meant that most patients were only able to gain necessary nutrients through intravenous feeding, which often meant longer hospital stays that still did not completely resolve these gastrointestinal problems.
As a result, physicians began to investigate how a diet consisting of foods that were already in their “pre-digested” state may improve patient outcomes while also giving them a greater quality of life in the process.
The elemental diet was originally developed in the 1970s for a couple of reasons:
- By a group of physicians investigating how breaking down certain proteins could improve both human and animal intestinal health. 1
- For use in space exploration by astronauts on prolonged journeys where the problems of storage, ingestion, and waste disposal were important. 2
Basically, it has been shown that the elemental diet is one of the most effective treatment options for patients suffering from a variety of digestive conditions, particularly those struggling with small intestinal bacterial overgrowth SIBO symptoms. 3
In this article, we will detail everything you need to know about the elemental diet so that you can decide if this treatment approach is right for you. As you will see, using the elemental diet for SIBO treatment, inflammatory bowel disease, and other digestive issues is very effective.
What is an Elemental Diet?
Very simply, the elemental diet is a liquid formula (usually in powdered form) that contains all the essential nutrients humans need to live broken down into their simplest forms so they are easily absorbed.
Types of Nutrients Included:
- Carbohydrates in the form of monosaccharides
- Proteins in the form of amino acids
- Fats in the form of fatty acids
- Essential vitamins and minerals
By eliminating the need for the GI systems of these patients to perform normal digestive functions, as well as limiting the fuel source for bacteria, the elemental diet acts as a protective way to ensure that patients still consume all the necessary nutrients during this treatment period while allowing the bowels to rest and decreasing bacterial overgrowth.
The main mechanisms by which the elemental diet helps a damaged GI system include:
- Enable passive absorption of nutrients
- Little to no stimulation of biliary and pancreatic secretions
- Decreasing the activity of these enzymes prevents the ability of potentially painful endogenous (naturally occurring) agents present in the GI tract to release
- Reduced load of potentially allergic components in food products
- Improved nutrition consumption, particularly if a patient appears to be deficient in certain elements/vitamins
- Reduce GI bacterial flora populations
To achieve these physiological benefits, the main components of an elemental diet must include:
- FATS – in the form of an oil (soybean, coconut, olive, etc.)
- PROTEINS – in the amino acid form (or peptide chain form)
- CARBOHYDRATES – NOT in the form of long-chain and complex carbohydrates (dextrose, glucose, and/or maltodextrin)
- ESSENTIAL VITAMINS AND MINERALS
An elemental diet is recommended for individuals, typically with SIBO, IBS, IBD, and other GI disorders, who experience the following symptoms:
- Very high gas levels
- Inflammation or a damaged gut
- Methane positive breath test (this can be a more difficult type of IBS to treat)
- Herbal medication sensitivity
- Pharmaceutical medication sensitivity
- Highly restricted diet
- SIBO has appeared to be resistant to other treatments and/or antibiotics
- Patient prefers a natural treatment option
Using The Elemental Diet for SIBO
As a result of an alteration in the type and/or a number of bacteria present within the small intestine, patients with small intestinal bacterial overgrowth (SIBO) often experience a wide variety of GI symptoms including bloating, abdominal pain, diarrhea, constipation, gas, cramping and more.
As one of the most promising treatment options for patients with both moderate to severe SIBO, the elemental diet is a life-altering tool that has helped many patients reduce bacterial overgrowth and re-establish a more normal gut.
Compared to using antibiotics for SIBO treatment the elemental diet has been shown to be even more effective. Patients who were prescribed Xifaxan had a success rate of approximately 64%, while patients who underwent a 2-week elemental diet had a success rate of 80-85% in eradicating SIBO.
The success of the elemental diet for patients with SIBO is primarily attributed to the pre-digested state of the nutrients which are quickly absorbed, preventing the surplus of bacterial species from feeding on carbohydrates.
