Nutrition
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September 16, 2024

Elemental Diet for SIBO: Expert Tips and Patient Experiences

Medically Reviewed by
Updated On
September 23, 2024

The elemental diet is a highly effective yet underutilized tool for treating a variety of gut-related disorders, including small intestinal bacterial overgrowth (SIBO), a gastrointestinal disorder commonly misdiagnosed as irritable bowel syndrome. This article aims to explore the utility of the elemental diet in treating SIBO and offer practical guidance for successfully implementing this dietary approach for those who qualify.

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Understanding SIBO

Small intestinal bacterial overgrowth (SIBO) is a gastrointestinal condition characterized by excessive bacteria in the small intestine. As our understanding of SIBO has evolved, we have been able to distinguish three subsets of SIBO, determined by the gas the overgrown microbes in the intestines produce:

  • Hydrogen-Dominant SIBO is caused by bacteria that produce hydrogen gas. Hydrogen-dominant SIBO shares many similarities with diarrhea-predominant irritable bowel syndrome (IBS-D). (16) 
  • Intestinal Methanogen Overgrowth (IMO) is caused by an overgrowth of a microorganism called archaea in the small or large intestines. IMO shares many similarities with constipation-predominant irritable bowel syndrome (IBS-C). 
  • Hydrogen Sulfide SIBO is caused by bacteria that produce hydrogen sulfide gas  (16).

A relatively low concentration of bacteria grows in the small intestine (especially in comparison to the large intestine, which houses the gut microbiome) in a healthy digestive tract. Various factors can allow these microorganisms to overgrow, including:

  • Digestive enzyme deficiencies
  • Poor intestinal motility
  • Anatomical anomalies within the intestines
  • Immune deficiencies

Patients who have SIBO often complain of IBS-like digestive symptoms. The most common SIBO symptoms, present in more than two-thirds of affected patients, are:

However, it's also possible for SIBO to cause many other symptoms that may not necessarily be associated with poor gut health, such as: 

Given the extent to which this wide variety of symptoms can disrupt daily activities and overall sense of well-being, SIBO has been linked to poorer health-related quality of life. 

What Is an Elemental Diet?

The elemental diet (ED) is a hypoallergenic and anti-inflammatory liquid meal replacement beverage. It is often used in clinical practice as a medical formula to treat severe inflammatory digestive disorders, such as Crohn's disease. 

The ED differs from other meal replacement formulas because it is "nutritionally complete" – it contains all the necessary nutrients humans need to live – and the ingredients are broken down into their most basic ("elemental") forms. Proteins, fats, and carbohydrates are broken down into their simplest building blocks: amino acids, short-chain triglycerides, and simple carbohydrates (glucose or maltodextrin). The formula also contains vitamins and minerals. (27)

The semi-elemental diet is a variation of the full ED. Its formula contains partially hydrolyzed proteins (amino acid chains) and medium-chain triglycerides. This composition makes semi-elemental diets more palatable and easier to tolerate than EDs while still offering the benefit of reduced digestive workload. 

How the Elemental Diet Works for SIBO

The ED treats SIBO by feeding the affected patient but starving the overgrown bacteria. The nutrients are absorbed quickly within the first portions of the small intestine before bacteria can ferment (digest) them for their own benefit. During an ED protocol, the patient will use the ED as their only source of nutrition for 2-3 weeks. (44) 

Compared to prescription or herbal antibiotics, ED prescriptions are far less common in clinical practice, likely due to their associated cost and restrictive nature. However, a 2016 primary care review suggested the ED as a plausible SIBO treatment option, given its association with improved SIBO breath test results and gastrointestinal symptoms in patients who followed it. 

This recommendation is backed by a combination of empirical and scientific evidence that supports using the ED to treat SIBO in clinical practice. 

The most widely referenced study used in support of the ED for SIBO is a 2004 study that involved 93 people with IBS and positive SIBO lactulose breath tests (LBT). After adhering to the ED for 14 days, 80% of patients had a normal LBT. Those who still had abnormal LBT results continued the diet for an additional week and repeated the LBT. At the end of the 21-day trial, 85% of participants had normal LBT results, indicating an eradication of SIBO. Normalization of the LBT also coincided with symptom improvement. 

