Can a Short-Term Elemental Diet Help Treat SIBO? | Chris Kresser
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Can a Short-Term Elemental Diet Help Treat SIBO?

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SIBO symptoms can be debilitating. The elemental diet may provide relief. istock.com/Heiko119

This is a guest post written by staff nutritionist Kelsey Marksteiner, RD. Click here to read her blog or join her newsletter!

For those with small intestinal bacterial overgrowth (SIBO), the symptoms can sometimes be unbearable. Bloating, gas, diarrhea, constipation…the list goes on. While simply getting diagnosed in the first place is half the battle, when it is diagnosed, how do we treat it? If you’ve tried some of the options out there like rifaximin or herbal antimicrobials with no luck, what’s left?

What Is SIBO?

Before we talk about treatment options, it’s important to know exactly what SIBO is. Small intestinal bacterial overgrowth is exactly what it sounds like – an overgrowth of bacteria in the small intestine.

Normally, the small intestine has very little bacteria compared to the large intestine, which houses most of our gut bacteria. However, bacteria from the large intestine can translocate to the small intestine under some circumstances, leading to the development of SIBO.

There are many underlying factors that relate to this translocation, including low stomach acid, pancreatic enzyme insufficiency, and intestinal motility disorders, among others. (1)

The usual treatment of SIBO can include diets like the Specific Carbohydrate Diet (SCD) or the GAPS diet (usually in combination with a low-FODMAP approach), antibiotics or herbal antimicrobials. (2) The SCD and GAPS diets help reduce the bacterial load of SIBO, but it can take a long time for dieters to feel significant improvement in their symptoms without the addition of other helpful treatments such as antibiotics or antimicrobials.

Rifaximin, the the antibiotic most commonly used to treat SIBO, is expensive, thus many patients cannot afford treatment. These patients may choose to forgo antibiotics completely and opt for natural antimicrobials such as oregano oil or berberine. These can be very useful in eradicating SIBO, especially in combination with a low-FODMAP SCD or GAPS diet.

However, I’ve had more than one client claim that they can’t tolerate the herbal antimicrobials. For these people, waiting months to over a year for relief with the SCD or GAPS diet can seem like eternity, yet they feel as though they don’t have any other options to try. Others have tried antibiotics or antimicrobials and failed. This is where the short-term elemental formula can be helpful.

What Is an Elemental Formula?

In the simplest terms, an elemental formula is one that contains pre-digested carbohydrates, proteins, and fats. This means that it is absorbed very quickly from the digestive system.

This is key for those with SIBO as we don’t want food sitting in the small intestine, where it would be used as fuel for the unwanted bacteria living there. Instead, an elemental formula provides a way to nourish the patient while starving the bacteria. When implementing the elemental diet, the patient will drink the formula instead of their regular meals for two to three weeks, depending on their case.

How Effective Is It?

In a study using the elemental formula Vivonex Plus, patients were instructed to consume only the formula for 14 days. On the 15th day, they were re-tested for the presence of SIBO. Remarkably, 80% tested negative. Those who were still SIBO-positive were instructed to continue the formula for another 7 days, after which the cure rate went up to 85%. (3)

So how does this compare to the other SIBO treatments I discussed above (rifaximin, herbal antimicrobials)? Though figures vary for the efficacy of rifaximin, the majority of studies I’ve seen estimate it to be around 50% effective, but some studies show even lower rates. (4) One study in particular showed the cure rate for rifaximin to be 34%, while herbal antimicrobials were more effective at 46%. (5)

An 85% cure rate for a three week elemental formula diet is impressive and should certainly be considered as a treatment option for those with SIBO. However, that doesn’t mean that it’s for everyone.

What Are the Drawbacks?

There are definitely some downsides to the elemental formula. First, and probably most important in terms of compliance – it tastes pretty nasty. A patient has to be willing to stick it out for at least two weeks (where we get the 80% cure rate) and potentially up to 3 three weeks to see results. While this doesn’t sound that long, it can  be tough to stick to when the drink doesn’t taste so good! This means that anyone about to try this treatment has to be very committed.

Second, typical elemental formulas are not what we’d call “real food”. Vivonex, produced by Nestle, contains the following ingredients:

Screen Shot 2014-07-14 at 5.34.12 PM

That said, you can make your own elemental formula if you choose. If you’re interested to see what goes into a homemade formula, check out this recipe from SIBO researcher, Dr. Allison Siebecker. Both homemade and commercial elemental formulas are expensive (though less expensive for most than a course of rifaximin), which is also a barrier.

Also, for those who are underweight already, embarking on a two to three week elemental diet can cause them to lose even more weight. This is potentially dangerous, thus an elemental diet should be very carefully implemented or not implemented at all in those who are underweight. Whether you’re underweight or not, an elemental diet should always be implemented under the supervision of a medical professional.

An elemental diet is also a short-term fix. SIBO is a condition that recurs frequently, thus during and after any type of treatment for SIBO, it’s imperative that the patient addresses these underlying factors to prevent future SIBO episodes. This means that those looking to an elemental diet to solve their problem forever still have a long road ahead of them after completing the diet.

Lastly, we’re not sure how it affects the rest of our gut bacteria. Does it starve the bacteria in the large intestine? If so, to what extent? We just don’t know, and only future research can tell us.

Chris’s Experience

I asked Chris to share his experience with elemental formulas with me for this article. He responded:

“I created my own elemental formula, back when I was still struggling with my own gut issues. While it did reduce bacterial overgrowth, it seemed to exacerbate the fungal overgrowth problem I was also dealing with. I developed a thick, white coating on my tongue and the symptoms I associated with fungal overgrowth worsened. I also experimented with it in my work with patients with SIBO early on, but I found that compliance was low (because even the homemade formulas are pretty gross) and the SIBO tended to return soon after the patient started eating real food again. Nevertheless, elemental diets may have a place for patients that don’t respond to anti-microbial treatments (whether botanical or pharmaceutical).”