By starving bacteria in this area, an elemental diet is an effective tool in reducing bacterial overgrowth in the small bowel 4.
If using the elemental diet for SIBO, it’s recommended that you use it for at least 2 weeks if not longer to see results. This allows the bowel rest and enough time to reduce bacterial overgrowth in the small intestine.
Full Elemental Diet vs. Semi-Elemental Diet
So what’s the difference between a “full” elemental diet and a “semi” elemental diet?
In terms of the elemental product formulations, the main difference is usually in the protein structure. For example, a “full” elemental formula is usually just composed of free-form amino acids while a “semi” elemental formula has longer chains of amino acids or protein peptides like whey isolate.
In terms of the elemental diet treatment process, a “half” elemental diet could also be when someone uses an elemental formula like Absorb Plus or Vivonex Plus and combines that with real foods using the elemental formula as a supplement for a certain amount of meals or extra nutrition.
Various scientific studies have found that patients with GI disorders show a beneficial response when their normal diet is supplemented with elemental formulations. In fact, these studies show that a full elemental diet may actually suppress the patient’s diet and ultimately reduce their ability or interest in consuming normal foods following the completion of their elemental diet regimen.
Overall, it has been shown that “semi” elemental diets are just as effective if not more effective in patients as compared to full elemental diets.
Studies Supporting the Full Elemental Diet
The elemental diet has become an increasingly popular treatment option recommended by physicians as clinical research has continued to demonstrate the efficacy of this treatment option for SIBO, as well as a variety of other GI disturbances 5.
Below are some of these studies and the results of patients’ health following completion of the “full” elemental diet.
Table 1: Collection of clinical research studies supporting the elemental diet for treating a variety of GI disorders.
| PURPOSE OF STUDY | RESULTS | STUDY |
| Test changes in intestinal microbiota of Crohn’s patients on the ED |
|
Shiga et al. (2012) |
| Comparison of elemental and empiric elimination diets for the treatment of eosinophilic esophagitis (EoE) (chronic immune-mediated disorder of the esophagus) |
|
Warners, et al. (2015)Markowitz et al. (2003) |
| Improving GI symptoms following radiation treatments for pelvic cancers |
|
McGough et al. (2006) |
| Both long term and short-term use of the elemental diet to manage Crohn’s Disease |
|
Teahon et al. (1990) |
| Treatment of IBS/SIBO patients with abnormal lactulose breath test (LBT) rates |
|
Pimental et al. (2004) |
Studies Supporting the Semi-Elemental Diet
It is important to note that the “full” elemental diet will only contain protein sources in their free amino acid form, carbohydrates in their simplest form of oligosaccharides or monosaccharides, and fats as medium-chain triglycerides (MCT).
On the contrary, the semi-elemental diet instead can contain protein in the form of peptides of varying chain length, carbohydrates in the form of simple sugars, glucose polymers, and/or starch and fats as MCTs.
One of the biggest advantages associated with the semi-elemental diet in comparison to the full elemental diet is attributed to the different protein forms used in these two diets.
While the free amino acid forms used in the full elemental diet prevent the patient from experiencing any type of allergic reaction to the protein component of the formulation, this form of protein does not prove to be effective in improving weight gain and/or malnutrition issues.
In fact, research has shown that free-form amino acids cannot help build muscle for patients unless they piggyback on a dipeptide (or higher) protein bond 6, such as that which can be found when consuming whey isolate, for example.
To learn more about this process, see this paper.
Basically, a high-quality semi-elemental diet formula or semi-elemental diet that includes a little bit of food can be even better than a full elemental formula.
