Elemental Diet
This approach seeks to starve the bacteria, but feed the person, by replacing meals for 2 weeks with an Elemental Formula. Elemental formulas are powdered nutrients in pre-digested, easily absorbed form.
Elemental Formulas
_Many brands are available over the counter. The formula studied for SIBO is Vivonex Plus. It contains protein as amino acids, carbohydrate as maltodextrin, fat as various oils, and vitamins & minerals.
Semi-Elemental Formulas
These differ from elemental formulas in that they contain partially or semi-digested protein in the form of hydrolyzed whey, casein or fish protein. The protein has been enzymatically digested yielding single amino acids and small proteins (peptides). Studies show increased protein absorption from semi-elemental vs elemental formulas, but no studies have been done on treatment of SIBO with semi-elemental formulas. Unfortunately, whey contains some naturally occurring lactose, which many cannot tolerate even in tiny amounts. Additionally, many are sensitive/allergic to whey, casein and/or fish protein.
Advantages of Elemental Diet
80-84% success in eradicating of SIBO. Proven effectiveness, safety and tolerability. Easily obtained in retail stores.
Drawbacks
Expensive
High carbohydrate/sugar %
Unpleasant taste
No eating for duration of treatment (2-3 weeks)
Weight loss (a dangerous drawback for those of low weight)
High carbohydrate/sugar %
Unpleasant taste
No eating for duration of treatment (2-3 weeks)
Weight loss (a dangerous drawback for those of low weight)
Options for homemaking
Recipes for homemade elemental and semi elemental formulas are posted in the resources. Disclaimer: These recipes have not been formally tested, their safety, tolerability and effectiveness is unknown.
The following information is provided to clarify the components of elemental and semi-elemental formulations.
Protein
1. Amino Acid powder
Can be expensive because so much is needed. The RDA for protein is 45-55 grams/day. 1 gram = 1000 mg.
Amino acids taste unpleasant.
2. Hydrolyzed whey, casein or fish protein powder. Sensitivities to these proteins are possible.
Note- most whey contains small amounts of naturally occurring lactose.
Carbohydrate
1. Honey
2. Dextrose (glucose)
3. Glucose flavored liquid
4. Grape syrup (similar profile to honey)
Fat
1. Oil
Note- medium chain triglyceride oil (MCT &/or Coconut Oil) are recommended in cases of fat malabsorption, common in SIBO, as they absorb easily.
Vitamins & Minerals
1. Multivitamin/mineral that contains no fiber, food or anything other then synthetic nutrients.
Some options include Freeda SCD Multi, Klaire VitaSpectrum Powder, Pure Encapsulations Nutrient 950.
Avoid
For more details, please see my class videos and the other resources at Learning More.
The following information is provided to clarify the components of elemental and semi-elemental formulations.
Protein
1. Amino Acid powder
Can be expensive because so much is needed. The RDA for protein is 45-55 grams/day. 1 gram = 1000 mg.
Amino acids taste unpleasant.
2. Hydrolyzed whey, casein or fish protein powder. Sensitivities to these proteins are possible.
Note- most whey contains small amounts of naturally occurring lactose.
Carbohydrate
1. Honey
2. Dextrose (glucose)
3. Glucose flavored liquid
4. Grape syrup (similar profile to honey)
Fat
1. Oil
Note- medium chain triglyceride oil (MCT &/or Coconut Oil) are recommended in cases of fat malabsorption, common in SIBO, as they absorb easily.
Vitamins & Minerals
1. Multivitamin/mineral that contains no fiber, food or anything other then synthetic nutrients.
Some options include Freeda SCD Multi, Klaire VitaSpectrum Powder, Pure Encapsulations Nutrient 950.
Avoid
- Fiber, gums, thickeners, food items, or prebiotics.
- Forms of protein and sugar not listed above.
- Standard cleansing formulas such as Mediclear, Clearvite or Ultraclear are not elemental or semi-elemental formulas.
For more details, please see my class videos and the other resources at Learning More.
Site author: Dr Allison Siebecker