When to Consider an Elemental Formula

There certainly are benefits to an elemental formula, namely its short duration (2-3 weeks). This is equal or one week longer than a course of rifaximin (14 days), and potentially up to four weeks shorter than a course of herbal antimicrobials, which are usually given for 4 to 6 weeks. Its effectiveness is also quite good (80-85%) compared to other treatment options. It might be worth considering for someone who doesn’t want to take antibiotics but wants a short treatment period, or for someone who has tried antibiotics and herbal antimicrobials and failed. It certainly wouldn’t be my first choice of treatment if I was going through it (mostly due to the taste and lack of real food), but if I had trouble with some of the other options, I’d certainly consider it. It’s a careful decision that one should make with their medical team and not something to take lightly, but its 80-85% cure rate deserves a look. Hopefully reading this article has made you think about the pros and cons of an elemental diet and allows you to make this decision more easily!

Now I’d like to hear from you. What do you think about elemental diets for SIBO? Do the positives outweigh the negatives or vice versa? Have you tried an elemental diet?

 

kelseyrd03This is a guest post written by Kelsey Marksteiner, RD. Kelsey is a Registered Dietitian with a Bachelors degree in Nutrition from NYU and a Master’s in Human Nutrition and Functional Medicine. She works in private practice and recommends individualized dietary therapy focusing on biologically appropriate diet principles to aid her clients in losing weight, gaining energy, and pursuing continued health. She is a firm believer that everyone is different, and she tailors her plan for each and every individual. Through her work, she aims to meld the dietary wisdom of traditional cultures with the latest science in integrative and functional medicine to create plans for her clients that work in the modern world. You can learn more about Kelsey on her staff bio page, or by visiting her private practice website. Join her newsletter here!

345 Comments

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  1. Hi, Has anyone tried the elemental diet for just a week? Also, how did you get rid of the die off? My skin is pissed off and I haven’t had a bowel movement in 4 days. I think the bacteria is dead and needs to leave my intestines. Thoughts? My doctor is out of town.

    • I do coffee enemas to clear intestines but it also cleanses the liver – Dr. Max Gerson used coffee enemas on his cancer patients when they would have life threatening die off from his treatments… Google for more information 😀 You will be amazed how this will help you through a healing crisis!

  2. Dear all SIBO fighters,

    I am on day 7 homemade elemental diet (the standard one) and I burp a lot. I notice no symptom relief so far. I use 21 pure blend, dextrose, L-glutamine and coconut oil in tea. I noticed that I burp after eating fats specifically. Any fat really, even fish oil in capsules. VB2005 mentioned that if one has SIBO it’s likely that the small intestine is damaged and you can’t digest fat. Can this be the reason for burps? How can I get the fat in while fighting SIBO if I can’t digest it?

    Also, it is not clear to me, how can glucose be used in elemental diet, if there is a glucose-based SIBO test. I understand glucose is absorbed quickly so bacteria don’t have time to ferment it. But then, glucose SIBO test would be highly ineffective which is not the case, as bacteria manage to ferment glucose and produce the gas that we measure. Does this mean that we feed bacteria with dextrose during the elemental diet??? *CONFUSED*

    If anyone could clarify this for me – Thank you! 🙂
    Best of luck to everyone.

    • I also really would like to know this as dextrose seems like my only possible carb source (really don’t want to go back into Ketosis, does not work well for me). Please can someone in the know clear this up for us because it is a very suitable question as there is lots of mixed info out there. I am not doing elemental just yet but am on a SIBO diet, however am very sensitive to carbs as there activate my GERD. Cheers

    • Hi Yulia,
      Happy to clarify this for you since I learned the hard way. I had SIBO 10 years ago and it was treated quickly with a course of Xifaxan, followed by 2 weeks of Vivonex Plus. It worked and I was SIBO-free for the next 10 years until I got Norovirus and again ended up with SIBO. This time Xifaxan was ineffective so I went straight to an elemental diet (Dr. Siebecker’s homemade version) for 2 weeks. I was shocked to see that my gas levels doubled. I figured it had something to do with the honey portion of the diet. So then I did Vivonex for 2 weeks. You can imaging my horror at finding out afterwards that my levels this time had tripled. What I eventually learned was that I had proximal overgrowth, which is overgrowth located in the upper reaches of the small intestine. In this instance, an elemental diet will actually feed the bacteria and your levels will increase. The glucose hydrogen breath test can rule in or out proximal overgrowth. Many practitioners think distal overgrowth is more common and, therefore, only use the lactulose test. Hope that explanation helps.

      • Ally, how did you find a doctor that could help you? My son is 21, non verbal and in excruciating intermittent gas pain daily. I have tried vivinox and xifaxin but without success. I THINK the die off was so painful with the xifaxin, he couldn’t stand it. The gas got worse with the Vivonex. I MUST find a physician who can help me trouble shoot.

        Amy

        • Hi Amy, So sorry to hear about your son. Hang in there, though. Sometime it takes time a long time to heal these issues. I’m in LA and fortunately have Dr. Pimentel as my doctor. Try to get a referral to someone who is a true SIBO specialist. Best of luck.

  3. I need some help. I just finished a month of Neomycin and Xifaxin. My doctor emailed me Dr. Siebecker’s food list but not an elemental diet list. I was unable to have an appointment because of a snowstorm but I’m losing weight. I’m less than 100 lbs and I’m 5’5. My SIBO symptoms have continued while eating low FODMAP foods. Are Dr. Siebecker’s measurements on the food list per meal or per day? Any advice to gain weight and stay low FODMAP?

  4. I need to know where and how to test for SIBO no doctor so far believes in it, they say we all have bacteria in our guts, I have had many testsl, egd/colonoscopy barium swallows, ct scans, blood work, blood work, blood work, hair analysis, urine analysis everything normal but I have rapid dumping syndrome and mild gastritis, but my symptons are off the chart for these diagnoses I did the home spit test for yeast and candidas, looked like a jelly fish was in the cup and about an 1/8 inch of sandy grit on bottom do candidas yeast and SIBO co exist? Help I feel helpless

    • Hello Donalee! Conventionally trained doctors can become very complacent in their med-school knowledge and many don’t keep up with the latest studies in my experience. I’m certain most of the people on this thread have felt just as you’re feeling, including me! Commonwealth Laboratories will sell the glucose SIBO breath test directly to the patient without a doctor’s signature. I think they may even help with interpretation of results. Go here: http://www.hydrogenbreathtesting.com/store.html

      • I clicked the Commonwealth Lab link, and it says that they are going out of business. Is there another lab that sells directly to the patient?