Table 2: Collection of clinical research studies supporting the semi-elemental diet for treating a variety of GI disorders.
| PURPOSE OF STUDY | RESULTS | STUDY |
| Compare a full elemental diet (enteral feeding) with a semi-elemental diet (amino acid-based feed combined with a whole protein-based diet) in Crohn’s patients |
|
Raouf et al. (1991) |
| Investigate the nutritional and health benefits associated with a semi-elemental diet |
|
Alexander et al. (2016) |
| Investigate how a semi-elemental diet vs. a full elemental diet (using Vivonex-TEN) improves outcomes of adults with moderate to severely active Crohn’s Disease |
|
Royall et al. (1994) |
Expert Advice Using The Elemental Diet
I had a chance to sit down with Jini Patel to discuss the elemental diet and her experience working with people around the world to heal their guts naturally.
Pros and Cons of the Elemental Diet
So, you’re thinking of using the elemental diet for SIBO or another gut illness. These are the pros and cons you should consider.
Pros:
- 80-84% success rate
- Easy to order formulations online
- Can dramatically reduce gas levels and symptoms in a 2-3 week course
- Can reduce the need for antibiotics and their side effects
- Allows the patient to take a break from preparing meals
Cons:
- Products can be expensive as the treatment course continues
- Not allowed to eat food for 14 days
- Die-Off Symptoms can be severe
- Some people don’t like the taste
When is the Elemental Diet Recommended?
A physician may recommend an elemental diet for a variety of medical purposes, some of which include:
- Postoperative Management
- Nutritional support
- Particularly useful in healing patients following colonic and rectal surgeries, as well as neonatal and pediatric surgeries where adequate nutrition may be difficult to achieve following surgery
- Preoperative preparation
- Management of GI fistulae following procedures
- Associated with reducing mortality rates
- Balances nitrogen, potassium, and magnesium levels in patients while on the diet
- Improved serum protein levels
- Management of malabsorption and maldigestion states
- Short bowel syndrome management
- IBD/IBS-SIBO
- Improved symptoms
- Reduced diarrhea, constipation, gas, bloating
- Nutritional management during cancer treatments
- Protection against weight loss
- Reduced rectal lesions during chemotherapy
- Protects against radiation damage that can affect small intestinal mucosa
- Liver disease and failure 7
When is the Elemental Diet Not Recommended?
- History of eating disorders
- Low body mass index (BMI), underweight patients
- Note that the elemental diet has been associated with increased body weight for individuals with malabsorption issues so this may not be an issue
- Diabetic patients
- Higher sugar content of the elemental diet
- Intestinal fungal overgrowth
- Can be used for these individuals if they are also prescribed an antifungal agent
Potential Side Effects of the Elemental Diet
It’s not uncommon for individuals on the elemental diet to experience a variety of side effects, mostly due to the ingredients in the formula or the “die-off” reaction to a changing microbial environment.
Some common symptoms that should not alarm an individual on the elemental diet include:
- Feelings of constipation
- Maybe a result of decreased bowel movement due to decreased fiber
- Does not necessarily mean it is abnormal
- Most nutrients are being completely absorbed before food enters the colon
- Can be treated with magnesium, suppositories, enemas, herbal laxatives, etc.
- Nausea
- Can occur if the elemental diet is ingested too quickly. Sip slowly
- Usually begins in the first few days
- Will typically resolve itself if the formula is diluted
- Can also occur if a patient is also taking vitamins/supplements when on the ED
- Diarrhea
- Maybe a result of an ingredient in the formula that the patient is sensitive to or a die-off reaction
- Recommended that patients increase water intake and relax
- Feeling lightheaded
- Symptom aggravation
- Abdominal cramps
- Body aches
- Fatigue
- Blood sugar dysregulation
Elemental Diet Dosage
One of the most important aspects of the elemental diet is ensuring that you are consuming a sufficient amount of calories each day throughout the duration of your elemental diet.
This is particularly important for individuals who are interested in maintaining their weight during this time.
If you are using just elemental shakes on your diet then you need to make sure to get the recommended amount of calories for your body weight. Be sure to use an online nutrition calculator to figure out how many calories you need, then order the correct amount of product for the duration of your treatment.
Elemental Diet Product Options
Currently, there are a few main elemental formulas on the market. Check out the table below to compare the main elemental formula options.
