Guidelines for Using an Elemental Diet for The Treatment of SIBO
An elemental diet is a liquid formula consisting of powdered nutrients in pre-digested, easily absorbed form.
The main ingredients of an elemental diet include:
- Amino acids
- A carbohydrate, typically maltodextrin in commercial formulas
- Fat, which is industrial seed oils in commercial formulas
- Vitamins and minerals
So an elemental diet is arguably the most effective treatment for SIBO and has been shown to be safe without risks and complications.
Disadvantages of the Elemental Diet
However, there are some disadvantages of using an elemental formula including:
- They are expensive
- They taste awful!
- They are they are high in sugar like maltodextrin
- The fats in commercial formulas are industrial seed oils
- The patient can’t eat solid food for two to three weeks
- They can lead to significant weight loss if the patient is underweight already
- Many people that do an elemental diet develop a thick white coat on the tongue, which could be indicative of oral thrush or candida overgrowth.
The main formula used in studies to test the efficacy of elemental diets is Vivonex Plus which is made by Nestlé.
As I mentioned above the ingredients are not very healthy. The main constituent in the Vivinex Plus formula is maltodextrin made from corn. The formula also includes modified corn starch and soybean oil.
Fortunately, there are some alternatives to Vivinex Plus including Absorb Plus.
Absorb Plus is formulated by Jenny Patel-Thompson, a nutritionist that suffered from severe IBD and healed herself with an elemental diet.
Absorb Plus uses whey protein in addition to freeform amino acids. The carbohydrate source is maltodextrin as well, but it is derived from tapioca.
Absorb Plus does not contain any fat, so you can add your fat using coconut oil or medium-chain triglyceride (MCT) oil.
Two downsides off Absorb Plus are that it never been tested in a study, and it’s not technically a pure elemental formula.
Absorb plus contains whey protein which is not an amino acid, so it may not be as readily digested as amino acids.
Dr Alision Siebecker’s DIY Elemental Diet Formula
Dr Allison Siebecker is a naturopathic physician in Oregon who specialises in treating SIBO. She has a do-it-yourself elemental diet formula recipe which is freely available on her website.
Bear in mind, and this formula has also never been tested in a study.
General considerations for using an Elemental Diet
Duration of Use
Two weeks is standard duration, although you can go as long as three weeks. In my opinion, people should be closely supervised by an experienced health practitioner.
In my opinion, I would not recommend mixing an elemental diet with herbal or antibiotics treatments.
When to use an Elemental Diet for SIBO
Typically, in my opinion, you should consider an elemental diet as a last resort treatment if herbal and rifaximin therapies have failed and test results have continued to be unequivocally positive.
These types of people will often relapse, unfortunately, and usually will require periodic retreatment.
Retreatments may take the form of an elemental diet, botanical or drug protocols.
If you are the type person who is continually experiencing recurrence, then it is crucial that you are your health practitioner continue looking for the underlying cause or mechanism.
This article is not intended to provide medical advice, diagnosis or treatment.
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