  5. Hello all! Is anybody interested in trying Dr. Siebecker’s homemade elemental formula at a discounted price? Back in July, I purchased the Black Label Pure form 21 Blend indicated on the ingredient list of the homemade formula shown here- http://www.siboinfo.com/uploads/5/4/8/4/5484269/homemade_elemental_diet_options.pdf

    With shipping, it cost me $168.75. Unfortunately, I have never been tolerant of drinking any kind of oil/fat, so when I made the first shake with the coconut oil, it was difficult for me to stomach and I had to forego the whole elemental diet after paying all that money. I literally only used 1 serving of the Black Label Pure form 21 Blend, and it’s been sealed up and untouched since July. I will sell it to anyone who is interested for $85- half price. Shipping included.

    On the site I originally purchased it from- http://www.jomarlabs.com/faq#answer12 – it states that the shelf life can be 3-5 years if well sealed in a cool dark place, or at least 2 years, so you definitely won’t be getting a less potent formula.

  6. Would eating meats really help maintain SIBO, especially if taken with Betaine HCl, pepsin, and pancreatic enzymes? Shakes are so not satiating.

    • Hello, I am starting the elemental diet next week… I am most nervous about the die off that will occur. I don’t deal with herxheimers well. I get severely depressed (ND says it is neurological inflammation …possibly). Anyone else had this with the elemental diet? Any other ways to deal with it?
      Thanks!

      • Activated charcoal helps to bind to toxins. If you’re doing an elemental diet idk if you are able to do colonics, but they do help flush out your intestines of bacteria/die off and toxins

      • Shelly, did you get this answered?
        The Elemental Diet is powdered vitamins, minerals, amino acids, dextrose and fats. There is no food involved. You mix the formula into water and drink it. It is easy to digest and has no FODMAPs.

    • Physicians elemental diet from integrative is great!!!! I’ve been living on it for about 6 months due to chronic vomitting (all foods) from a case of sibo caused by EPI (lack of pancreatic enzymes). It is straight up paletable and I feel so nourished! Starting to reintroduce foods but so grateful for physicians formula. Couldn’t keep down the homemade version.

      • How does it taste?? I’ve had SIBO for a long time now and I’ve been through so many different antibiotics and diets that haven’t worked and I’m desperate. I can feel the bacteria getting worse each day and I can’t just sit here doing nothing about it but I’ve been pretty picked for all my life. It is better now but I’m not sure if I would want to put so much money into it if I am unable to stomach it.

    • I have this product, the physicians elemental diet, and it’s FANTASTIC. i blend it with water and ice and it tastes like a weird coconut slushy .

  7. Follow up post: This past year has been interesting to say the least. Here is what I have discovered……I have adrenal fatigue syndrome. For me, this means that it has shut down my stomach acid production, among other irritating symptoms, but it was the basis for my SIBO. I’m slowly improving with the AFS but it takes a long time, and the symptoms can seem like very unrelated conditions. As far as the SIBO goes…..stomach acid triggers intestinal motility. I have very little or no motility so I’ve been taking supps for that. But the bloating persisted and I can’t even begin to describe how chronically dry my skin is (low/no stomach acid does this). Long story short, I figured out because the adrenals shut down the stomach acid. The release of stomach acid causes intestinal motility. Low or no motility sets the stage for SIBO.

    The symptoms were very similar to the SIBO in a lot of ways too…..anything I ate made me bloat to unreal levels. As soon as I started supplementing with HCI, raw apple cider vinegar, digestive bitters, and enzymes, the problem went away in a matter of 24 hours. My skin has improved drastically but I’m not healed, just trying to turn things around.

    Antibiotics are NOT the answer, I’m convinced. It may help when things are really out of control, but the condition is going to return quickly. You have to find the underlying cause. So for those of you with fatigue, sluggish thyroid, dry skin, anxiety, depression, and some other random “conditions”, you may want to look into adrenal fatigue syndrome.

    Here’s the thing, don’t get roped into thinking you need certain herbal supps for adrenals, meds, prescriptions…..you need to eat clean, rest, ditch any and all caffeine, and research this until you’re blue in the face and research more after that. The best resource I’ve found thus far is Dr.Michael Lam. Look his articles up online, and get a copy of his book “Adrenal Fatigue Syndrome”. Basically anything that is governed by hormones is bound to get all jacked up if the adrenals aren’t working right. They work together with the thyroid, reproductive organs, pancreas, and pituitary. When they are out of balance, your whole world is out of balance. Everyone is different, and nobody has the same exact symptoms. It’s hard to diagnose and regular doctors won’t recognize the condition at all, they just hand out prescripts for symptoms and that will hose you up worse.

    Basically, if you have had test after test after test and nothing shows anything wrong, and you still feel rotten with low energy, look into this. I can’t stress enough how much you have to read and research this on your own. I don’t trust holistic docs, I feel their knowledge is hit or miss at best with this condition. I went to one who said she was highly knowledgeable and she assigned adaptogenic herbals that made me worse. Why? Because you cannot generalize the treatment. Herbs that are healing in earlier stages are very damaging in later stages, and I was easily at a stage 3C, which is pretty advanced.

    If this happens to be the cause of your SIBO, then just treating the SIBO isn’t going to work. It will always return if you don’t heal what’s needing to be healed. And this can take up to 2 years. It’s far from instant.

    Just my 2 cents worth. Again, this isn’t going to apply to all of you, and this is just bare min. info, but when the adrenals aren’t functioning correctly, your entire endocrine system gets thrown out of whack horribly. In some case the body stops making stomach acid and then you get the SIBO symptoms. As an example, I had all kinds of problems with this. However, I have a close friend with the same condition way worse than I had it and she produces stomach acid just fine. So here again, it’s not going to apply to everyone and there are other causes for SIBO. But this is definitely worth looking into.

    I did the elemental diet last summer and it did wonders, then I continued to look into why certain things were happening and just kept digging until I found answers. Dr.Lam’s info was what got me on track.

    I hope this helps at least one person out there.

