A New Tool for Better Gut Health: Elemental Diet

Problems in the gut can really take a toll on your quality of life. Perhaps you are counting the bathrooms in public or conversely, counting the number of days until your next bowel movement. Other symptoms include uncomfortable gas and bloating that makes you loosen your waistline.

However, an unhappy gut can also cause non-digestive symptoms through increasing inflammation in the body. Such signs of sub-optimal gut health include:

• Fatigue
• Sleep issues
• Brain fog
• Hormone imbalances (thyroid, female hormones)
• Joint pain
• And more…

One of the first things I help patients with who are desiring better gut health is to find an initial dietary template and ensure their lifestyle is not wreaking havoc on their gut (e.g. 4 hours of sleep, sedentary, etc.).

However, I’ve found that many people with an impeccable diet still suffer from poor gut health. My goal for every patient is to find the broadest diet possible while not flaring symptoms. Unfortunately, I’ve found many people further restrict their diet to a list of items that they can count on one hand. Many times, more diet rules and restrictions is NOT the answer. Rather, they need to take further steps to improve their gut health and thus, the symptoms.

An elemental formula can be used as a tool to help repair your gut and get back to better health.

What is an elemental diet?

Imagine you sprained your ankle running. The natural thing to do is to not run on it until it is fully healed, right? You are naturally inclined to give your body a break when it is damaged or hurt. In the same way, we often forget to give our gut a break when it is not in an optimal state of health.

An elemental diet is NOT a set of rigid diet rules and restrictions (it is different from the elimination diet). Instead, it is a meal replacement tool that consists of PRE-digested protein and carbohydrates. As the name implies, the protein and carbs in the elemental formula are broken down into their most elemental form.

Why is this helpful? The elemental formula comes in a powder form much like a normal protein shake. You mix with water or blend with ice to make a shake of sorts. When you drink the elemental shake, it is all absorbed in the first two feet of the small intestine. Therefore, it gives the rest of your gut a break. It does this through 4 key ways:

1. “Starves” overgrowth of bacteria and other “bad bugs” in the gut that can be causing problems
2. Reduces inflammation by limiting foods that could be triggering your immune system
3. Reduces the amount of fiber in your diet that some can be sensitive to
4. And repair the gut lining that can be damaged in those with IBS and inflammatory bowel disease

Can an elemental diet help me?

A little known secret is that the elemental diet has been used in multiple research studies. The most amount of research is found for the following symptoms and conditions:

• Inflammatory bowel disease like Crohn’s disease and ulcerative colitis [1,2,3,4,5,6,7,8,9]
  • One study found it was MORE effective than steroids [10]
• Irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO)
  • One study found SIBO was cleared in 80% of cases, and IBS symptoms improved in 65% of participants after just 2 weeks of using the elemental diet [11]
• Those with Celiac disease who are on a gluten-free diet but still have symptoms [12,13]
  • This may be because a notable portion of those with Celiac disease also have SIBO
• Rheumatoid arthritis [14]
• Reduce side effects of chemotherapy such as mouth ulcers [14]
• Colonoscopy prep [16]

At our clinic, I’ve also found benefit by helping patients with:

• Rashes, acne, and other skin conditions
• Food reactions
• Fatigue
• “Brain fog”
• Female hormone imbalances (PMS, painful periods)
• Thyroid imbalances (low thyroid, symptoms thought to be from thyroid dysfunction actually from poor gut health)

You can also use it whenever you are having a “flare” of your symptoms or other times you are having an increased amount of inflammation.

How to use an elemental diet?

The tricky part is knowing how and when to use the elemental diet effectively to get the most “bang for your buck”. Here are a few options:

• Exclusively for 2 weeks (or longer for more serious cases)
• Meal-replacements as needed
• Add on to normal meals for extra calories and nutrients (for those who are underweight or malnourished)

However, the most common way I use it to help patients is as follows:

• Shorter 1-4 day reset: most calories coming from the elemental shake
• Followed by a “hybrid approach”: replace 1-2 meals per day with the elemental shake

By using a short reset, you can continue the benefits with the “hybrid approach” by giving your gut an extended break each day allowing it to fully become restored.

If you are thinking about using the elemental diet formula, ensure that you are getting a good quality. Also, make sure you are using it at the right time in your care along with other personalized gut-healing therapies. In other words, you will not likely get the full benefit from using it in isolation.

Is the elemental diet safe?

Research also shows that elemental diets are not only effective but also safe [7,16] and to my knowledge, do not present any long-term health problems.

Importantly, the elemental diet formula has all the nutrients, vitamins, and minerals to maintain a healthy diet. In one study, participants who took an elemental diet for 3 months saw an improvement in malnourishment rates [8]. In fact, I drink an elemental shake almost everyday for my first morning meal. I have felt a renewed state of energy and mental clarity since using it.

I’ve used an elemental diet, now what?

Let’s say that you’ve used the elemental diet but are still experiencing symptoms of poor gut health. The good news is that there is still hope for you and your journey back to better health. There are a multitude of gut therapies that we can use to get you back to better health.

The problem is that most clinicians and patients alike don’t have a system for prioritizing therapies to heal the gut. Fortunately, I have focused on using a comprehensive intake process along with labs to uncover why you are experiencing your symptoms. I then create a treatment roadmap to fix the underlying root cause to give you lasting solutions to your health.

The bottom line

An elemental diet is a very powerful and effective strategy to alleviate the most common gut health ailments along with other symptoms that may be caused from poor gut health. Just remember to use it strategically and along with other personalized gut-healing therapies.

If you want to learn more about minimally-invasive ways to heal your gut, then download the “Gut Reset Guide”. If you want to take your health to the next level with personalized care, then call our clinic to book an appointment with me. 

I hope you found this information useful and helpful in your journey back to a healthier and happier life.

