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Elemental Diet: Explained by a Dietitian

If you’ve been dealing with stubborn gut issues for a long time, you may have come across elemental dieting. Maybe you’re wondering what an elemental diet is and how it works. If so, you’re in the right place! In this article I will describe what an elemental diet is, how it is used, what to expect available options and possible contraindications.

Elemental dieting is a therapeutic approach that involves consuming a nutritionally complete liquid formula composed of easily digestible components. This specialized diet provides all essential macronutrients, micronutrients, and trace elements in a highly absorbable form. Carbohydrates, proteins and fats in these formulas are partially broken down, which means less work for your digestive system! 

Elemental diets are primarily used for managing various gastrointestinal conditions, including inflammatory bowel disease (IBD), small intestinal bacterial overgrowth (SIBO), and other digestive disorders. Elemental dieting may be suggested for other conditions, such as obesity. However, evidence does not support the use of elemental dieting for weight loss.

In addition, there are two different types of elemental formulas: 1. Full, in which all proteins are broken down into amino acids , 2. semi, in which some proteins remain intact. It is also important to mention that the research behind elemental diets refers to exclusive consumption of these formulas. However, some patient experience benefits from a more gentle approach: replacing 1-2 meals per day with the formula.

How Elemental Dieting Works

Elemental diets work by providing essential nutrients in their simplest, pre-digested form, allowing the digestive system to rest and heal. The formulas typically consist of amino acids, simple sugars, medium-chain triglycerides (MCTs), vitamins, minerals, and trace elements. These nutrients are broken down to their most basic components, requiring minimal digestion.

By reducing the workload of the digestive system, elemental diets help reduce inflammation, support gut healing, and starve out problematic bacteria or yeast overgrowth. The simplified nutrient composition ensures easy absorption in the small intestine, bypassing any potential malabsorption issues.

Uses of Elemental Dieting

Inflammatory Bowel Disease (IBD)

Elemental diets can be used as an adjunctive therapy for managing active Crohn’s disease or ulcerative colitis. The low-residue and highly absorbable nature of elemental diets help reduce inflammation and provide essential nutrition during flare-ups.

Small Intestinal Bacterial Overgrowth (SIBO)

Elemental diets are often used as a short-term intervention to starve off “bad” bacteria in the small intestine to allow for re-balancing of the gut microbiota. By depriving bacteria of complex carbohydrates, which they thrive on, elemental diets can help restore a healthier gut microbiome.

Irritable Bowel Syndrome

Most of the research behind elemental diets focuses on IBD (see above). However, for IBS patients who are flaring or have stubborn symptoms that won’t respond to traditional approaches, an elemental diet can provide significant relief and an opportunity for healing.

Gut Healing and Rest

Elemental diets can provide relief and promote healing for various gastrointestinal disorders, including leaky gut syndrome, intestinal permeability, and chronic diarrhea. By eliminating potential irritants, the gut is given an opportunity to rest and repair.

What to Expect When Following an Elemental Diet

Temporary Transition Phase 

Transitioning to an elemental diet may take some adjustment, both mentally and physically. It is important to be prepared for a period of adaptation as the body gets used to the new form of nutrition.

Improved Digestion and Reductions in Symptoms

If the elemental diet is working, you will likely notice a reduction in symptoms within a few days. Your response will depend on your initial symptoms. But, you can expect a reduction in severity and frequency of symptoms such as abdominal pain, bloating, cramping, diarrhea, etc. 

Reduced Hunger and Appetite

The highly digestible nature of elemental formulas can often result in reduced hunger and appetite. While this can be advantageous during the diet, it may take time to adjust to smaller portions and fewer eating occasions.

Potential Side Effects

Some individuals may experience initial side effects such as temporary constipation, diarrhea, bloating, or changes in bowel movements. These symptoms usually subside as the body adjusts to the diet.

Compliance and Commitment

Elemental diets require strict adherence to the liquid formula for a specific duration determined by a healthcare professional. It is important to commit to the diet as prescribed to achieve the desired therapeutic outcomes.

Options for Elemental Diets

Commercial Formulas

Several commercially available elemental formulas exist, such as Vivonex, and Elemental 028. These formulas are pre-mixed, nutritionally complete, but highly processed. They should only be used under medical supervision.

Homemade Formulas

Some individuals may choose to create their own elemental formula using specific ingredients. This option requires careful consideration of nutrient composition and consultation with a healthcare professional or registered dietitian to ensure nutritional adequacy. Do not try to make your own formulas without close monitoring.

Semi-Elemental Options

Semi-elemental diets contain partially hydrolyzed nutrients that are easier to digest than whole foods but still require some digestive effort. Dr. Ruscio makes a semi-elemental formulation that many of my clients have used successfully. These diets may be used as an alternative to full elemental diets in certain situations.

Contraindications and Precautions

While elemental diets can be highly effective, there are certain contraindications and precautions to consider:

Caloric and Nutritional Adequacy

It is essential to ensure that the chosen elemental diet provides adequate calories, macronutrients, and micronutrients for the individual’s specific needs. Consultation with a healthcare professional or registered dietitian is crucial to avoid nutritional deficiencies.

Individual Tolerance

Elemental diets may not be well-tolerated by everyone. Some individuals may experience digestive discomfort, allergies, or intolerance to specific ingredients. It is important to monitor for any adverse reactions and adjust the diet accordingly.

Duration and Monitoring

Prolonged use of an elemental diet may have nutritional implications. It is crucial to follow the diet under the supervision of a healthcare professional and regularly monitor nutritional status and overall health.

Psychological and Emotional Considerations

Elemental diets can be challenging from a psychological and social standpoint due to the limited food choices and the social aspect of eating. It is important to have appropriate support and guidance to navigate these challenges.


Elemental dieting is a therapeutic approach used to manage various gastrointestinal conditions by providing a simplified, highly absorbable form of nutrition. With its ability to reduce inflammation, support gut healing, and starve out problematic bacteria, elemental diets offer a potential solution for individuals with conditions such as IBD, SIBO, and food intolerances. However, it is crucial to consult with a healthcare professional or registered dietitian before embarking on an elemental diet to ensure its appropriateness, nutritional adequacy, and proper monitoring.

By understanding the principles behind elemental dieting, its uses, expectations, available options, and potential contraindications, individuals can make informed decisions and explore this therapeutic approach as part of a comprehensive treatment plan for gastrointestinal health.

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