    • You hoped to help at least one person out there with your informative post. And though I am just at the beginning of my path to heal my various issues and not yet a success story, this post has indeed helped me if for no other reason than offering a respite of common ground. I too have SIBO, extremely low stomach acid, and adrenal fatigue. I will keep digging! Thank you for sharing <3

      • For the adrenal fatigue I cannot stress enough to get ahold of Dr.Michael Lam’s book. It’s a tad pricey but the most comprehensive book I’ve found yet. His articles online are good too. Good luck, it’s so frustrating but if you’ve identified the adrenal fatigue, you’re on the right path!

    • Hi Shasta and everyone, great post and thanks for the info. I feel like most of the people in our bloated community could write for days about our stories. I’ve been struggling for 20 years and have tried Everything. I tested positive for SIBO and tried multiple rounds of antibiotics and antimicrobials with no luck.

      My bad luck started 15 years ago when the doctor didnt know what was wrong with me so he put me on Nexium. I was taking double the normal dosage every day. So it was pretty safe to say I didnt have any stomach acid which was a major issue. Other doctors added on more meds to mask the symptoms but never tried to fix anything. I finally started all the research on my own and found some holistic help.

      Sadly i’m at the point where I can’t eat anything without the bloat and discomfort. For a couple years now I haven’t had gluten, dairy, eggs, corn, soy, sugar, garlic, onions, and many others. Basically all I eat is meat, rice, some veggies, and gluten free breads.

      My big question to you and the group is about the HCI and enzymes. The first time I tried this it was HEAVEN for two weeks. I felt what could be normal for the first time in my life – high energy, no bloat, food digested, weight gained, and hungry. However, after 2 weeks it was all gone, poof back to my crappy normal. Then I waited a month and tried it again…it was fantastic for 3 days, then nothing. I’ve tried it multiple times with dosage variations within the past year to figure out why and I cant get anywhere. Have you or anyone else come across this?

      • I’m quite similar…..took the HCl for a bit and then bloat was back. More digging. You need to look into the symptoms of a chronically congested liver, happens with any kind of hormone imbalance, toxins, meds, etc over the years and tests will NOT reflect this. A congested liver means you probably aren’t producing bile correctly. Is your skin always dry no matter what you do? It’s one of the biggest symptoms. I started taking ox bile with any foods containing fats and that has helped a lot. Got this lead from one of Dr.Lam’s articles so just do a google search for “congested liver Dr.Michael Lam” and you should bring up his article. Then research the topic til your eyes bleed. I’ve been taking 100% apple juice and raw apple cider vinegar daily and going to do a liver cleanse soon, I’m pretty sure I’m full of gallstones. The apple products soften stones to help my kick them out during the cleanse. I’m also doing other things (all natural) to help detox my liver, could take up to 4 or 5 months. I do a LOT of juicing, almost all veggies in it, and that really makes me feel better and delivers nutrition the body can instantly absorb and will help the body repair any damage. Juice typically makes at least two of my daily meals and I feel WAY better. It heals, detoxes, and delivers extreme nutrition that your body may not be absorbing otherwise. I wish I’d known about juicing when I did the elemental diet, as I feel the basic elemental diet was nutritionally incomplete.

        And for those of you who think it (juicing) will contribute to SIBO, it won’t. At least not in my experience. Use 90% veggies and the rest fruit, but don’t use fruit with much sugar. I only use lemon, lime, or green apples. A little carrot or yam helps flavor but my body prefers bitter juice. I strain out a lot of the pulp, but when I leave the pulp in I find it has no bearing on SIBO and just gives you a bit more fiber so don’t be afraid of it. Try and add a good handful of dandelion leaves/stems/flowers but be sure they’ve never been sprayed or given chemical fertilizer. They detox and are good for digestive issues and help bloating. Be sure to take in a lot of water daily. Do your research as to what is going to help the most with bloating, inflammation, detox, hormone balance, and nutrients when it comes to what veggies to juice. Start with less, maybe only 4-6 ounces. You may be running for the potty the first couple days because it will release a ton of toxins. I’m up to around 40 ounces of juice daily split into two meals. Anyway, I’m similar in symptoms and this has helped the most. I also do a lot of protein shakes from an organic vegan protein powder and that seems to digest very well since plant based nutrition doesn’t require stomach acid for digestion. My body is slowly getting back on track, it does take a lot of time, but I feel is a better approach. Hang in there and keep doing all the research you can on holistic approaches. Research adrenal fatigue until you can’t stand it anymore and use Dr.Lam as a resource for that. I know this doesn’t apply to everyone, but from what I have learned, SIBO is a very common result of poorly functioning adrenals. Shuts down a lot of hormonal responses, and that includes intestinal motility shutting down, stomach acid production shutting down, and a congested liver that also has a bad effect on digestion. Once healing starts, things should start coming back online for you, but again, healing properly does take time. It took years to get this bad, will take up to a couple years of die-hard persistence and patience to get back on track. Rest a lot too, and eliminate stress from your life. And get as much sunshine as possible. Good luck!

    • Hey Shasta,
      Thanks for your inspiring hope with your posts. The adrenal aspect lit up for me with the low motility. In my case, ll cascaded down from emotional trauma and resulting massive high stress to digestive issues to adrenal dysfunction to this damn SIBO. Reading many stories, such as yours, and seeing the same common bases for provoking SIBO, it gives me much hope that as these things are corrected, my life will be back on trace to health. Am considering the elemental along with the xifaxin and Allimed.
      II want this thing resolved after 10 years of frustration

      • You know, I’m not convinced that any kind of antibiotic is beneficial for SIBO at all. Seems it kind of relieves symptoms a little bit and then it comes back because the problem is still there. If you have motility issues, you need to address that. If you have adrenal issues, you need to address that. It does take time, but when the problem is balanced, you will be SO HAPPY! I do recommend juicing, motility supps, learn about adrenal issues, look into Dr.Michael Lam’s book Adrenal Fatigue Syndrome as well as his online articles. Last, I want to say that I did that liver cleanse and OMG……that made a world of difference!! No joke, I did the cleanse in early November and I have not had any bloating since. I’m ramping up for another cleanse at the end of the month, as this really needs to be done every six weeks until the body stops kicking out gallstones. All I know is that after that cleanse I was better than I had been in over 3 years. No joke.
        Hang in there, and try to avoid antibiotics or drugs. I really feel its the wrong approach and will only drain the bank account. Find the cause, then you will eliminate the symptoms. Good luck!!

