SIBO Elemental Diet Treatment

Like pharmaceutical antibiotics, this SIBO treatment approach works fairly quickly, but differently: it seeks to starve the bacteria, but feed the person, by replacing meals for 2 weeks with an Elemental Diet Formula. Elemental Diets are powdered nutrients in pre-digested, easily absorbed form. They have an excellent success rate of 80-84% [1] [2] and 100% [3] in eradicating SIBO, and work especially well at lowering very high gas levels quickly. Like all antibacterial SIBO treatments, it must be followed with preventative measures, since relapse is so common.

What Is An Elemental Diet?

Elemental diets are medical food beverages that contain nutrients in simple, absorbable form; protein as amino acids, carbohydrate as glucose &/or maltodextrin, fat as various oils, and vitamins & minerals.[4] The majority are powders, mixed with water at home. Many brands are available over the counter, or it can be homemade.

(See "Where to Get Elemental Diets" and "Homemade Elemental Diet" below.)
There are 3 main options
  • Elemental diet: contains fully broken down protein as amino acids, studied as effective for SIBO.[1] [3]
  • Semi-elemental diet: contains partially broken down protein as peptides, which may taste better and be less expensive. Shown effective clinically for SIBO (not studied).
  • Homemade: can be elemental or semi-elemental with the option to alter the carbohydrate and fat levels. Taste varies by ingredients and may be less expensive. Shown effective clinically, and in a published SIBO case study.[2]  (Homemade Elemental Diet Recipe Handout)
See video below: "What is an Elemental Diet".
Elemental diets have the ability to reduce high gas levels in one 2 week course, potentially reducing the need for multiple rounds of antibiotics or herbal antibiotics. However, they can be challenging because the elemental diet drink replaces all other food for 2 weeks. Taste can also be an issue, which can contribute to weight loss if full calories (1800-2000+/day) are not consumed.

Typically, elemental diets are high in carbohydrate/sugar. For those requiring lower carbohydrates, homemaking is an option (Homemade Elemental Diet Recipe Handout). A potential side effect is intestinal yeast overgrowth, particularly in those already susceptible. Prophylactic anti-fungals can be considered in these cases (such as nystatin, fluconazole, undecyclenic acid (Amazon or exclusive pricing at Fullscript) or capryllic acid (Amazon or exclusive pricing at Fullscript).

Despite the challenges, many patients who have completed multiple rounds of antibiotics/herbal antibiotics report they wish they had chosen elemental diet as their first treatment for SIBO. (See third video below: "Elemental Diet Challenges & Tips".)

Videos to Learn More About Elemental Diets

From Dr. Siebecker

1. What is an Elemental Diet

2. Elemental Diet for SIBO

3. Elemental Diet Challenges & Tips

SIBO Elemental Diet Dosing

Unlike antibiotics and herbal antibiotics, elemental diets are not based on SIBO type. They are effective for all types of SIBO/IMO/ISO (hydrogen, methane and hydrogen sulfide gases).

A standard treatment round of elemental diet is 2 weeks. On average, one round of elemental diet lowers gas levels by 70 ppm, though it can be more or less. This can eliminate, or greatly reduce, the need for multiple antibiotic or herbal antibiotic treatment rounds commonly needed to clear SIBO. See Treatment Overview for more info. Retesting is used to determine if/when treatment should be extended to 3 weeks, or if more rounds of treatment are still needed.

See second video above "Elemental Diet for SIBO" for an explanation of how to do an elemental diet for SIBO with real-life success stories and case examples. See medical disclaimer below.
SIBO Elemental Diet Protocol
As per Dr. Pimentel's study [1]
  • 1800-2000 calories/day elemental diet x 14 days
  • Retest SIBO on day 15
    – Elemental diet is the Test prep-diet on day 14.
    – If results are received at the completion of the test, such as with in-clinic testing, and are still positive, consider extending elemental diet to 3 weeks total.
    – If results are negative, stop elemental diet and start prevention of relapse.
• Antibiotics or herbal antibiotics are not used during this protocol since bacteria are hibernating - see "Combination Dosing" below.

• Many choose to transition off the liquid elemental diet, by following the SIBO breath test prep-diet for 1-2 days.

