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What Is an Elemental Diet?

Medically Reviewed by Dan Brennan, MD on November 16, 2021

An elemental diet is a very restrictive diet that replaces foods and drinks with special formulas. It’s meant for people with serious health conditions and should be monitored by a health-care provider.

Elemental Diet Basics

The formulas used in an elemental diet usually come in liquid or powder form.‌

These formulas are easy to digest and nutritionally complete, which means you get all the nutrients you need. The proteins are broken down into simple amino acids, and they have very little fat.

Elemental diets usually last 2 to 6 weeks to allow healing or other treatment, depending on the condition. After that, you’ll start to slowly reintroduce foods back into your diet.

Who Can Benefit From an Elemental Diet?

An elemental diet is intended for people who have severe digestive problems including:

  • Small intestinal bacterial overgrowth (SIBO)
  • Eosinophilic esophagitis
  • Crohn’s disease
  • Ulcerative colitis
  • Cancer
  • Radiation-induced diarrhea

People who have these conditions often have a damaged digestive tract, which causes trouble absorbing foods. This can lead to malnutrition, dehydration, and other serious problems. 

An elemental diet may also ease symptoms of digestive disorders like:

Some people are drawn to the elemental diet for weight loss. You should not try this diet unless recommended by your doctor. It is a strict diet that is intended for medical use only.

SIBO and the Elemental Diet

As the name implies, SIBO is a digestive problem in which too much bacteria grows in the small intestine. Most of the bacteria in your gut is in the large intestine rather than the small.

Too much bacteria in the small intestine can cause digestive problems like:

  • Gas
  • Cramping
  • Bloating
  • Diarrhea
  • Constipation‌

These symptoms usually happen after you eat certain foods. The bacteria ferment the food fibers and release gas. Depending on the dominant type of bacteria, you can have too much methane or hydrogen. Methane-dominant SIBO tends to cause constipation, and hydrogen dominance causes diarrhea.

SIBO can be hard to treat because bacteria can become resistant to antibiotics and quickly grow back. Many people use a low FODMAP diet to control symptoms, but sometimes that doesn’t help.

In these cases, an elemental diet can be helpful. Studies show that an elemental diet helps lower bacteria in SIBO patients.

Eosinophilic Esophagitis and an Elemental Diet

Eosinophilic esophagitis is a long-term (chronic) allergic condition in your esophagus, the tube that sends food to your stomach. Allergies cause white blood cells to gather in your esophagus, causing inflammation and damage. Symptoms include:

This condition can make it hard to eat, which can lead to weight loss and other problems.

Your doctor might suggest an elemental diet for 6 weeks to allow your esophagus to heal. Studies show that 95% to 98% of people with eosinophilic esophagitis get better with this diet.

Inflammatory Bowel Disease (IBD) and an Elemental Diet

Inflammatory bowel diseases (IBD) are autoimmune diseases that cause inflammation in your digestive system. Your immune system attacks your intestines and causes damage. Some people have periods of remission with flares in between. These flares can cause symptoms like:

  • Diarrhea
  • Ulcers
  • Fevers
  • Bleeding
  • Bloody stools
  • Urgency to poop
  • Feeling full
  • Sore joints
  • Tiredness‌

If flares last a long time, you have a high risk for dehydration and malnutrition, especially if there is diarrhea.‌

Because IBD damages your intestines, your body can have trouble absorbing food, which can result in a lack of vitamins. An elemental diet can help lower disease activity and improve your overall nutrition.

Challenges of an Elemental Diet

An elemental diet is very restrictive and can be hard to stick to. People, especially children, often find it very hard to give up food for 6 weeks. The dietary restrictions can also be challenging for parents and families of children on the diet.‌

Because of the change in food intake, an elemental diet can be very emotional. You might notice that you feel:

  • Angry
  • Frustrated
  • Depressed
  • Stressed
  • Worried‌

You might miss eating food and be frustrated with your health. Parents might feel guilty and sad about taking food away from children.‌

The special formulas on an elemental diet may also taste unpleasant. This can be very upsetting, especially for children, and it can also make it hard to get proper nutrition. Drinking the formulas cold or making them into a smoothie with ice can help.‌

These special foods often have to be prescribed by your doctor. If you have a digestive disorder, talk to your talk about whether an elemental diet is a good fit for you.

Show Sources

SOURCES:

‌American Academy of Allergy Asthma & Immunology: “Eosinophilic Esophagitis: Symptoms, Diagnosis & Treatment.”

American Gastrointestinal Association: “Inflammatory Bowel Disease (IBD).”

‌CDC: “What is inflammatory bowel disease (IBD)?”

Children’s Health Orange County: “Elemental Diet.”

Digestives Diseases and Science: “A 14-day elemental diet is highly effective in normalizing the lactulose breath test.”

Gastroenterology & Hepatology: “Small Intestinal Bacterial Overgrowth.”

Medicine: “Elevated methane levels in small intestinal bacterial overgrowth suggests delayed small bowel and colonic transit.”

‌Merck Manuals Professional Edition: “Eosinophilic Esophagitis – Gastrointestinal Disorders.”

‌Oncology Nursing Society: “Elemental Diet.”

Saudi Journal of Gastroenterology: “Therapeutic efficacy of an elemental diet for patients with crohn's disease and its association with amino acid metabolism.”

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