  8. I can say that orange extract (Simply Organic brand “Orange Flavor”–ingredients: sunflower oil, orange oil) is a very good flavoring to add, if you’re making the homemade elemental recipe on Dr. Seibecker’s site. The shake is not delicious, but it is palatable and doesn’t make me want to gag at all like other commenters mention. Yesterday was my first day on the diet and I did get a fair amount of nausea, that worsened the more drinks I consumed, followed by very watery diarrhea. I don’t know whether this is die-off already, or if my gut is sensitive to the formula. I did mix a probiotic capsule into my last drink of the day, as recommended on Listentoyourgut.com, and this morning had a formed poo. So I’m going to stick with it, take some gut-soothing supplements, and see how it goes. I began this because I was just too tired of recurrences, and I’m not throwing in the towel!

    • Hi Heather! I’m very curious as to how it turned out for you. Were you able to follow through the entire 2 or 3 weeks? Did you retest and find your overgrowth had improved or resolved completely? Eager to hear as I am considering starting ASAP. Thanks!

      • After 6 days, I noticed candida symptoms cropping up, so I stopped. I was doing herbal antibiotics along with elemental, and continued them for another three weeks. Even 6 days was very effective; my symptoms were greatly reduced and I felt even the short run was worth it. I stuck to strict low-FODMAP AIP afterwards and felt pretty great. My breath test was last week and I’m waiting on numbers.

        • I also added in iberogast when I went back on food. The elemental made my stools very loose (I’d had c prior to that), and the d continued once on food. I did a couple probiotic enemas, a couple weeks apart, since I was scared of putting probiotics back into my small intestine! The d gradually faded and currently I’m regular.

          • Heather, if you were “c” dominant, were you also methane dominant? I am terribly ill (25 years of symptoms). Would you be able to privately email me offline to share stories if you were methane/constipation? [email protected].

            • Mary (and anyone else with SIBO): Join the SIBO discussion group on Facebook to find a community where there are lots of ideas and treatments shared for SIBO and related gastro issues. I am SIBO-C methane dominant and am on day 21 of elemental diet. It has helped significantly this time. I am combining with “Heavy Duty Mullen protocol.”(you can find on google.) In april I did 14 days with candibactin AR & BR and my symptoms did not significantly improve. I didn’t want to waste the money on retesting at that point.

              • Tess and/or others doing the elemental diet: do you have an MD or other health care professional supervising your elemental diet?

                • My doctor wasn’t familiar with the elemental diet until I told him about it. He offered rifaximin initially, but I’d like to avoid that if possible. I will keep him updated throughout if I feel his input would be helpful, but his involvement will really depends on my communication.

              • I would like to join the Sibo community on Facebook. My daughter has been diagnosed with this and treated with antibiotics, but still has debilitating symptoms. We are looking for answers. I don’t know anything about sibo-c methane dominant so I’d like to be more educated as this is severe and affects our whole family. Thank you!

          • Thank you for sharing!! I’d also love to hear whether the numbers on your breath test come back normal.

  9. Hi. I was wondering what one eats after coming off the elemental diet. Do you follow low FODMAPS, GAPS, SCD or a combo?

  10. To be honest, I think we are doing a disservice to people with SIBO by overemphasizing the negative aspects of the elemental diet, especially taste–we are discouraging people from even considering it, when so far it is the most effective and shortest therapy available.

    After reading all the blogs, I was really afraid that I wouldn’t be able to do it–the taste was described as horrible, the regimen difficult, etc. But what I find is that it is a very personal thing, and it really depends on your mental attitude and experiences going in–I don’t find it bad at all! I have taken numerous Chinese herbal concoctions for giardia that were far worse tasting than this. I make the homemade recipe from Allison Siebecker’s website (low carb/higher fat). Maybe the amino acid formula has improved since others did this, but I find the taste relatively bland. I mix the aminos with the dextrose and salt, throw in 2T liquid coconut oil, and then add some flavor–cinnamon is the best so far–and it actually tastes quite fine to me. I may not win any Michelin stars with it, but don’t let the taste scare you! Sure, the oil congeals in a cold drink, but it improves the taste immensely–just keep swishing it around and eventually it will melt at the end. I down a tablespoon or so of olive oil beforehand–I find it soothing–and then eat the encapsulated vitamins with the drink. I have every confidence I will make it through three weeks of this with no problem–for me, it is far better than continuing to suffer with my SIBO symptoms. I don’t feel hungry after drinking one of these–I am actually consuming more calories than I was before this! I also try to remind myself that this is a very small problem in a world of very large ones–I know there are many starving people on the planet who would literally kill to have an amino acid/dextrose shake right now, and I am grateful that I have access to one.

    I have suffered from SIBO for almost 20 years, and it took me 15 years to get a diagnosis (thank you, Allison Siebecker!), so maybe I am more desperate and ready to try anything! I have been on the SCD for three years, taken multiple rounds of rifaximin and neomycin, and up until the time I got another gastroenteritis in Indonesia a year ago, I was well on my way to recovery. After that bout, though, I have gone back to where I started, with my highest H2 number >130 in my small intestine. I took one round of Candibactin AR and BR and cut out all foods that were irritating my leaky gut (eggs, nuts, dairy, most fruit, alcohol)–that got rid of the methane producers. But in consultation with my docs, I decided to go for the elemental diet and kill these things off quickly! I am not done with the diet yet, but feel confident this will get me back to a much better place, if not entirely better. In retrospect, it would have saved me a lot of time and money if I had taken the plunge after the first six months of SCD and rifaximin, so my words of encouragement to others out there is YOU CAN DO IT!

    • Did the elemental diet help you with methane production? I am methane / constipation dominant and would like to share stories.

    • Thanks so much for sharing and encouraging. I start this week on 2 week protocol… I am nervous about giving up food! I am a mom and spend hours everyday in the kitchen preparing food for my family. This is going to be difficult but you are right…after 17 years of pain and bloating this will be worth it. Thank you

    • Thank you so much for sharing your perspective. It is hard to quit food but remembering how lucky I am, compared to millions of starving people around the world, well, it helps make this process more doable – regardless of the taste.

