Elemental Diet Explained: Usage with SIBO and other diseases
Initially, elemental diets were developed as high-calorie, low-fiber nutrition for space travel. The objective was to minimize waste and excretion while ensuring astronauts were well-nourished. Nowadays, this "astronaut food" has found its way into medicine, particularly for very ill patients.
What is an Elemental Diet?
An elemental diet is defined as a "low molecular weight, fiber-free diet, where components (amino acids, di- and tripeptides, glucose, trace elements, and vitamins) are fully absorbed in the small intestine, thus relieving other parts of the intestine."
It's used for chronic inflammatory bowel diseases like Crohn's disease and ulcerative colitis. However, many patients reportedly find it challenging to accept.
Essentially, the elemental diet is so digestible that it doesn't burden the intestine with digestion. Instead, the nutrients are absorbed in the first section of the intestine. This provides people with intestinal inflammations essential nutrients and calories.
It's also important to distinguish whether the diet is suitable as the only source of nutrition or not.
Full vs. Supplemental Elemental Diet
A fully balanced elemental diet contains enough nutrients, tailored for the patient's specific condition, meaning no other food is necessary. However, not every elemental diet meets the criteria of being a standalone nutritional source. Supplemental versions are not sufficient for long-term use without other foods.
Overview of Applications and Forms of Elemental Diet
Originally intended for gastrointestinal diseases, the range of applications for the elemental diet has expanded. Despite its proven benefits for various ailments, this therapeutic approach is often not well-received due to significant changes in a patient's daily life.
· Usage in Gastrointestinal Motility Disorders: Besides Crohn's disease and ulcerative colitis, the elemental diet is used for severe gastrointestinal motility disorders. When peristalsis, the intestine's natural movement, stops working, the diet ensures proper nutrition. In some cases, more permanent solutions like gastric tubes may be employed.
· Elemental Diet for Crohn's Disease and Ulcerative Colitis: For Crohn's disease, the elemental diet has shown high remission rates. In one study involving over 100 patients, 85% achieved remission, regardless of gender, age, or severity of the disease. Similarly, the elemental diet showed improvements in ulcerative colitis patients, with remission in over 40% of cases after high-dose corticosteroid therapy had failed.
· Elemental Diet for Small Intestine Bacterial Overgrowth (SIBO): SIBO, where bacteria unusually populate the small intestine, can cause symptoms like bloating, diarrhea, and constipation. It's believed to be responsible for some irritable bowel syndrome cases. Fortunately, besides antibiotics, the elemental diet has been effective for SIBO by depriving bacteria of digestible food.
· Elemental Diet for Eosinophilic Esophagitis (EoE): EoE, an immune response in the esophagus often caused by food allergens, can lead to swallowing difficulties, pain, and inflammation. Hypoallergenic elemental diets have led to remission in over 70% of cases in one study.
· Elemental Diet for Mast Cell Activation Syndrome (MCAS) or Gastrointestinal Allergies: While not extensively researched, individuals with gastrointestinal allergies, MCAS, and multiple intolerances can benefit from the elemental diet under therapeutic supervision. It can combat inflammation caused by contact with intolerable food components and supplement missing nutrients.
· Usage in Pancreatitis, Liver, and Kidney Diseases: The elemental diet can support patients with pancreatitis (inflammation of the pancreas) or those with liver or kidney diseases. For example, in kidney diseases, it's crucial to strictly limit potassium intake to prevent heart rhythm disorders.
· Diet for Dysphagia: For swallowing disorders, liquid diets can be used. However, these diets don't necessarily have to be fiber-free or "elemental". In fact, slightly thicker consistencies can minimize choking risks.
· Supplement for Involuntary Weight Loss: In diseases like cancer where involuntary weight loss can occur, high-calorie drinks/supplements are used. These aren't necessarily fiber-free or hypoallergenic, and hence not strictly elemental diets. In gastrointestinal inflammations, however, the lack of fiber is intentional to relieve the intestines.
Given its challenges and potential side effects, the elemental diet should always be undertaken under medical supervision.
If you're keen on practical advice and tips, check out my article with ten tips to make life with the elemental diet more bearable.
Have you had experiences with the elemental diet? Feel free to share in the comments.
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