Implementing the Elemental Diet: A Practitioner's Guide

Implementing the elemental diet in clinical practice involves several key steps to ensure patient safety, compliance, and effectiveness. Here is a guide for practitioners:

Step 1: Patient Assessment

Determine if the ED is appropriate for the patient. Screen for any contraindications that would disclude the ED from being a reasonable treatment option for your patient. These include: 

Step 2: Patient Preparation and Education

Educate the patient on the purpose and process of the elemental diet. Explain that this liquid-only diet involves drinking a formula of pre-digested nutrients designed to minimize digestive effort and absorption issues. 

Despite these digestive benefits, following a liquid-only diet for an extended period presents mental and emotional challenges that the patient should be prepared for. Additionally, one of the major drawbacks that patients report with the ED is its unpalatable taste, which can make it difficult to adhere to. (28)

Patients should continue taking all essential medications during the protocol. Supplements are optional and can be used as needed to manage side effects. For example, electrolytes can be added to prevent dehydration if they begin to experience diarrhea, and Vitamin C and magnesium can be used to treat constipation.

Step 3: Diet Selection

Recommend a prescription or nonprescription commercial ED formula.

Alternatively, patients can make their formula themselves at home, which tends to be less expensive than the commercial options. Example recipes can be found here.

Calculate the patient's daily caloric needs based on their age, weight, activity level, and clinical condition. This determines how much formula the patient will need to drink daily to meet their daily caloric goals.

Step 4: Monitoring and Support

Healthcare providers should be readily available to their patients during the ED protocol to monitor their clinical response, including symptom improvement and side effects, and address any questions that arise. 

Common side effects of the ED include (28, 44):

  • Increased hunger and weight loss, when not drunk in sufficient amounts
  • Digestive symptoms: bloating, diarrhea, abdominal pain, nausea, less frequent bowel movements
  • Headaches
  • Fatigue
  • Muscle and joint pain
  • Mood swings
  • Fungal overgrowth 

Step 5: Assess Treatment Efficacy

The 2004 study referenced above set the ED's standard treatment timeframe of 14-21 days. Once the ED is completed, SIBO status can be evaluated by repeating the SIBO breath test or assessing the patient's clinical symptoms. When treating based on symptoms, many doctors will continue treatment until the patient reports an 80-90% improvement.

Transitioning Off the Elemental Diet

The ED is not designed to be a long-term diet. Once the patient has completed their protocol, they should be guided in gradually reintroducing solid foods back into their diet to prevent digestive upset. 

Here is an example of a 3-day transition diet that I will recommend to my patients: 

  • Day 1: eat a low-fiber diet consisting of meats, eggs, fats, white rice, and (if tolerated) lactose-free dairy
  • Day 2: add cooked low-FODMAP vegetables, such as green beans, green bell peppers, and carrots (32) 
  • Day 3: add low-FODMAP fruits, such as melon, blueberries, or oranges (32) 
  • Day 4: return to regular diet

An alternative approach would be to follow a half-elemental diet, which involves replacing one to two meals per day with an elemental shake, providing approximately 50% of daily caloric intake. The remaining meals consist of a healthy, whole-food diet. This approach better allows for long-term use of the ED and offers a balanced way to support digestive health while maintaining the benefits of regular whole foods.

Dietary strategies can also be worked into a long-term SIBO prevention plan. Popular diets for the treatment and prevention of SIBO include (15):  

These dietary plans are all variations of elimination diets that aim to limit the intake of fermentable carbohydrates that bacteria thrive on, thereby reducing their population. By doing so, SIBO diets help to minimize clinical symptoms. (15)

Practitioner Tips for Maximizing Success

Here are tips that can help your patients successfully follow an elemental diet: 

Take the time to properly prepare your patients before they start the ED: Before your patient begins their ED, have them schedule an appointment with ample time for you to explain the procedure and answer all of their questions.

Modify the ED: Consider prescribing a semi-elemental diet or prescribing a shortened ED protocol to kick-start SIBO treatment. Then, use antibiotics or herbal antimicrobials to finish eradicating SIBO. 

Prevent fungal overgrowth: Because intestinal fungal overgrowth is a common side effect of the ED, many practitioners will prescribe prophylactic antifungals for their patients during the ED protocol. Drinking the formula through a straw can also help prevent oral thrush (yeast overgrowth in the mouth).  