  11. On Day 1 of the home made elemental diet made from the recipe on siboinfo.com. I tried low FODMAP, which helped, then Paleo, which helped a lot. I still had a residual SIBO and couldn’t tolerate herbal antibiotic so tried Augmentin which my integrative Doctor recommended and felt worse. I thought I would try this diet before the Rifaximin and really cannot imagine going through it for 2 to 3 weeks. First of all, I chose the high fat/low carb option since I have a bit of yeast problem too and found out that the fat just doesn’t blend at all with the rest of the drink so I had to eat it separately. Second of all, the taste of the drink is so gross! I had to suppress my gag reflex every time I drank my drink. I usually can eat just about anything. I am an integrative pediatrician and I don’t think I’ll be recommending this to anyone.

  12. Hey!

    2 questions:

    1) Why not get a feeding tube?

    2) I have stockpiled a bunch of things that I’ve read are good to take – but now trying to ingest them all is difficult. Here is a list of what I have:

    -Interfase plus
    -candibac br
    -olive leaf extract
    -oregano oil
    -peppermint oil
    -lauricidin
    -NAC
    -saccharomyces boulardii
    -probiotic (doctor recommended)

    Can someone please recommend a good way to stagger these so that I am using them beneficially/not contraindicating things? I was taking peppermint oil at the same time as interfase for a few days and realized that it might be counterproductive to try to break down biofilm while consuming gelatin and oil… Also not sure about using probiotics / saccharomyces boulardii while on the interfase regiment.. should I wait until finished with it? Thank you for your thoughts.

    • Another quick question- If I were going to try the elemental diet but take the vitamins separately – in capsule form – how significant would the change in efficacy be? Thank you

  13. Dear Kelsey and Chris.
    I am trying not to get frustrated here so I wonder if you can help me. My girlfriend has horrible stomach issues. She’s been in numerous surgeries removing masses of bacteria, parts of her colon, it’s horrible. She’s been a vegetarian all her life eating cereal grains mostly because she doesn’t like to cook. I also have SIbo and struggled with stomach issues but I’ve embraced animal products and gut healing foods (eliminating fodmaps, AIP diet etc) which is helping me but meanwhile I can’t convince her. IN fact she’s wanting to go vegan with another surgery coming up. I realize I can just let it go and give her support as a friend, however I thought I would reach out to you and try my luck:

    Is there anything, any studies or research that specifically show that excluding animal foods is not going to improve the state of a compromised stomach? Is there studies that prove that including animal products gives far better results?

    thank you.

    • Just my two cents worth but if someone is dead set against eating meat, then it’s going to be very difficult to convince them otherwise. If she’s not getting enough protein in her diet from a vegetarian lifestyle then eventually she will have other health issues from that, the body needs protein. Logically speaking, meat doesn’t provide food for the bacteria and overloading with grains is going to be a bad thing with a bacterial overgrowth. I’m no expert but everything I’ve read about SIBO and similar issues generally says to avoid all grains, she needs to do her homework. But, really, I think you hit the nail on the head…..you may have to just be a supportive friend if she has her mind made up and is being stubborn. Maybe a holistic expert would be someone she would listen to?? I honestly don’t believe doctors steer people in the right direction with diet simply because they aren’t taught this stuff in medical school, they are only taught how to write prescriptions. Good luck to your friend, maybe some others on this page will have better advice than I do.

      • Hi Shasta, Thanks

        Yeah I just hardly have the energy myself to try to convince her. IT’s strange. We talk at length sharing our health journeys and she keeps saying to me, “I want to learn from you, tell me more… ” I send her emails with menus for SIBO of course containing bone broth and explanations why it’s important, why animal products are easy on the stomach, that grass fed ethically raised meat is available, links to articles (to this site as well) and still nothing gets through to her.

        I think we both know the right thing is to just be supportive but most of all I can’t allow myself to get upset or stressed out. This is only taking energy from me, and she’s not truly wanting to learn if she insists she’s going to become a vegan anyways.

        I’m just going to let it go and focus on myself. Thanks for the input. I’m totally done with trying to convince her. She’s on her way to I think her 6 or 7th surgery in a couple weeks. I can only wish her good luck and bring balloons as chicken soup would be useless to her.

        • Hi Lisa,

          If Your friend was vegan she is probably zinc deficient – she will feel bad from eating meat – i know this from experience. She probably have low stomach acid – zinc is needed to produce stomach acid. There is a study that shows that zinc deficiency is the root cause of most gut problems here is the link http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231515/
          If you open any site that sell zinc supplements and read comments under zinc supplements you will see that it works. I think she have at least 2 options:
          – to take Betaine HCl supplements and to eat meat
          – to take zinc supplements
          The problem with zinc is that grains prevent it’s absorption because they contains phytates – she have to change wheat with potatoes or tapioca products or masa harina flour instead of white flour – all of those dont have phytates.
          Actually i think most vegans avoid meat because they can not digest it – there are many people that are born deficient in zinc – without zinc many digestive enzymes are simply not produced in the body. So meat is rich in zinc but they can not digest it – it’s catch 22 situation. She can also take other digestive enzymes too – not only HCL.I personally think that one can also cure sibo with digestive enzymes.

        • Maybe instead of focusing on getting her to eat meat you could try to get her to cut out the gluten-containing grains. Concentrate on rice, low-FODMAP vegetablesnd a good multivitamin pill. See if that helps.

    • Hey Lisa, I know this is a few months later, but if your friend is still experiencing digestive issues and is a hard vegan/vegetarian, give her the book “Tissue Cleansing through Bowel Management” by Bernard Jensen. There are different ways to heal. She’ll resonate more with this book than the SCD or other meat-centered gut-healing diets.

