Most of my audience experience bloating. In fact, I polled my Instagram followers last week, and 96% of them voted yes to having a distended stomach.
In my opinion, most of these cases can be at least partly attributed to small intestine bacterial overgrowth, or SIBO. Research now shows that up to 80% of endometriosis patients have SIBO, and the majority of my clients test positive for it.
If you’re new to SIBO, I recommend going back and reading my earlier columns before diving into treatment options.
Today, I’d like to explore the final of three main treatment options: the elemental diet.
What is the elemental diet?
The elemental diet is a liquid containing all the nutrients and calories we need in a predigested formula. This formula contains carbohydrates in the form of glucose or dextrose, proteins as amino acids, fats in the form of some type of oil, and vitamins and minerals in supplements.
This predigested formula means the gut doesn’t have to do any work to absorb the nutrients and therefore gets a break. Because there isn’t any food to be broken down, the nutrients are rapidly absorbed. This rapid absorption allows our bodies to be fed but doesn’t give the SIBO anything to feed on. Over time, the bacteria starve.
Which type of SIBO is the elemental diet suited for?
The elemental diet is suited for all types of SIBO — methanogen overgrowth, hydrogen, and hydrogen sulfide. However, leading SIBO doctor Allison Siebecker cautions about using the elemental diet with the hydrogen sulfide type of SIBO, which can sometimes react to sulfur-containing foods and products. Some of the amino acids contain sulfur, so this may become a problem.
The elemental diet is a fairly aggressive approach to treating SIBO, and it requires a lot of discipline and dedication. But it also is very effective. Therefore, it’s helpful in severe cases, as it can reduce SIBO levels dramatically and quickly.
How long is a treatment round?
A treatment round is two weeks, though in more severe cases this can be extended to three weeks. This means that you will only be drinking this formula for meals, without any food, for at least 14 days.
What are the benefits of the elemental diet?
What makes the elemental diet so attractive is its incredible success and gas-reduction rate. The elemental diet has an average success rate of 80-85%, and reduces gas levels by 70 parts per million (ppm) on average, per round. So, it clearly is a compelling option for anyone with high gas levels, such as 100 ppm.
Another benefit is that if you’ve been living with SIBO, you most likely have some level of leaky gut or inflammation. By having time off from digesting, your intestines can focus solely on healing.
What are the risks and side effects?
Of course, the most obvious difficulty here is that it’s an entirely liquid diet, so emotionally it may be challenging. The ideal scenario would be to plan out two weeks when there aren’t any specific social engagements where food is at center stage, such as a wedding or birthday. Set time aside for the elemental diet, and let your loved ones know so they can support you.
Next is the issue of blood sugar dysregulation. Because you’re drinking glucose and there’s no fiber to slow down the release, you may experience spikes in your levels. As I’ve discussed previously, balanced blood sugar is essential for keeping inflammation levels down and for happy hormones. Dysregulated blood sugar may lead to issues such as inflammation, pain, and estrogen dominance.
A few of my clients have struggled with this, and the best option we’ve tried is to split three meals into six, and to sip each one over the stretch of an hour.
When sipping on the pure sugar, another problem is possible candida overgrowth, especially oral thrush. Siebecker, my tutor, recommends rinsing your mouth after each meal. You also could use an antifungal.
The elemental diet isn’t cheap. An over-the-counter option can cost nearly $1,000 for a full course, and a prescription formula may also be expensive if not covered by insurance. You could make your own, which is much more affordable, but it often tastes pretty bad. One of my clients tried this option and found herself gagging so much she would avoid having her meals, which of course is not what we want, because she wasn’t getting any nutrients.
This is another valid point. If you don’t calculate your calorie needs correctly, you may end up not eating enough and losing weight. So be sure to know what your daily intake needs are before starting.
This diet should be done ideally under the care of a practitioner, so please keep that in mind.
Note: Endometriosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Endometriosis News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to endometriosis.