Make the ED more palatable: To improve the taste of the ED formula, one of its major deterring factors, recommend a flavored commercial ED or semi-elemental formula to your patient. Drinking the beverage cold, such as by blending the formula with ice, can also help improve taste.   

Make the ED more affordable: Patients can save money by homemaking their ED formula instead of buying commercial products. 

Regulate blood sugar: The ED's high glucose load can lead to fast peaks and dips in blood sugar, contributing to symptoms like fatigue, headache, and irritability. To help stabilize blood sugar, instruct patients to sip on their elemental shake throughout the day instead of drinking three "meals." 

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Key Takeaways

  • SIBO is a gastrointestinal condition that mimics the symptoms of IBS and requires a reduction of bacterial overgrowth for treatment.
  • The elemental diet is a hypoallergenic liquid formula that starves bacteria and reduces inflammation in the intestines. It can be used to treat SIBO and its associated symptoms. 
  • Successfully prescribing the ED to patients involves many logistical elements. Patient education and providing tools to navigate obstacles that commonly arise with an ED protocol help patients complete their diet. Most patients who complete the ED find that the challenges were worth it.
The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.

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References

  1. Alexander, D. D., Bylsma, L. C., Elkayam, L., et al. (2016). Nutritional and health benefits of semi-elemental diets: A comprehensive summary of the literature. World Journal of Gastrointestinal Pharmacology and Therapeutics, 7(2), 306. https://doi.org/10.4292/wjgpt.v7.i2.306
  2. Bertagna, B. (2024, February 13). Exploring the Gut Microbiome's Influence on Anxiety and Depression. Rupa Health. https://www.rupahealth.com/post/exploring-the-gut-microbiomes-influence-on-anxiety-and-depression
  3. Bertagna, B. (2024, March 5). The GAPS Diet: Principles, Therapeutic Uses, and Benefits. Rupa Health. https://www.rupahealth.com/post/the-gaps-diet-principles-therapeutic-uses-and-benefits
  4. Bushyhead, D., & Quigley, E. M. M. (2022). Small Intestinal Bacterial Overgrowth, Pathophysiology and its implications for Definition and Management. Gastroenterology, 163(3). https://doi.org/10.1053/j.gastro.2022.04.002
  5. Christie, J. (2023, January 26). 5 Lab Test Can That Help Diagnose The Root Cause of Chronic Bloating. Rupa Health. https://www.rupahealth.com/post/5-lab-test-that-help-diagnose-the-root-cause-of-chronic-bloating
  6. Chuah, K. H., Hian, W. X., Lim, S. Z., et al. (2023). Impact of small intestinal bacterial overgrowth on symptoms and quality of life in irritable bowel syndrome. Journal of Digestive Diseases, 24(3), 194–202. https://doi.org/10.1111/1751-2980.13189
  7. Cloyd, J. (2023, March 1). How to Use The Elemental Diet in Clinic. Rupa Health. https://www.rupahealth.com/post/how-to-use-the-elemental-diet-in-clinic
  8. Cloyd, J. (2023, March 6). The Microbiome-Joint Axis: Exploring the Gut's Influence on Joint Pain. Rupa Health. https://www.rupahealth.com/post/the-guts-role-in-joint-inflammation
  9. Cloyd, J. (2023, March 7). An integrative medicine approach to fatigue. Rupa Health. https://www.rupahealth.com/post/an-integrative-medicine-approach-to-fatigue
  10. Cloyd, J. (2023, March 14). SIBO Testing 101: A Complete Guide to The Top 3 SIBO Tests. Rupa Health. https://www.rupahealth.com/post/sibo-testing-101-a-complete-guide-to-the-top-3-sibo-tests
  11. Cloyd, J. (2023, March 20). Top 5 Functional Medicine Labs for IBS-C Patients. Rupa Health. https://www.rupahealth.com/post/top-5-functional-medicine-labs-for-ibs-c-patients
