Elemental diet

An elemental diet is a diet composed of nutrients in an essentially pre-digested form that is assimilated by the body very quickly and easily. It is usually composed of amino acids and carefully selected fats, sugars, vitamins and minerals blended together with water. It may be consumed by mouth, or delivered by gastric feeding tube or intravenous feeding. In the context of ME/CFS, it is most commonly used to treat Small Intestine Bacterial Overgrowth (SIBO).

Uses

 * Small Intestine Bacterial Overgrowth (SIBO) – with a goal of starving out the bacteria in the small intestine while still feeding the patient.
 * Nutritional support – In hospital settings and when patients are unable to absorb nutrients in other forms
 * Resting the intestines – to support healing of various GI conditions.

Composition
An elemental formula will typically consist of And will explicitly avoid or exclude
 * Amino acids – Including all 8 essential amino acids. A higher quantity of L-Glutamine may be included with a goal of promoting healing of the intestines, which utilize high quantities of L-Glutamine.
 * Fats – A combination of long chain oils and Medium Chain Triglyceride (MCT) oils. MCT oils are emphasized since they can be absorbed most easily by the small intestine.
 * Sugars – Typically as glucose to make absorption as easy as possible. Other forms may be included to smooth out absorption and avoid a blood sugar spike.
 * Starch – In a modified form.
 * Vitamins
 * Minerals
 * Electrolytes – Sodium, potassium, magnesium, etc.
 * Proteins – which must be broken down into smaller pieces before absorption.
 * Undigestible ingredients – such as fiber, thickeners, sugar alcohols, artificial sweeteners, etc.

Semi-Elemental Diet
Peptides may be substituted for amino acids to create a semi-elemental diet. (Peptides are chains of amino acids, that are at least two long, but too short to qualify as a protein.) This variant is used to avoid muscle loss, since the body can use peptides to build and maintain muscle, which it cannot do with raw amino acids.

Evidence
In a 2004 study, 85% of patients SIBO-positive patients became SIBO-negative, according to a lactulose breath test, after following an elemental diet for 2-3 weeks.

Supplies / Formulas
Elemental formulas are available from a few vendors in powdered or pre-mixed form. They are available without a prescription, though at least one brand is sold only through doctors. They are considered a medical food, which means they are generally not covered by health insurance.

It is also possible to create a homemade preparation from a combination of foods available in grocery stores and supplements available over the counter.

Commercial Products

 * Vivonex by Nestle - available in a powdered and pre-mixed form. Taste is often reported to be difficult to tolerate.
 * Absorb Plus by Listen to Your Gut - available in powered form. Available in various flavors.
 * Physicians' Elemental Diet by Integrative Therapeutics - available in powered form. Only sold through physicians / not available over the counter.

Homemade

 * Homemade Elemental Diet by Dr. Allison Siebecker

Learn more

 * Elemental Diet video series by Dr. Allison Siebecker, ND.