What is the elemental diet?

An elemental diet is a set of formulas that contain all the nutrients your body needs to thrive in an easy-to-digest, broken down form. They are designed for people with extreme gut dysfunction who are having trouble digesting whole foods like vegetables, fats, and animal protein. Since the formulas in an elemental diet come in liquid or powder form, they are automatically easier for the gut to digest since it doesn’t have to work as hard to break down the nutrients.

Who can benefit from the elemental diet?

Anyone with gut dysfunction could theoretically benefit from an elemental diet for a period of time, however most people with moderate gut dysfunction can heal by making a few dietary changes and taking supplements to support optimal gut function. But for those with chronic gut dysfunctions, an elemental diet can be beneficial if you haven’t seen success with these less invasive therapies.

1. Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is characterized by a variety of bowel symptoms including stomach pain, bloating, diarrhea, and/or constipation. IBS affects close to 25-45 million people in America with two out of three people affected being female.

In conventional medicine, standard treatment focuses on managing symptoms by prescribing medications that can mitigate pain and diarrhea or alleviate constipation. A person is typically diagnosed with IBS after crossing off other possible conditions. However, a new blood test has been developed that looks at the antibodies, anti-C-dtB and anti-vinculin, since those antibodies have been shown to be elevated in IBS patients.

2. Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a more general term for a variety of inflammatory health problems in the digestive tract including Crohn's disease and ulcerative colitis. IBD affect around 1.6 million people in the United States. Similar to IBS, the goal of conventional treatment is to reduce inflammation and manage symptoms. This is achieved through medication and in some cases, surgery to remove inflamed areas of the GI tract.

To diagnose these conditions, it's important to rule out other conditions with similar symptoms as well as stool tests to measure the level of inflammation in the digestive tract. X-rays, MRIs, and scoping are also used to help make more definitive diagnoses.

3. Small Intestinal Bacteria Overgrowth

Your gut is comprised of the small and large intestines, and when you are not eating, the migrating motor complex (MMC) pushes gut bacteria down into the large intestines. But sometimes this process can fail. In cases of decreased MMC function, bacteria meant to migrate grows up into the small intestines where it doesn't belong. This wayward bacteria will eat what you eat, fermenting the food in the wrong area, causing gas, swelling, acid reflux, diarrhea, and constipation. This is Small Intestinal Bacteria Overgrowth (SIBO).

SIBO is usually treated with prescription antibiotics and prokinetic drugs to kill bacteria in the intestine and discourage bacterial overgrowth but it is very common for SIBO symptoms to reoccur, especially considering the fact that these treatments are aimed more at management rather than treating the root cause of why this happens in the first place.

Diagnosis of SIBO is made through a breath test to measure the amount of specific gases in a person's breath since the fermented bacteria produces certain gases that are expelled in a person's breath.

4. Crohn’s Disease

This inflammatory bowel disease affects the lining of the digestive tract causing swelling in the area, abdominal pain, fatigue, diarrhea, and weight loss. Symptoms of Crohn’s Disease can be mild to severe and can lead to an increased risk of colorectal cancer or the need for surgery. 

To be diagnosed for Crohn’s Disease your doctor can run various blood and stool tests in addition to performing a colonoscopy to look for the presence of inflamed cells. If you are diagnosed with Crohn’s the standard treatment in conventional medicine is various anti-inflammatory medications that come with their own set of side effects. There is no cure for Crohn’s disease but it can be put into remission through managing symptoms. In functional medicine, we aim to lower inflammation through dietary changes and supplements.

Benefits of the elemental diet

The elemental diet has been around for years and confirmed by researchers to be beneficial for those diagnosed with these conditions. 

1. It can help alleviate symptoms

One study looked at 93 patients diagnosed with both IBS and SIBO who were given an elemental diet as a sole source of nutrition and found (1) that 85% of participants experienced symptom improvement and normal SIBO breath tests after three weeks.

2. It can help achieve remission

Another study (2) found that an elemental diet was effective at achieving remission in those with Crohn's disease.

3. It can help lower inflammation

One of the main reasons why an elemental diet can be so good at alleviating symptoms, is its ability to soothe inflammation. Since the formulas in an elemental diet include broken down forms of macronutrients like protein, fats, and carbs, your gut gets a break from this step of the digestion process and in turn, lowers inflammation.

Can the elemental diet help you lose weight?

As a diet designed to help improve gut function, the elemental diet is not meant to be a tool to lose weight. While some people may experience weight loss that is often a byproduct of regaining proper gut function and restored health. You should never do an elemental diet if you don’t have gut problems and your main goal is to lose weight.

How the elemental diet works

Because elemental diets are designed to give your gut a break, they are typically done as a stand-alone diet with no other solid food. However, depending on where you are at in your healing journey, you may choose to follow a semi-elemental diet where you include a limited amount of some whole foods alongside your elemental diet formulas.

No matter what type of elemental diet you follow, it is almost always done with supervision from a medical professional. Since the goal with an elemental diet is to promote healing, your doctor will be able to work with you to determine the right formula - some are prescription-only and others can be bought over-the-counter - and dosage for you and monitor your progress until you are able to incorporate whole foods again. In some cases like a colectomy where part of your bowel has to be removed, an elemental diet may be done indefinitely.

If following an elemental diet, it is recommended to start slowly and gradually increase your amount over time to avoid stomach upset. While most elemental diet formulas are designed to be mixed with water you should still be drinking plain water as well.

Consulting a functional medicine professional for implementing the elemental diet

If you have tried healing your gut on your own with little to no results, it might be time to see a functional medicine professional. In my telehealth functional medicine clinic we look at all aspects of your health - diet, toxin exposure, emotional stress, and lab work - to identify the root cause of your gut problems. Then, we are able to put together a plan of action to facilitate healing based on your unique bioindividuality.

Then, if we determine that the elemental diet is the next step in your healing journey, we can walk through the process with you, recommend the most effective formulas for your health case, and help you to reintroduce whole foods back into your diet the right way for minimal symptom recurrence or side-effects.

If you are ready to learn more, check out our telehealth consultation to see how we can help you regain your gut health and if an elemental diet is right for you.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.

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