  12. Cloyd, J. (2023, March 29). Top 5 Differential Diagnosis for Abdominal Pain and How to Treat With Functional Medicine. Rupa Health. https://www.rupahealth.com/post/top-5-differential-diagnoses-for-abdominal-pain-and-how-to-treat-with-functional-medicine
  13. Cloyd, J. (2023, March 30). An In-Depth Overview of the Three Types of SIBO: Hydrogen, Methane, Hydrogen Sulfide. Rupa Health. https://www.rupahealth.com/post/an-in-depth-overview-of-the-three-types-of-sibo-hydrogen-methane-hydrogen-sulfide
  14. Cloyd, J. (2023, April 3). 5 Health Conditions That Are Associated with Small Intestinal Bacterial Overgrowth (SIBO). Rupa Health. https://www.rupahealth.com/post/5-health-conditions-that-are-associated-with-small-intestinal-bacterial-overgrowth-sibo
  15. Cloyd, J. (2023, April 26). Dietary Modifications for a Successful SIBO Treatment Plan. Rupa Health. https://www.rupahealth.com/post/dietary-modifications-for-a-successful-sibo-treatment-plan
  16. Cloyd, J. (2023, May 4). A Functional Medicine SIBO Protocol: Testing and Treatment. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-sibo-protocol
  17. Cloyd, J. (2023, June 8). A Functional Medicine IBS-D Protocol: Testing, Differential Diagnosis, and Treatment. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-ibs-d-protocol-testing-nutrition-and-supplements
  18. Cloyd, J. (2023, June 13). A Functional Medicine Intestinal Methanogen Overgrowth Protocol (IMO): Testing, Nutrition, and Supplements. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-intestinal-methanogen-overgrowth-protocol-imo-testing-nutrition-and-supplements
  19. Cloyd, J. (2023, June 22). The Cedars-Sinai Diet: A Comprehensive Guide for IBS and SIBO Patients. Rupa Health. https://www.rupahealth.com/post/the-cedars-sinai-diet-a-comprehensive-guide-for-ibs-and-sibo-patients
  20. Cloyd, J. (2023, June 23). Individualizing The SIBO Bi-Phasic Meal Plan With Specialty Labs. Rupa Health. https://www.rupahealth.com/post/individualizing-the-sibo-bi-phasic-meal-plan-with-specialty-labs
  21. Cloyd, J. (2023, July 28). A functional medicine diarrhea protocol: Comprehensive lab testing, therapeutic diet, and supplements. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-diarrhea-protocol-comprehensive-lab-testing-therapeutic-diet-and-supplements
  22. Cloyd, J. (2023, November 28). Are You Having Trouble Sleeping?: Learn About The Surprising Link Between Your Gut Microbiome and Sleep Disorders. Rupa Health. https://www.rupahealth.com/post/are-you-having-trouble-sleeping-learn-about-the-surprising-link-between-your-gut-microbiome-and-sleep-disorders
  23. Cloyd, J. (2024, January 25). What is the Gut Microbiome? Rupa Health. https://www.rupahealth.com/post/what-is-the-gut-microbiome
  24. DePorto, T. (2022, November 30). Restless Leg Syndrome: Causes, Symptoms, and Treatment. Rupa Health. https://www.rupahealth.com/post/restless-leg-syndrome-causes-symptoms-and-treatment
  25. DePorto, T. (2023, January 5). Electrolytes Imbalance: Symptoms & How to Treat It. Rupa Health. https://www.rupahealth.com/post/electrolytes
  26. DePorto, T. (2023, January 26). Using the Specific Carbohydrate Diet for IBD Symptom Relief. Rupa Health. https://www.rupahealth.com/post/using-the-specific-carbohydrate-diet-for-ibd-symptom-relief
  27. Elemental Diet. ScienceDirect. Retrieved June 27, 2022, from https://www.sciencedirect.com/topics/medicine-and-dentistry/elemental-diet
  28. Elemental Diet. (2021, November 18). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/22053-elemental-diet
  29. Greenan, S. (2021, November 2). Constant Burping Is A Sign Of This Harmful Bacterial Overgrowth. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-sibo
  30. Greenan, S. (2021, November 18). How To Do A Low FODMAP Elimination Diet. Rupa Health. https://www.rupahealth.com/post/what-are-fodmaps
