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
Contain protein as amino acids, carbohydrate as glucose &/or maltodextrin, fat as various oils, and vitamins & minerals. Many brands are available over the counter or througha doctor (see below).
Advantages
80-84% success in eradicating SIBO. Proven effectiveness, safety and tolerability.
Obtained in retail/web stores or through a doctor.
Can reduce high gas levels in one 2 week course, reducing the need for multiple rounds of antibiotics/herbal antibiotics.
Obtained in retail/web stores or through a doctor.
Can reduce high gas levels in one 2 week course, reducing the need for multiple rounds of antibiotics/herbal antibiotics.
Drawbacks
Can be expensive (if not homemaking, depending on brand)
High carbohydrate/sugar % (if not homemaking)
No eating for duration of treatment (2-3 weeks)
Weight loss if full calories (1800-2000) not consumed
Unpleasant taste if formula has no flavoring (only Vivonex & Homemade are unflavored. Neocate Jr, Physicians Elemental Diet, Physicians Elemental Diet-Dextrose Free, Elemental Nutrition and Keto-Elemental Nutrition, and Elemental Heal Whey Free are flavored)
High carbohydrate/sugar % (if not homemaking)
No eating for duration of treatment (2-3 weeks)
Weight loss if full calories (1800-2000) not consumed
Unpleasant taste if formula has no flavoring (only Vivonex & Homemade are unflavored. Neocate Jr, Physicians Elemental Diet, Physicians Elemental Diet-Dextrose Free, Elemental Nutrition and Keto-Elemental Nutrition, and Elemental Heal Whey Free are flavored)
Commercial Options
Flavored:
Elemental Heal Whey Free (Functional Medicine Formulations) Direct patient ordering available.
ElementAll - Chocolate (elemental diet) (Amazon) direct patient ordering available.
ElementAll - Pink Lemonade (elemental diet)(Amazon) direct patient ordering available.
Physicians Elemental Diet and Physicians Elemental Diet-Dextrose Free (Integrative Therapeutics) Practitioner ordering only.
Elemental Nutrition and Keto-Elemental Nutrition (Vita Aid) Practitioner ordering only.
Neocate Jr, Practitioner ordering only.
Unflavored:
Vivonex Plus (Nestle)
Homemade
SEMI-ELEMENTAL DIET - see 1st video for an explanation of the difference. Semi-elemental diets have not been studied for SIBO.
Elemental Heal Low Carb (Functional Medicine Formulations) is a commercially available Semi-Elemental Diet.
Brands such as Elemental Heal and Absorb Plus are partial Semi-Elemental Diets. They do not contain any fat, which is required in an elemental diet and thus must be added separately. They also contain protein in non-elemental form.
Elemental Heal Whey Free (Functional Medicine Formulations) Direct patient ordering available.
ElementAll - Chocolate (elemental diet) (Amazon) direct patient ordering available.
ElementAll - Pink Lemonade (elemental diet)(Amazon) direct patient ordering available.
Physicians Elemental Diet and Physicians Elemental Diet-Dextrose Free (Integrative Therapeutics) Practitioner ordering only.
Elemental Nutrition and Keto-Elemental Nutrition (Vita Aid) Practitioner ordering only.
Neocate Jr, Practitioner ordering only.
Unflavored:
Vivonex Plus (Nestle)
Homemade
SEMI-ELEMENTAL DIET - see 1st video for an explanation of the difference. Semi-elemental diets have not been studied for SIBO.
Elemental Heal Low Carb (Functional Medicine Formulations) is a commercially available Semi-Elemental Diet.
Brands such as Elemental Heal and Absorb Plus are partial Semi-Elemental Diets. They do not contain any fat, which is required in an elemental diet and thus must be added separately. They also contain protein in non-elemental form.
Options for Homemaking
See my Recipes for homemade elemental diet Here. The following information is provided to clarify the components of elemental diets.
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 brands do not match the complete amino acid profile used in Vivonex.
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. MCT oil can cause diarrhea- increasing amounts slowly helps to avoid this.
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.
Salt
Sodium is an essential electrolyte. The Adequate Daily Intake for salt is 1500mg (CDC).
Avoid
For more details, please see my class videos and the other resources at Learning More.
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 brands do not match the complete amino acid profile used in Vivonex.
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. MCT oil can cause diarrhea- increasing amounts slowly helps to avoid this.
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.
Salt
Sodium is an essential electrolyte. The Adequate Daily Intake for salt is 1500mg (CDC).
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 formulas.
For more details, please see my class videos and the other resources at Learning More.
Site author: Dr Allison Siebecker