Elemental Diet

An elemental diet is a liquid diet that gives you complete nutrition in a form that’s easy to absorb and requires little digestion. It contains protein, fat and carbohydrates that are already broken down into smaller parts. It also provides the vitamins, minerals and electrolytes your body needs.

The diet usually comes as a ready-to-drink liquid or a powder that you mix with water. You’ll likely drink it, but you may need to get it through a feeding tube.

An elemental diet reduces your digestive system’s workload. Your body absorbs most of the formula in the upper part of your small intestine. This allows the rest of your digestive system to rest and recover from illness or injury.

The diet also limits the amount of undigested food farther down in your gut that bacteria can feed on. This is why healthcare providers often use it as a targeted nutrition therapy for certain digestive conditions.

What is the elemental diet used for?

Your healthcare provider may use an elemental diet to manage certain digestive conditions, including:

• Small intestinal bacterial overgrowth (SIBO)
• Intestinal methanogen overgrowth (IMO)
• Crohn’s disease
• Eosinophilic esophagitis (EoE)
• Other eosinophilic GI disorders
• Conditions that make it hard to digest or absorb nutrients

The elemental diet isn’t a common treatment. It’s very restrictive and can be hard to follow. Your provider will usually only recommend it when there’s a clear medical reason. They’ll often try other treatments first. But if you need an elemental diet, they’ll help you understand how it works and everything you need to know.

How does the elemental diet work?

Your healthcare provider or a dietitian will select a formula for you. They’ll calculate how much you need each day. They’ll consider your:

• Age
• Weight
• Health condition
• Calorie needs
• Fluid needs
• Activity level

On a full elemental diet, the formula replaces all food. You can usually drink water, too. But ask your provider before drinking tea, coffee or other beverages. Even small amounts of food and drinks can affect how well the treatment works.

You’ll divide the formula into several servings throughout the day. It’s important to sip it slowly. Drinking it too quickly may cause nausea, cramping or diarrhea.

Some people have trouble drinking enough formula. You may not like the taste, or you may feel full before finishing. In these cases, you may have to use a feeding tube. But your provider will walk you through the steps and guide you through this treatment.

What’s in the elemental diet formula?

The elemental diet contains nutrients in their simplest form:

• Free amino acids instead of whole proteins
• Simple carbs
• Fats, like medium-chain triglycerides (MCTs)
• Vitamins
• Minerals
• Electrolytes

These nutrients require little digestion before your body can absorb them.

What’s a partial or half-elemental diet?

On a partial elemental diet, the formula provides some of your daily calories. The rest of your calories come from the food you eat.

Your provider might recommend this type if you:

• Need extra calories or nutrients
• Can’t tolerate a full elemental diet
• Are moving into or out of a full elemental diet
• Use nutrition therapy to help manage Crohn’s disease

How long will I need to stay on the elemental diet?

The length of treatment depends on why you need it and how your body responds.

An elemental diet for SIBO or IMO usually lasts two to three weeks. For Crohn’s disease, it often lasts six to eight weeks. Treatment for EoE may last about six weeks before your provider checks for improvement.

These time frames aren’t the same for everyone. Follow the schedule your healthcare provider gives you. Don’t extend the diet on your own.

What are possible elemental diet benefits and side effects?

The main benefits of the elemental diet are:

• Bowel rest: The diet allows your digestive system to heal from severe illness and injury without sacrificing your nutrition.
• Decreased inflammation: Many health conditions cause flare-ups that affect your digestion and quality of life. Reducing irritants in your digestive system can lessen inflammation.
• Reduced bacterial overgrowth: Overgrown gut bacteria depend on undigested food in your lower digestive tract to live. The diet keeps food out, starving the bacteria and restoring balance.

Elemental diet side effects may include:

• Nausea
• Belly pain or cramping
• Bloating
• Diarrhea
• Headaches
• Fatigue
• Dizziness
• Changes in blood sugar
• Unwanted weight loss

The elemental diet may not taste very good — it may taste bland. Also, you may poop less often, which doesn’t always mean you’re constipated. Elemental formulas leave behind less waste than regular food. But tell your provider if you have pain, hard poop or trouble pooping.

What should I do after the elemental diet?

It’s important to reintroduce foods gradually as your digestive system is ramping back up again. Your healthcare provider may recommend following a half-elemental diet or a low-FODMAP diet during the transition.

Your provider may also recommend:

• Probiotics to repopulate your gut with beneficial flora
• Prokinetic agents to stimulate your bowels to begin moving more regularly again

As you return to your normal diet, pay attention to the way different foods affect your digestive system. If they cause too much distress, back off a bit and try again later.

How long will it take for me to feel better?

It depends on which condition you have and how your body responds. Some people notice fewer symptoms during treatment. Others don’t feel better until after they finish the diet and begin eating food again.

The elemental diet doesn’t work for everyone. Even if it helps, symptoms may return. For example, SIBO can come back if you still have the condition that caused bacterial overgrowth.

Is there anything I can do to make this treatment easier on me?

There are ways you can make things easier:

• Chill the formula before drinking it.
• Sip it slowly instead of drinking it all at once.
• Divide your formula into several servings.
• Use a straw if the taste bothers you.
• Follow the mixing instructions exactly.
• Drink the amount of water your provider recommends.
• Carry prepared formula in a temperature-controlled container.
• Plan nonfood activities during your usual mealtimes.
• Ask loved ones for support.
• Keep track of your symptoms and how much formula you drink.

Don’t add flavorings or other ingredients without asking your care team. Added ingredients may change how the diet works.

Talk to your provider for other tips. They can help you find ways to get through the treatment.

When should I call my healthcare provider?

Contact your provider if you:

• Can’t drink or tolerate the prescribed amount of formula
• Have repeated vomiting or diarrhea
• Feel very weak, dizzy or faint
• Notice signs of dehydration, like dark pee or peeing less often
• Lose weight without meaning to
• Have blood sugar readings that are too high or too low
• Develop new or worsening symptoms
• Have side effects that make it hard to continue treatment

Seek immediate care if you have:

• Severe belly pain
• A swollen belly
• Vomiting that won’t stop
• Bloody or black poop
• Confusion