• For transition diet, other tips and what to expect, see second and third videos above: "Elemental Diet for SIBO" and "Elemental Diet Challenges and Tips". Also see The Elemental Diet Success Plan.

The Elemental Diet
​Success Plan

Step-by-step support for the Elemental Diet treatment.
(From my trusted colleagues Dr. Roy Steinbock MD and Nutritionist Debbie Steinbock.)

Where to Get Elemental Diets 

Consult label to calculate amount of product needed for 2 week treatment course.

Elemental Diets Oil-Free Elemental Diet (oil is added separately - see MCT oil below)
Semi-Elemental Diets
  • Peptamen (Amazon) - comes as premixed liquid
Oil-Free Semi-Elemental Diets
Oil must be added separately to these formulas (see label directions). Any oil can be used.  
MCT Oil
Medium chain triglyceride oil ("MCT", coconut or palm oil) is recommended in cases of fat malabsorption, common in SIBO, as it absorbs easily. MCT oil can cause gastrointestinal distress - increasing amounts slowly helps to avoid this.
Vertical Divider

Homemade Elemental Diet  

The following information is provided to clarify the components of elemental diet formulations. Homemade elemental diets are unflavored, however some ingredient options below are available flavored, and non-calorie flavorings such as "crystal light" or flavored stevia have historically been used to increase palatability.
Protein
  • 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. Many commercial amino acid blends do not match the complete amino acid profile used in     Vivonex Plus     (the elemental diet tested for SIBO).
  • Jo Mar Labs Amino Acids: Black Label 21 Blend

Carbohydrate
Fat
Vitamins & Minerals 
Salt
  • Sodium is an essential electrolyte. The Adequate Daily Intake for salt is 1500mg [5]
Vertical Divider

Free Elemental
​Diet Recipes

Here are my Recipes for homemade elemental diets. These recipes have been in widespread use since 2011 and have shown clinical effectiveness - see a published case report here, and see case examples in the second video above: "Elemental Diet for SIBO". Formal safety testing of these recipes has not been done. See medical disclaimer below.

  Avoid

  • Fiber, gums, thickeners, food items, or prebiotics (ie. FOS, inulin, chicory, GOS ...). 
  • Forms of protein, sugar and carbohydrates not listed here.
  • Standard cleansing/detox formulas such as Mediclear, Clearvite or Ultraclear are not elemental diets and cannot be used for this purpose.   
  • See first video above "What is an Elemental Diet" for more info   

Combination Dosing

Unlike antibiotics or herbal antibiotics, the elemental diet protocol is not combined with other treatment types.[1] This is because elemental diet works by starving microbes into hibernation (and then death), whereas antibiotics and herbal antibiotics need active replicating microbes to be effective. This means using antibiotics and herbal antibiotics during elemental diet is a waste at best, and at worst, the carbohydrates in herbs may lessen effectiveness by feeding microbes (which eat carbohydrates). However, occasionally "Atrantil" (Amazon or exclusive pricing at Fullscript)is used with elemental diet for high methane cases (a type of SIBO/IMO), since it primarily inhibits methane production.
For more details about elemental diet and SIBO treatment, see Courses, join a Q&A and sign up for Dr. Siebecker's newsletter.
More Resources: Elemental Diet playlist on my YouTube  

   Learn more
Vertical Divider
Vertical Divider

Get free SIBO classes and updates​, latest SIBO podcasts, and discounts on professional-grade supplements.
Copyright © 2025  ·  Dr. Allison Siebecker   ·   All Rights Reserved
As an affiliate for many products and services linked on this site, including Amazon, I earn qualifying commissions when you purchase through my links. Please see Affiliate Disclosure.
This website is not intended to provide diagnosis, treatment or medical advice. Content is for informational purposes only. Always consult with a licensed healthcare professional regarding any medical or health related diagnosis or treatment options. Information on this website should not be considered as a substitute for advice from a licensed healthcare professional that knows your individual information. References to and statements made about specific products on this we website have not been evaluated by the U.S. Food and Drug Administration (FDA) and are not intended to diagnose, treat, cure or prevent any disease.
SIBOINFO