    • Dr Ritamarie Loscalzo is a functional medicine/nutritional endocrinologist who offers an online course called GRAND (Gut Repair and Alkalizing Nutrition for Digestion). It is extremely thorough, highly specialized and customizable, and very good for healing all kinds of gut issues, including the most serious ones. Most importantly for your girlfriend, Dr. Ritamarie is plant-based and offers plant-based options for every nutritional intervention, including the SCD and low FODMAPS diets. It is a really thorough and time-consuming program but it works, and your girlfriend might resonate a lot better with this approach. It actually really isn’t necessary to consume animal products to heal the gut, though you need to be willing to eliminate all the foods that harm it, particularly all processed foods (including all refined grains and flour products, refined oils, etc.). http://www.drritamarie.com

  14. So…..I’m about 2 1/2 months since I completed the elemental diet. I definitely have motility issues, if I slack on my motility supplement I get really backed up but a little SmoothMove tea will correct the issue in a day or two. Just this last weekend I had a horrible SIBO flair up and I’m still bloated, the tea did nothing, and I suspect that event though I’ve been very careful with diet, I’ve still had to take in carbohydrates, maybe it’s been a tad too much in conjunction with the motility? I’ve also slacked off on the Lugol’s iodine so back on that, starting to see a difference in two days. For a couple few weeks I’m gonna be on high protein, high fat, low carb and back on my herbals to try and get back on track.

    Here’s my questions for anyone who wishes to offer their opinion on the matter: I’m seriously considering the elemental again for about two weeks and doing the antibiotic……what antibiotics have people had the best luck with? Also, I honestly don’t know what is in it or why it helps but Monster Lo-Carb Energy drinks (I have one a day) seem to help considerably. I’m guessing that either the taurine, the L-Carnitine, or the B vitamins help somehow? Any ideas why? All I can say is that they definitely make a difference. I don’t really think it’s the best habit to be in but if I get positive results and they make my life easier, bring ’em on! So if there is an expert on this list, I’d love to hear your opinion on why Monster Lo-Carbs seem beneficial??

    I’ve been having luck addressing my estrogen dominance with a progesterone cream, happy with that. Been taking selenium and the iodine liquid for thyroid, unsure if I’m having progress but getting back on iodine after a good month and a half of blowing it off seems to help, but I’m also back on herbals and have cut out carbs for the time being. So a little unsure which action is helping, or if it’s a bit of everything combined. Bloating is reducing fairly quickly though, compared to what I had dealt with before I did the elemental, I’d be bloated for days/weeks/months with no relief. Anyway, my point to this post is just a follow up to say that if you slack off, this condition can and will flare up in no time flat! I guess it can be trial and error as to what happens since we’re all different. I plan to stay low carb for a while and then slowly introduce things back in one at a time in tiny quantities to see what does and doesn’t work. And I do plan on having dextrose in my post workout shakes, so I will be getting some fast action carbs at any rate, I won’t cut them out totally. Cucumbers and greens don’t seem to be a problem but they don’t lend much in the way of carbs. White rice seems to work too but avoiding it for now.

    Just my two cents and two questions worth. Your turn….opinions anyone?

    • Hi Shasta – I’m in the midst of a 10-day course of antibiotics. I’m following one of the protocols outlined on siboinfo.com for constipation dominant SIBO. Rifaximin + Metronidazole Dosing: Rifaximin 1600 mg per day + Metronidazole 750 mg per day x 10 days. I’m on day 7 of the protocol. I have had loose stools, more gas and am tired but no other side effects. The abdominal pain has improved though I still have it at times. It’s the constipation and gas that cause the pain for me. I’ve had terribly dry skin that no amount of lotion or oil was helping at all. Since I’ve been on the antibiotics my skin is not nearly as dry. And, it was almost painfully dry and hot. I recently started seeing a new doctor – a very traditional osteopath – that doesn’t have experience with SIBO but is willing to work with me on this. I have worked with a pharmacist that studies functional medicine as well. The protocol on SIBOinfo.com is the protocol that is being recommended by functional medicine practitioners at conferences as well. After I finish the antibiotics, it’s recommended that I do 6 weeks of herbal antibiotics. I’m starting with Oregano Oil and will rotate through a couple of other herbals as well. I may also try one of the motility meds suggested on SIBOinfo.com too. It depends how I do after I finish the antibiotics. I ate more fruit than I have in a long while yesterday and am paying the price with bloating today. My bad. I thought I could get away with it since I’m on the antibiotics. I won’t do that again. The pharmacist that I’ve worked with said that it’s not unusual to have to repeat the antibiotic protocol several times. I’m really hoping one round will be enough for me. I think that being very disciplined with food is going to be important. Note, if you do decide to do the antibiotics, don’t stay low-card. You need the bacteria to be active. Listen to the interview Chris Kresser did with Dr. Pimentel to learn more on that. Reading about your experience helped me a lot. I was feeling too crummy to do the elemental diet which is why I decided on the antibiotics. I was very resistant to trying the antibiotics since I’m not a fan of meds. Let me know if I can answer any questions for you. I am not a medical practitioner. I’m just someone that reads a lot to try and figure out what I need to do to get healthy. I do yoga, walk, and eat clean food and have for years. It’s speculated that a parasite is what caused the issues I’m trying to sort through now.

      • Sorry to interject. Did antibiotics cause your SIBO to begin with? It is what caused mine. I was healthy and happy before antibiotics destroyed my GI. I recently tried to start up Xifaxin at 550 mg a day and it was unbearable, completely shredded my intestines.

        • Could we share stories about your xifaxan response? I just failed it for the 2nd time, and it left my methane dominant sibo issues even worse than before I started taking the drug!

          • It made me more bloated, felt worse overall and it hardly did a thing while I was on it. Have you done the elemental diet? There really isn’t a safer way than that, if you ask me. But it does cause yeast so if that is a concern (or histamine issues), then herbs might be the most route. Look up the Dr. Gerard Mullin protocal. Or do Biocidin + Neem Plus + Allimed 3x a day for a couple of weeks. That should take down your methane levels.

          • I have done three rounds of Rifaximin/Xifaxan.

            Prior to the SIBO diagnosis, I was vegan for about a decade. It took me a year to prepare to bring bone broth into my diet. I now eat fish, chicken, and turkey for protein. I don’t eat it for every meal, but can’t sustain on a plant-based diet given all the foods that I am unable to tolerate.

            1) First was 550 mg TID for two weeks.
            Felt slight improvement, but never fully better.

