For individuals dealing with IBS, IBD, Crohn’s, or SIBO, something as simple as eating a meal can be difficult and uncomfortable. After eating, the body digests food into absorbable nutrients and challenges arise when those steps are disrupted or become less efficient. Gastrointestinal/digestive impairment (GDI) conditions are characterized by a limited or impaired capacity to digest, absorb, or metabolize ordinary foods or certain nutrients. The existence of distinctive nutritional requirements of patients experiencing GDI drives the need for specific dietary approaches.
An elemental diet provides nutrition in an easily absorbable form and includes a balance of all macronutrients: carbohydrate, fat, and protein. Because these macronutrients are in a pre-digested form, further breakdown is not necessary, essentially allowing the gut to rest without jeopardizing the body’s nutritional intake or nutrient status. Elemental diets have been used in hospitals since the 1940s. Recently, use of elemental diets has increased for the dietary management of various gastrointestinal/digestive impairment (GDI) conditions under medical supervision.
Clinical Research
Published clinical studies have shown that elemental diets are effective for the nutritional management of patients with moderate to severe impaired gastrointestinal function.1 A 2004 study of 93 patients with symptoms of IBS (irritable bowel syndrome) and abnormal lactulose breath tests indicating the presence of SIBO (small intestinal bowel overgrowth), were given an elemental diet formula as the sole source of nutrition. After two weeks, subjects were retested and 80% had a normal breath test; those who still had abnormal test results were provided an additional week of the elemental diet. At the end of three weeks, 85% of total subjects had normalized breath test results and experienced an associated improvement in clinical symptoms compared to subjects who failed to normalize.2 Research has shown that elemental diets can also be effective for the dietary management of IBD (Inflammatory bowel disease). In one controlled clinical study, 28 patients with active Crohn’s disease were placed on an elemental diet for four weeks with no other food or medication. Clinical remission was achieved in 71% of cases.3
How does it work?
Patients should consult and work with their healthcare practitioner to build the program including identifying nutritional needs, program duration, and symptom monitoring.
Here is an example of a 3-phase framework approach that practitioners may apply while working with patients.
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Patient adherence
Communicating with the patient to keep them motivated and encouraging them to adhere to the routine can be challenging.
Here are some easy tips to encourage patient adherence:
 For a smoothie-like experience, incorporate ice in a blender along with the formula |
 Consider consuming with additional water to adjust the flavor to your liking. |
 Take your time. Sip it slowly over the course of an hour. |
 Consider making social engagements around activities other than dining out. |
It’s important to establish a clear and open line of communication with your patient as they complete the elemental diet. Be sure to check in regularly to see how your patient is feeling, any concerns they may have, and any notable digestive or body changes they have noticed during the program. Take the first steps to digestive health together.
References:
- Ueno, F, Matsui, T, Matsumoto, T, et al. 2013. J Gastroenterol. 48:31–72.
- Pimentel, M, et al. 2004. Dig Dis Sci. 49:73-7.
- Yamamoto, T, et al. 2005. Inflamm Bowel Dis. 11:580-8.