Comparison of Main Elemental Formulas:
| FORMULA | RATING | PROTEIN TYPE | CARB TYPE | FAT TYPE | SEE PRODUCT |
| Absorb Plus | #1 | Whey Isolate | Tapioca Maltodextrin | No fat included, add your own | SEE PRODUCT |
| Physicians Elemental | #2 | Free Form Amino Acids | Dextrose & Tapioca Maltodextrin | Medium Chain Triglycerides | SEE PRODUCT |
| Vivonex Plus | #3 | Free Form Amino Acids | Corn Maltodextrin | Soybean oil | SEE PRODUCT |
Absorb Plus
Absorb Plus is a high-quality elemental formula and one of the best.
Some consider it a “semi” elemental formula due to the whey protein isolate but this allows you to pack on muscle and maintain weight more effectively. The product tastes good and has been used successfully by many people with IBD and IBS.
Especially good for:
- Maintaining weight and adding muscle
- People looking to order online
- Anyone who is sensitive to fat and wants to adjust their intake
Physicians Elemental Diet
The Physicians Elemental diet is another high-quality elemental formula. It is a “full” elemental formula because it contains protein in the form of free-form amino acids. This product tastes excellent as well and many people have used it successfully.
A physician is required to order the product.
Especially good for:
- Someone who needs to use a free form amino acid formula or cannot tolerate other proteins
- Someone who is having a doctor orders their product for them
Vivonex Plus
Vivonex Plus is a full elemental diet product that contains free-form amino acids and corn maltodextrin as the carb source. The ingredients in this formula are low quality and it tastes nasty. Many people have had successful results using the formula but it is very difficult to get down due to the horrible taste.
Recommended Elemental Formula
In summary, we recommend using Absorb Plus because of the quality of ingredients, taste, and protein structure which will enable you to put on muscle and maintain weight while on the elemental formula. With Absorb Plus you can also control the amount of fat depending on your body’s tolerance and requirement.
Homemade Elemental Diet
A patient may be interested in creating their own elemental diet formulations for a variety of reasons.
Some patients have found that a homemade elemental diet was better for them because they could customize the ingredients used and switch up the carbohydrate and fat ratios. You can also save a little bit of money taking the DIY route.
But, this method usually takes more research, time, and commitment to figure out the exact specifications.
If you are interested in preparing your elemental formulations at home, here is a recipe that can help you get started:
“Homemade Elemental Diet” – Dr. Allison Siebecker
You Just Finished the Elemental Diet – Now What?
Most often it’s recommended that patients who have successfully completed the elemental diet slowly transition back to actual foods by beginning with broths and a low FODMAP diet over the course of a week. Additionally, it may be beneficial to continue to supplement with elemental formulations during this transition period.
It is also highly recommended, particularly for patients with SIBO, that immediately after completing the elemental diet that they begin to take a prokinetic supplement to help stimulate the migrating motor complex which helps prevent the re-growth of unwanted bacterial populations.
Conclusion
In conclusion, the elemental diet is a great way for patients struggling with GI issues, nutrient absorption, or a wide variety of other health issues to absorb important nutrients through their diet!
The benefits associated with both full elemental and semi-elemental diets are well documented. While there are some formulations such as Vivonex Plus, which are hard to tolerate, there are a couple of other products available, such as Absorb Plus, that can help make this diet a little easier on your taste buds.
With over an 85% success rate, particularly in patients with SIBO, the elemental diet is a clearly valid and highly recommended treatment option that may help you.
Still not sure which treatment is best for you? Learn more about the different treatment options for SIBO. Also don’t forget to checkout out SIBO Survivor Cookbook to explore our vast collection of tasty, gut-friendly, and easy to prepare recipes.
- Read more about SIBO diet here
i have sibo-c
is Elemental Diet is also good for sibo-c
i mean constipation or it dose not metter if it sibo-d or sibo- c
best regards
igal gilboa
israel
Good question. No, it doesn’t matter if you have constipation or diarrhea. It works effectively for both.