  31. Heuschkel, R. (2009). Enteral Nutrition Should Be Used to Induce Remission in Childhood Crohn's Disease. Digestive Diseases, 27(3), 297–305. https://doi.org/10.1159/000228564
  32. High and low FODMAP foods. (2019). Monash University. https://www.monashfodmap.com/about-fodmap-and-ibs/high-and-low-fodmap-foods
  33. Krajicek, E. J., & Hansel, S. L. (2016). Small Intestinal Bacterial Overgrowth. Mayo Clinic Proceedings, 91(12), 1828–1833. https://doi.org/10.1016/j.mayocp.2016.07.025
  34. Narula, N., Dhillon, A., Zhang, D., et al. (2018). Enteral nutritional therapy for induction of remission in Crohn's disease. Cochrane Database of Systematic Reviews, 2018(4). https://doi.org/10.1002/14651858.cd000542.pub3
  35. Neibling, K. (2023, February 27). Integrative medicine treatment for headaches. Rupa Health. https://www.rupahealth.com/post/integrative-medicine-treatment-for-headaches
  36. Neibling, K. (2023, March 24). Why Functional Medicine Practitioners Focus on Gut Health. Rupa Health. https://www.rupahealth.com/post/why-functional-medicine-practitioners-focus-on-gut-health
  37. Pimentel, M., Constantino, T., Kong, Y., et al. (2004). A 14-day elemental diet is highly effective in normalizing the lactulose breath test. Digestive Diseases and Sciences, 49(1), 73–77. https://doi.org/10.1023/b:ddas.0000011605.43979.e1
  38. Pimentel, M., Saad, R. J., Long, M. D., et al. (2020). ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. The American Journal of Gastroenterology, 115(2), 165–178. https://doi.org/10.14309/ajg.0000000000000501
  39. Preston, J. (2024, February 15). Magnesium 101: RDA, Magnesium-Rich Foods, and Supplementation. Rupa Health. https://www.rupahealth.com/post/magnesium-101-rda-magnesium-rich-foods-and-supplementation
  40. Rezaie, A., Pimentel, M., & Rao, S. S. (2016). How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach. Current Gastroenterology Reports, 18(2). https://doi.org/10.1007/s11894-015-0482-9
  41. Shah, A., & Holtmann, G. (2024, January 23). Small intestinal bacterial overgrowth: Etiology and pathogenesis. UpToDate. https://www.uptodate.com/contents/small-intestinal-bacterial-overgrowth-etiology-and-pathogenesis/print
  42. Siebecker, A. Elemental Formula. SIBO - Small Intestinal Bacterial Overgrowth. https://www.siboinfo.com/elemental-formula.html
  43. Siebecker, A. (2022). Homemade Elemental Diet. https://www.siboinfo.com/uploads/5/4/8/4/5484269/homemade_elemental_diet_recipes_feb_2022.pdf
  44. Sparks Akers, A. (2023, May 17). Can the elemental diet reduce SIBO symptoms? Medical News Today. https://www.medicalnewstoday.com/articles/elemental-diet-sibo#benefits-for-sibo
  45. Sweetnich, J. (2023, May 9). Vitamin C 101: Understanding Testing, RDAs, and The Benefits of Supplementation. Rupa Health. https://www.rupahealth.com/post/vitamin-c-101
  46. Teeter, L. A. (2023, May 10). Complementary and Integrative Medicine Approaches to Eating Disorders. Rupa Health. https://www.rupahealth.com/post/complementary-and-integrative-medicine-approaches-to-eating-disorders
  47. Tingle, R. (2022, June 6). 10 Type 2 Diabetes Risk Factors You May Not Know About. Rupa Health. https://www.rupahealth.com/post/what-causes-type-2-diabetes
  48. Weinberg, J. L. (2023, February 24). An Integrative Medicine Approach to SIFO: Small Intestinal Fungal Overgrowth. Rupa Health. https://www.rupahealth.com/post/an-integrative-medicine-approach-to-sifo-small-intestinal-fungal-overgrowth
  49. Yoshimura, H. (2023, June 7). The Gut Microbiomes Role in Skin Health. Rupa Health. https://www.rupahealth.com/post/the-gut-microbiomes-role-in-skin-health
Jaime Cloyd
Author
Dr. Jaime Cloyd ND
Naturopathic Physician based in the greater Seattle area
Medically Reviewed by
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