Digestive Health Irritable Bowel Syndrome Nutrition How the Elemental Diet Works Purpose, Side Effects, and How to Follow It By Barbara Bolen, PhD Barbara Bolen, PhD Twitter Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. Learn about our editorial process Updated on June 08, 2022 Medically reviewed by Robert Burakoff, MD, MPH Medically reviewed by Robert Burakoff, MD, MPH LinkedIn Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York, where he is also a professor. He was the founding editor and co-editor in chief of Inflammatory Bowel Diseases. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Purpose Uses How It Works Formula Side Effects Frequently Asked Questions The elemental diet is a medical liquid diet used to help people recover from certain health problems, like Crohn's disease or small intestinal bacterial overgrowth (SIBO). The diet gets its name from the fact that nutrients are introduced into the body in as close to their elemental form as possible. This makes it easier to digest and absorb nutrients when recovering from specific conditions. Several commercial formulations are available as options for people who need to be on the elemental diet. In this article, you'll learn how the elemental diet works, when and why it's used, and potential side effects. David Sacks / The Image Bank / Getty Images Purpose An elemental diet allows for the absorption of nutrients in the most easily digestible form. It's mainly used by individuals with a serious digestive condition. The theory is to make it easier for all nutrients to be absorbed within the beginning of the small intestine. This allows the large intestine to rest. Conditions and Uses An elemental diet is rarely used. When used, it's only valid for a very restricted population. The elemental diet may be indicated for people with the following conditions: Crohn's disease Refractory celiac disease Small intestinal bacterial overgrowth (SIBO) Ulcerative colitis Chronic pancreatitis Atopic eczema Irritable bowel syndrome (IBS) After a surgery involving the digestive tract Malabsorption Short-gut syndrome Eosinophilic esophagitis (EoE) Eosinophilic gastritis Eosinophilic duodenitis High-output ileostomies Recurrent aspiration pneumonia from PEG feeding tube Severe burns How the Elemental Diet Works Elemental diet formulations may be taken in the form of a liquid drink or administered through a feeding tube. The amount of liquid will be slowly increased over the first few days. This helps reduce uncomfortable side effects like diarrhea or abdominal pain. When the diet is used to help rest the gastrointestinal tract, no other foods or liquids besides water are allowed. An exception may be made for plain tea or coffee. In other cases, the diet may be used as a dietary supplement. Because the elemental diet contains a full range of nutrients, it may be possible for a person to subsist on the diet for a long time. However, the elemental diet should never be used without medical supervision. Elemental Formula Ingredients Elemental diet liquids contain nutrients in an easily digestible form. Typical formulations include: Essential and non-essential amino acidsGlucose (an easily digested carbohydrate)Vitamins (fat- and water-soluble)MineralsElectrolytesSmall amounts of fat (less than 1%) Elemental Diet Side Effects The most common problem with the elemental diet is that the taste can be hard to tolerate, even with flavoring agents. Some patients report side effects like: Abdominal painDiarrheaNausea These side effects are especially likely to occur if too much is ingested too quickly. Patients with diabetes may experience high blood sugar levels. The elemental diet may also be inappropriate for a person who has kidney disease. Frequently Asked Questions How long can you stay on elemental diet? It depends on your condition and your symptoms.Some people find relief after being on the diet for a few days. Others may need to be on the elemental diet for two to three weeks, sometimes even 12 weeks, to rest their digestive tract.Your healthcare provider will recommend what's right for you. How do I reintroduce food after the elemental diet? Reintroduce food slowly and gradually. Start with foods you don't typically have negative reactions to.Reintroduction is usually done in stages but depends on the condition you were on the elemental diet for.For example, if you have eosinophilic esophagitis (EoE), there are four stages of reintroduction that start with foods least likely to cause EoE. Does SIBO return after the elemental diet? It could.In one study, 85% of SIBO patients experienced symptom relief after being on an elemental diet for three weeks. After one month, 83% of the patients who followed up still had improved symptoms.However, about 44% of people with SIBO have a relapse within nine months of their first treatment. Learn More: The 10 Most Important Things to Know About IBS and SIBO 9 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Zadak Z, Kent-Smith L. Basics in clinical nutrition: Commercially prepared formulas. European e-Journal of Clinical Nutrition and Metabolism. 2009;4(5)e212-e215. doi:10.1016/j.eclnm.2009.05.005 Rostami K, Al Dulaimi D. Elemental diets role in treatment of high ileostomy output and other gastrointestinal disorders. Gastroenterol Hepatol Bed Bench. 2015;8(1):71-76. Tsertsvadze A, Gurung T, Court R, Clarke A, Sutcliffe P. Clinical effectiveness and cost-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):1-138. doi:10.3310/hta19260 Ciampa BP, Reyes Ramos E, Borum M, Doman DB. The emerging therapeutic role of medical foods for gastrointestinal disorders. Gastroenterol Hepatol (N Y). 2017;13(2):104-115. Lucendo AJ, Serrano-Montalbán B, Arias Á, Redondo O, Tenias JM. Efficacy of dietary treatment for inducing disease remission in eosinophilic gastroenteritis. J Pediatr Gastroenterol Nutr. 2015;61(1):56-64. doi:10.1097/MPG.0000000000000766 Durchschein F, Petritsch W, Hammer HF. Diet therapy for inflammatory bowel diseases: The established and the new. World J Gastroenterol. 2016;22(7):2179–2194. doi:10.3748/wjg.v22.i7.2179 Hunter J. Elemental diet and the nutritional treatment of Crohn's disease. Gastroenterol Hepatol Bed Bench. 2015;8(1):4–5. UC Irvine School of Medicine: Children's Health Orange County. Elemental diet. Rao SSC, Bhagatwala J. Small intestinal bacterial overgrowth: clinical features and therapeutic management. Clin Transl Gastroenterol. 2019;10(10):e00078. doi:10.14309/ctg.0000000000000078 By Barbara Bolen, PhD Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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