Hello! I have been diagnosed with SIBO twice, and treated twice with Xixafan. I also have Hashimotos and one leads to the other, but I don’t know which came first – I think I had SIBO for a while, and menopause brought on serious symptoms as my hormones went nuts and my thyroid shut down. My symptoms got worse the second time I was treated with Xixafan – not better, MORE bloating and MORE gas, and my thyroid doctor and I now think I have fungal overgrowth (gas, thyroid meds stopped working overnight again, and skin lesions among other symptoms). I am taking Candex, have stopped eating sugars and carbs, but trying to decide whether an elemental or semi-elemental diet will help. I now know that no little pill is going to help me and diet is going to be the cure eventually, but nothing improves. However, you say an elemetal diet is NOT indicated for fungal issues – why not? Doesn’t the fungus get starved just as much as the SIBO bacteria? Thank you for any insight!
Thank you so much for all the details. Most info on the web details what the ED is and how to do it but not so much what to expect while you’re actually on it, in terms of how you’ll feel. Is it normal to feel hungry and a bit fatigued or weak throughout the process (especially when doing the full ED with no whole foods)? I am on day 2 of the Physicians Elemental Diet and feeling pretty out of it. Wondering if that is normal and will persist throughout or will improve as my body adjusts?
Yes, this is normal. Often times at the beginning people can experience some adjustment symptoms while the body is adapting to just the liquid formula and the bacterial are being starved. I usually find that the first week is challenging to adjust but the second-week symptoms decrease a lot.
Hi,
In need of some advice, I have recently completed a course of SIBO antibiotics (from the uk btw), I had severe symptoms such as weight loss and severe nausea. I feel better than before but I feel like my symptoms are coming back.. (I stress a lot). I don’t want to keep taking antibiotics and I want to be free of this once and for all. I am considering the elementary diet. Any advice is appreciated.
The elemental diet is definitely a great option to consider using!
Can u list ingredients as can’t have high sugar finds gluten dairy soy corn yeast shellfish
Says High in sugar as well
Hi Josh!
Thank you for a good and helpful blog!
I know there’s a dextrose free version of the elemental diet out there.. I was wondering if it’d possible to make one of these at home?
if I’d be possible to just skip the dextrose in the recepie or if I need to replace it with something?
I have high levels of candida and also parasites..
Yes, you can make it at home if you want using Mike’s mix tapioca maltodextrin. Honestly though, I would recommend using Absorb Plus unsweetened vanilla as it is dextrose-free. Another product that is dextrose-free is the physician’s elemental diet but I usually recommend Absorb Plus first. It’s so much easier to order the product so I would recommend that first.
Is it normal to have chills while on this diet. Day one and I feel trrrible and headachy
It’s possible to have die off symptoms at the beginning or symptoms due to the elemental formula. Make sure you are getting enough calories and drinking it slowly throughout the day.
Hi Josh!
I’am allergic to dairy, so I can’t have whey protein so would recommend the Physicians Elemental Diet? And also do I need to take any probiotic or vitamins with it? Im from Florida and Im basically guiding my orthomolecular because theres no SIBO specialist in my community. 🙁
Tomorrow Im going to see a GI for the 5Th time…. none of them had experience with sibo.
Usually, a lot of people who have problems with dairy actually can tolerate absorb plus since it contains no lactose and is a good source of whey. I know a few cases where people who had problems with dairy were able to tolerate absorb plus just fine. That being said, yes I’d recommend the physicians elemental diet if you don’t want to try absorb plus or another option is making your own version using vegan protein powder.
How do you make your own elemental diet powder?
It’s pretty simple. You just need to order all of the individual ingredients to mix into shakes including protein, carbs, fats, vitamins and minerals. If you want to learn exactly how to use the elemental diet you should definitely check out our course here: https://courses.sibosurvivor.com/p/elemental-diet-excellence/
Do you have access to a naturalpath or homeopathic doctor. That is who i use very knowledgeable and more results than the normal medical doctors. I have sibo.
