The Elemental Diet is one of the three main treatment options for SIBO. According to one study, 80% of subjects saw their SIBO breath test normalise after undertaking the Elemental Diet for 14 days.
There is so much to know about the Elemental Diet, so I decided to create a multi-part blog series that will help you have a deeper understanding of the Elemental Diet and if it is right for you.
In this article, I share with you what is the Elemental Diet, how to know if it’s suitable for you and what are the preparations you need to take.
What is the Elemental Diet?
It is a predigested liquid formula which replaces all nutrition for 14-21 days. The Elemental Diet comprises the basic building blocks of complete nutrition (amino acids, carbohydrates, fats, vitamins and minerals). It is absorbed quickly in the first three feet of the small intestine and it seeks to starve the bacterial overgrowth in your small intestine by feeding you, but not feeding the bacteria. The liquid formula is very easy to digest and can either be made at home or purchased in pre-made formulations.
This type of treatment is quick and effective for many SIBO patients. It’s also effective at rapidly reducing gas levels. Some patients can reduce gas levels by up to 150ppm within 14-21 days.
How to know if the Elemental Diet is suitable for you?
Before doing the Elemental Diet, it’s highly recommended you work with your practitioner to determine if this is the correct treatment for you. There are some conditions that prevent the use of the Elemental Diet, such as diabetes. You may also need additional medical monitoring, such as if an eating disorder is present or has been in the past and could be triggered by not eating, or if you are experiencing a candida overgrowth.
It’s also important that you are clear on your expectations. Although a lot of SIBOers have found success reducing their SIBO after the Elemental Diet, it’s not 100% effective. It can also worsen other conditions or food sensitivities in some patients.
Preparing for the Elemental Diet


Doing something as drastic as the Elemental Diet shouldn't be taken lightly. You need to be physically and mentally prepared to do it successfully. To get ready, you need to do the following:
Develop a game plan with your practitioner
When doing the Elemental Diet, you might experience:
- Fungal overgrowth
- Exhaustion and lack of energy
- Mood swings (it can be extremely emotional for some people)
- Hunger
- A sore mouth and white tongue (which can be signs of a fungal overgrowth)
- Strong die-off symptoms
- A histamine reaction
- Excessive bloating or diarrhea
This is why it’s important to have a practitioner who is experienced in taking people through the Elemental Diet. They will be able to guide you through it, as well as lookout for any signs it may not be agreeing with you.
Find a time where you can have a restorative 14-21 days
Plan to do the Elemental Diet at a time when you don’t have major work commitments, social engagements or travel. Think of it as a restorative, healing retreat. This is not the time to be super busy.
When I first tried doing the Elemental Diet, I told my friends what I was doing and that I would be in hibernation for a few weeks. Educate them and let them know why you’re doing this treatment and how important it is for you to receive their support.
Work out your calorie requirements
If you are underweight, you need to be consuming enough calories, so you don’t lose more weight. Some patients enjoy being able to finally gain weight, due to the formula being so easily absorbed and providing an undernourished body with some much-needed nutrients.
If you have excess SIBO weight to lose, you might like to slightly under consume calories to support the release of excess weight. The most important thing is that you are consuming sufficient calories each day to be able to satisfy your hunger cravings and your basic nutritional needs.


Meet with a psychologist
A disordered approach to food is common with many SIBOers mainly due to the years of digestive symptoms after eating. It is important that you are honest with yourself. If you are using the Elemental Diet as a way to control your food, to punish yourself, or even if you are feeling nervous about what it might raise for you psychologically, it’s important to work with a skilled psychologist who can help you develop a plan on how to cope during the Elemental Diet.
It can be emotionally draining when not eating food, especially if food has significant psychological meaning for you. A psychologist can help you develop some coping strategies on how you can survive the Elemental Diet, not only physically, but also mentally.
If you have experienced disordered eating in the past, you can agree on what might be some triggers or red flags. This will allow your psychologist to support you and prevent you from falling back into a disordered approach to food. It is also important to know that the Elemental Diet is not suitable for some people due to their history of disordered eating, and that is ok.
Stock up
Ensure you have enough of the Elemental Diet formula to last your 14-21 day treatment plan. It is also important to have some extra, which you will use during your food reintroduction phase.
There are a lot of formulations available in the market, but here are some of my trusted brands:
- Integrative Therapeutics Physicians’ Elemental Diet - It's the one I drank for 14 days. It tastes a bit like vanilla cake crossed with a tropical flavoured drink
- Dr Michael Ruscio's Elemental Heal - This one can be used for a partial Elemental Diet. It also has delightful vanilla and chocolate variants
- Dr Allison Siebecker’s homemade ED diet - A DIY Elemental Diet that can be easily made at home
How to eat before starting the Elemental Diet
Before starting the Elemental Diet, it’s wise to prepare your digestive system for the enormous change it’s about to go through. Consider the following to achieve the best outcomes:
- Wind down on food. Make sure to incorporate some extended fasting periods (if you’re not underweight) before starting
- Eat soft food or smoothies rather than hard food to get the gut used to the liquid-only intake
- A few days before starting, you may like to start replacing 1-2 meals with an Elemental Diet shake
Preparing for the Elemental Diet can be overwhelming. But remember that you don't need to do this on your own. Talk to your friends, family and practitioner, and ask for their support.
Reaching out to SIBO support groups online can also be helpful. Alternatively, you may like some 1:1 coaching support from someone who has experienced the Elemental Diet before.
This article is the first part of a four-part series on the Elemental Diet. Stay tuned for the next one!
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