References

1. DAY, A.S., WHITTEN, K.E., SIDLER, M. and LEMBERG, D.A. (2008), Systematic review: nutritional therapy in paediatric Crohn’s disease. Alimentary Pharmacology & Therapeutics, 27: 293-307. https://doi.org/10.1111/j.1365-2036.2007.03578.x
2. Nakahigashi, M., Yamamoto, T., Sacco, R. et al. Enteral nutrition for maintaining remission in patients with quiescent Crohn’s disease: current status and future perspectives. Int J Colorectal Dis 31, 1–7 (2016). https://doi.org/10.1007/s00384-015-2348-x
3. Tsertsvadze A, Gurung T, Court R, Clarke A, Sutcliffe P. Clinical effectiveness of elemental nutrition for the maintenance of remission in Crohn’s disease: a systematic review and meta-analysis. Health Technol Assess 2015;19(26)
4. Knight, C., El-Matary, W., Spray, C., & Sandhu, B. K. (2005). Long-term outcome of nutritional therapy in paediatric crohn’s disease. Clinical Nutrition, 24(5), 775–779. https://doi.org/10.1016/j.clnu.2005.03.005
5. Berni Canani, R., Terrin, G., Borrelli, O., Romano, M. T., Manguso, F., Coruzzo, A., D’Armiento, F., Romeo, E. F., & Cucchiara, S. (2006). Short- and long-term therapeutic efficacy of nutritional therapy and corticosteroids in paediatric crohn’s disease. Digestive and Liver Disease, 38(6), 381–387. https://doi.org/10.1016/j.dld.2005.10.005
6. Rajendran N, Kumar D. Role of diet in the management of inflammatory bowel disease. World J Gastroenterol 2010; 16(12): 1442-1448 URL: https://www.wjgnet.com/1007-9327/full/v16/i12/1442.htm DOI: https://dx.doi.org/10.3748/wjg.v16.i12.1442
7. Ferreiro B, Llopis-Salinero S, Lardies B, Granados-Colomina C, Milà-Villarroel R. Clinical and Nutritional Impact of a Semi-Elemental Hydrolyzed Whey Protein Diet in Patients with Active Crohn’s Disease: A Prospective Observational Study. Nutrients. 2021 Oct 16;13(10):3623. doi: 10.3390/nu13103623. PMID: 34684624; PMCID: PMC8538212.
8. Robert Heuschkel; Enteral Nutrition Should Be Used to Induce Remission in Childhood Crohn’s Disease. Dig Dis 1 September 2009; 27 (3): 297–305. https://doi.org/10.1159/000228564
9. Hiwatashi, Nobuo M.D.1. Enteral nutrition for Crohn’s disease in Japan. Diseases of the Colon & Rectum 40(10):p S48-S53, October 1997. | DOI: 10.1007/BF02062020
10. Borrelli, O., Cordischi, L., Cirulli, M., Paganelli, M., Labalestra, V., Uccini, S., Russo, P. M., & Cucchiara, S. (2006). Polymeric diet alone versus corticosteroids in the treatment of active pediatric crohn’s disease: A randomized controlled open-label trial. Clinical Gastroenterology and Hepatology, 4(6), 744–753. https://doi.org/10.1016/j.cgh.2006.03.010
11. Pimentel, M., Constantino, T., Kong, Y. et al. A 14-Day Elemental Diet Is Highly Effective in Normalizing the Lactulose Breath Test. Dig Dis Sci 49, 73–77 (2004). https://doi.org/10.1023/B:DDAS.0000011605.43979.e1
12. OLAUSSEN, R., LOVIK, A., TOLLEFSEN, S., ANDRESEN, P., VATN, M., DELANGE, T., BRATLIE, J., BRANDTZAEG, P., FARSTAD, I., & LUNDIN, K. (2005). Effect of elemental diet on mucosal immunopathology and clinical symptoms in type 1 refractory celiac disease. Clinical Gastroenterology and Hepatology, 3(9), 875–885. https://doi.org/10.1016/s1542-3565(05)00295-8
13. Podas T, Nightingale JM, Oldham R, Roy S, Sheehan NJ, Mayberry JF. Is rheumatoid arthritis a disease that starts in the intestine? A pilot study comparing an elemental diet with oral prednisolone. Postgrad Med J. 2007 Feb;83(976):128-31. doi: 10.1136/pgmj.2006.050245. PMID: 17308218; PMCID: PMC2805936.
14. Tanaka Y, Takeuchi H, Nakashima Y, Nagano H, Ueno T, Tomizuka K, Morita S, Emi Y, Hamai Y, Hihara J, Saeki H, Oki E, Kunisaki C, Otsuji E, Baba H, Matsubara H, Maehara Y, Kitagawa Y, Yoshida K. Effects of an elemental diet to reduce adverse events in patients with esophageal cancer receiving docetaxel/cisplatin/5-fluorouracil: a phase III randomized controlled trial-EPOC 2 (JFMC49-1601-C5). ESMO Open. 2021 Oct;6(5):100277. doi: 10.1016/j.esmoop.2021.100277. Epub 2021 Oct 6. PMID: 34626918; PMCID: PMC8511839.
15. Yoshida T, Homma S, Ichikawa N, Iijima H, Taketomi A. Preoperative Elemental Diet before Laparoscopic Anterior Resection in Patients with Advanced Stenotic Rectal Cancer. J Anus Rectum Colon. 2021 Oct 28;5(4):395-404. doi: 10.23922/jarc.2021-026. PMID: 34746504; PMCID: PMC8553358.
16. González-Huix F, de León R, Fernández-Bañares F, et al Polymeric enteral diets as primary treatment of active Crohn’s disease: a prospective steroid controlled trial. Gut 1993;34:778-782.