Hi Josh,
I started the dextrose free diet yesterday and had a terrible day, nearly ended up throwing up. I’m really struggling with the taste and nausea and it takes me 2h to drink one scoop. Yesterday I only managed to drink 600kcal which obviously is not enough but I just can’t get it down so I’ve started eating a bit of chicken. What foods are allowed on semi-elemental diet? All animal protein that I have no trouble digesting? What about non starchy vegetables?
Heli,
Sorry about that. THe semi-elemental diet is a term used to describe elemental formulas that have protein peptides in them like whey isolate or brown rice protein. When your read “semi-elemental” it means the formula has larger protein molecules compared to free form amino acids like in the physicians elemental diet. I think you are referring to the “half-elemental diet” where you use the elemental formula for half of your calories and real foods for the other half. Since you’re having issues you can definitely try doing a half elemental formula and drink your liquid for half your calories during the day and eat a low-fodmap diet for the other half of your calories. Hope that makes sense.
Ah ok thanks for clarifying. Not sure if I can do low fodmap to kill SIBO as it hasn’t worked in the past. So I think I will just stick to chicken and fish if I can’t drink all the calories that my body needs.
I’ve just started the Dextrose-Free Physicians Elemental Diet and it tastes better than most protein shakes I’ve tried.
Yep, the taste is good.
How is the half elemental working for you Heli? I just started the Full ED and am thinking of doing fish, meat and chicken in addition to the drink… but I am wondering if it works as well. Josh.. can you weigh in on this as well? thank you so much.
Half-elemental die works well also and can be used over a longer period of time. It really just depends on what you want to do. Half is much more gradual while the full will work quicker and you may experience more pronounced die off the first week.
Hi Josh,
I’m curious, in the article it mentions wanting the carbs to be monosaccharides which I get. The Physicians Elemental Diet has tapioca maltodextrin. Isn’t that a polysaccharide? Curious if you knew. I was interested in doing the Physicians Elemental Diet Dextrose Free as it tastes very good. Thanks for any insight you have on this.
Eric,
While maltodextrin is considered a polysaccharide it does not act as one in the elemental form of maltodextrin. I know this is a little bit confusing but it is absorbed as quickly as glucose so there is nothing to worry about. I’ve tested all the possible carbohydrate sources for the elemental formula including dextrose, maltodextrin, glucose, and cyclic dextrin. Tapioca maltodextrin was the best and caused the least symptoms. I would do the physicians dextrose-free version.
Thanks Josh- I had a quick question for you. Are you still doing a modified SCD diet? Did you find you made progress sticking with SCD but adding in rice & potatoes? Did you stick to 1/2 cup of each the low fodmap serving size? How much carbohydrates did you have per day if you don’t mind me asking of the safe-starches like potato & rice?
Thank you for all of that information. I bought the Dextrose free version from Physicians Elemental Diet and the taste is actually very good. All of that info makes perfect sense now.
Hi Josh,
Thank you for this info! I just started Allison Siebecker’s Elemental Diet and I’m wondering if the honey is necessary or just for taste? I’m having a hard time getting down 2 tablespoons, 3x a day.
Thanks!
Mel,
If you’re using honey as the carbohydrate source it’s definitely necessary. If you can’t tolerate honey you can also use a different carb source like tapioca maltodextrin.
Hi Josh,
I love ypur blog, it is sooooo very helpful to be able to find free info on this difficult disease called “SIBO” I just started the Physicians Elemental Diet at the end of March and will go to the end of April, but I’ve gotten weak a couple of times and ate some grapes. Can you please tell me what that does while on the diet…….does it put me back to the beginning of yhe healing process or what????????
Michele,
I would not advise eating grapes while on the elemental diet. You want to stick to just the full elemental formula if you’re using the product as a treatment. If you’re having issues with blood sugar swings which may have been the cause of your weakness the solution is to drink the formula slower throughout the day and consistently not like a regular meal.
I am about to attempt to treat SIBO with the elemental diet…If I were to use Absorb Plus, you say to add in fat, how do I add in fat? specifically, how is this done? If I chose to use Absorb plus over the Physicians Elemental Diet, I still only consume the shakes for 21 days, correct?
Yes, consume for 14-21 days or as long as you decided you needed. Just add in 1 tbsp of fat per shake. If you can wait for a few days we are releasing a course that walks people through how to use the elemental diet for successful results with included handouts and ordering guides. It is called elemental diet excellence and will be released this week hopefully.
yes, I will wait. I would really like the handouts and ordering guides. Is the unsweetened chocolate dextrose free, just like the unsweetened vanilla?
Yes, all Absorb Plus products are dextrose-free because they use tapioca maltodextrin
Have you released the Elemental Diet Excellence Course yet? Can you tell me where to find it on the website?
Stephanie,
Yep, we just released it a couple of days ago. I will be adding it to the website but you can currently find it here: https://courses.sibosurvivor.com/p/elemental-diet-excellence/
Hi Josh, thank you for answering my question a few weeks ago. I listen to your videos over and over again, because every time I listen I seem to get something new. I am now finished with the Physicians Elemental Formula after a month now and I have transitioned over to the semi elemental that I make myself with Bone Broth (Dr Axe), MCT oil, Maldextrin and L Glutamine. I also take Pure Encapsulations 950 Nutrient Plus multivitamin and started the LDN as my pro-kinetic and started taking the Wild Oil of Oregano drops twice a day after listening to your interview with Jini. I loss about 20 lbs and felt pretty good while on the Physicians, but now going to the semi, I am a bit scared about what I should really be eating in fear that the bacteria will grow. I experienced some bloating after eating chicken and a feeling that the chicken did not digest, so I tried it again and took a digestive enzyme with bile in it, but I still felt a bit funny. I also had a bad reaction to salmon as well. What would you recommend as the types of food and how much to eat to go along with the semi for the next 2 weeks, or would you recommend another regimen that would do really good for the next 2 weeks? I will retest in 2 weeks, just because I would like to make sure I give it the best shot of getting rid of the sibo.
Hi. At what stage of the SIBO treatment should the elemental diet be used? Would it get rid of the bacteria in the small intestine? Thanks
Yes, it gets rid of bacteria in the small bowel. This form of treatment can be used really at any stage of the process. It is one of the most effective solutions.
I thought I posted this earlier but I don’t see it here so I’m posting again. Apologies if 2 posts show up from me later.
I am starting the Physicians Elemental Diet for SIBO, but I’m not sure of the exact quantity of shakes (and the powder/water ratio) I’m supposed to be eating every day. How do I calculate that?
I go over everything in this course: https://courses.sibosurvivor.com/p/elemental-diet-excellence/. You can also check Integrative Therapeutics website for the calorie calculator.
Would it be ok to continue taking my gummy multi vitamins while doing the full elemental diet with the physicians formula? Or would
That maybe alter it and not be as effective? Thank you !
If they have anything in them that could feed bacteria I would avoid them during the diet. Things like fiber, carbohydrates, additives, ect.
Same as the others, thanks for the article! What all can be done to decrease discomfort? I read elsewhere maybe an Epsom salt bath, heat pack on the stomach, peppermint oil with a diffuser. Are those good ideas? Any others? And are there any extracts that can be added to the mixture to change the flavor? Thanks!
Epsom salt baths, castor oil or heat pack on the stomach, peppermint oil are all great options to help with discomfort.
Hi Josh.
I am desperate to try the elemental diet, but none of the resources i have read (including your blog) mention how much (grams) of the formula to take at a time, and how many times a day one has to take it. I’ve read Dr Siebeka’s recommendations, and I am keen to try Neocate Jnr or Vivonex Plus. Can you advise on grams per serving for both, please?
Thanks so much 🙂
Hi Josh
Can I concurrently engage in the 2-3 weeks semi-elemental diet while taking the some of the anti bacterial substances that were referenced under the two options protocol on the SIBO site (Biotics Dysbiocide and FC Cidal orMetagenics Candibactin AR and Candibactin BR/ berberine, oregano oil, etc)?
Or is it perhaps better to stay on the semi elemental diet first, complete it and only then take the anti bacterial naturopathic substances as I will slowly return to a FODMAP diet?
Thank you for your time.
I was advised by my nutritionist that I could add a serving of moist white organic chicken or organic grass-fed ground meat with one serving while on the full elemental diet for sibo.
I am a bit underweight and maybe this is to help me maintain my weight while on the diet.
I am using the dextrose free Physicians Elemntal diet, drinking 10 scoops a day or trying to drink that much.
Is there anything else you would advice to take as far as supplements, etc. while on the diet?
I have been suffering with sibo for over 2 years now and just want it to go for good.I have taken multiple rounds of several antibiotics with not much relief so far.I am really hoping the elemental diet will be the answer.
Thank you for your advice.
Hi Josh,
I’m on medication for RA (prednisone) and wondering can i still do the elemental diet?
Thanks.
There is definately a lot to know about this topic.
I really like all of the points you have made.
It’s going to be ending of mine day, but before end I am
reading this wonderful piece of writing to improve my
know-how.
Hi there! I’m going to be starting the dextrose free Physician’s Formula for SIBO. Isn’t tapioca a prebiotic? That confuses me.
Is there an amount that is “too much” to drink during the day? I’m small and I want to get enough calories.
Can I add some plain organic hemp protein to it? Anything else like this that I can add to get more calories?
Also, can I still take my herbals like CandiBactin AR and BR or do I have to stop them?
I have Candida, so I plan on continuing with caprylic acid.
Thank you so much. This info is extremely helpful!
What happens if you want to use the Elemental DIet but you have CANdida and no anti fungal has worked? What are the options?
I want to encourage anyone with SIBO- I had the methane C variety and did the Elemental Diet for 21 days and it completely cured it! It was actually an enjoyable experience once I was a few days in. I didn’t like any of the supplements that were recommended so I just did the dextrose free physicians formula. You can do this. There is hope!
Thank you for another informative blog. Where else may I get that kind of info written in such a perfect method? I’ve a undertaking that I am just now running on, and I have been on the glance out for such information.
Hi Josh,
I am about to start the Elemental Diet and would love to take your course. Would you be able to tell me how I can register? I don’t see a link and it says course “is not currently open for registration.”
Hi, Thank you so much for this information! I can’t tell you how much I appreciate it! I am suffering with SIBO and have been on two phyto based protocol’s already that didn’t work. The doc finally prescribed me an antibiotic recently, but where i live I can’t get the rifaximne so I am interested in doing the elemental diet or semi-elemental diet. But the question i have is about the dextrose. Dextrose is simply glucose, so I do not understand why so many wish to avoid it. What don’t I understand about dextrose and sibo?
Please help because I bought dextrose for my formula carb source.
Thanks bunches!!!
Melannie
Hi I have a quick question regarding the elemental diet. I am not sure if I have a candida problem. The doctor that diagnosed my SIBO with a breath test said I do NOT have it. But just in case, should I take an anti-fungal with the elemental diet to be certain I don’t have a problem?
Also should I take Iron with the multivitamin during the elemental diet ?
Should I take enzymes so as to clear the gunk out of the gut during the elemental diet?
thanks so much for your help! I truly appreciate it as I have been fighting this for about 2 years and have been to 4 different doctors with no success.
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Thank you for all the good information. Can the elemental diet, dextrose free be mixed with a food, such as 1/4 piece of avocado into a smoothie, to cut down on the too sweet taste?
Hi. I am one week in to the Elemental Diet and am wondering if I could also take Atrantil at the same time?