            2) Second treatment. I ate high FODMAPS to build the bacteria.
            * Rifaximin – 550 mg TID for 30 days
            Following for 60 days:
            * Interfase Plus – Three capsules BID on empty stomach
            * Lauricidin – One scoop TID with meals
            * PHGG – a fiber supplement – Five grams/day with or without food
            * Prescript-Assist: probiotic – One capsule BID taken away from antimicrobials
            * Lactobacillus plantarum: probiotic -10 billion CFU/d
            * MegaSporeBiotic: Two capsules just after a meal
            * Metagenics Candibactin-AR – 2 caps 2 x day x 4 weeks
            * Metagenics Candibactin-BR – 2 caps 2 x day x 4 weeks

            Initially, I felt better, but had a really hard time tolerating the Candibactin and Lauricidin. They made me sick to my stomach, resulting in lethargy.

            Breath test was positive again, high methane.

            3) Third treatment of Rifaximin – 550 mg TID for 30 days.
            I couldn’t tolerate the herbals, so I ditched them all. Kept doing probiotics. I added NAC and liposomal glutathione to help with detoxification. I also drank about 16 oz of bone broth daily for L-glutamine. Given my vegan past, animal welfare and moral consciousness in regards to animals is very important to me. I am unable to bear making my own broth, so I buy it – made locally from farms that grass feed their cows and use sustainable practices. Do note ** a lot of bone broth is made with vegetables, then strained. I do better with straight broth, no veggies or spices. It took me a while to realize this, at first I thought it was all the same. Nope,

            Retested two days after I finished. Breath test numbers were still off the charts. The lab had to use their “high” numbers for calculations.

            * I just finished 7 days of Diflucan 200 mg
            * In 10 days I will take a stool sample for: http://www.parasitetesting.com/tests.cfm

            Now:
            4) * I am starting the homemade Elemental Diet tomorrow. I plan to do it for three weeks.
            * Rifaximin 550 mg TID for 14 days
            * Flagyl 750 mg BID for 14 days

            My plan for re-entry to food
            * Resolor at bedtime to help with motility
            * bone broth the first few days off ED
            * colostrum 8-10 caps/day
            * Great Lakes Collagen – every day
            * consult with HCL doctor to get levels tested
            * use SIBO app to add one low FODMAP item at a time: https://itunes.apple.com/us/app/sibo/id940664367?mt=8

            Other contributing factors of impact:
            – I have both genes for celiac, but have not had the biopsy to confirm
            – I am positive for both methylation factor mutations (MTHFR)
            – Magnesium oil on feet every night
            – Mag/Cal/Zinc 3 tabs QD
            – I am on 4.5 mg of Naltrexone to help with sympathetically-mediated pain; I also hear Naltrexone can help with motility. This has not been the case with me. I still have slow motility.
            – I am a 41 year old female, positive with a strong desire to feel awesome again.
            – I could not exercise while on the herbals. In fact, I had to change jobs and move out of a busy/hectic city because I couldn’t tolerate the demands of high external stress. I am not three weeks in to a 5-7 day/week exercise regimen. I think it’s really important to raise the body temperature – this is a priority for me.
            – Get at least 7.5 hours of sleep a night. Being on Naltrexone kind of requires this; I feel best on 8 hours of sleep.

            Both my iron and b-vitamin levels have tanked because of SIBO. I am supplementing for iron, and taking MethylGuard until injection methyl folate and b12 arrive from: http://www.keycompounding.com/

            Thanks to D’Arcy for the positive encouragement about the Elemental Diet. If I could have circumvented all the expense (meds, supplements, doctors) and feeling awful and just done a diet for three weeks – even if it’s unpleasant – I certainly would have.

    • Has anyone’s weight gone up despite low carb clean eating. I have gained over 30 lbs after a year of deep keto diet. Lost weight to 105 now I’m up 30++ lbs after keto and skin conditions that I never had rosacea cysts etc..I am guess too low carb acrewed up flora, the antibiotics after that even more. Currently there is not one kind of veg meat or fat I dont react too. What baffles me is the huge weight gain despite eating similar ans even less..very depressing

      • Hi Jen- I have noticed the last few weeks since I’ve been on Rifaximin, that my weight seems to be slightly increased, and seems more difficult to lose than it had previously. My guess is that it has a lot to do with the bacteria having consumed so much of my food- I was starving constantly. By the time I finally got help for the SIBO, it was really really bad. Extreme symptoms that had been going on a full year after I had been on 2 rounds of antibiotics for a bad UTI. I’m about to finish the Rifaximin and hoping I don’t go back to how things were before.

    • Have you looked into the Fast Tract Diet? It is designed for SIBO and differs from a low FODMAP approach in that it measures the potential of carbs to ferment in the gut. Foods with high fermentation potential are the ones to limit or avoid. It is also a quantitative approach in that it recommends consuming below a certain amount of fermentation potential points. Meat, fish and eggs have 0 points. Although I am not naturally a “counter,”this diet has helped me with SIBO. I use the Fast Tract Diet app, which makes it easier to track. Initiallly I have had to go below the recommended 25 points per day to see results, but a gradually gaining a tolerance to include higher levels in my diet.

      • Yes, I’m actually the first one to have posted about the fast tract diet on this discussion board. I don’t seem to have much issues with SIBO at this point so much as motility problems. As long as I take supps to help with that, I’m fine. There are a couple problem foods that I react to so I stay away from those and don’t seem to have problems other than that. What I HAVE learned, is that this all ties back into my adrenal glands, which have compromised my thyroid, which is probably one of the biggest reasons I had SIBO and gut problems. If you only address the SIBO, you will always have it, you absolutely HAVE to find out what the underlying causes are, SIBO in many cases is just a symptom, not the actual problem. Not always, but if you have thyroid issues, you may be having problems with adrenal fatigue. And that is hard to fix since the adrenals are constantly being hammered by every day life. Crazy stuff. I’m now working with a holistic doc to get healed up and back on track. It’s slow going.

  15. I managed to do Dr Siebeckers homemade elemental version for two weeks and it was the absolute most horrible thing I’ve done in the name of health so far! From day 5 onwards I just felt nauseous and just the sight of the stuff made me want to vomit! I didn’t retest straight away but some of my symptoms were better but not cured. I then had a fecal Microbiota Transplant and have since been quite a bit better. The good bacteria was almost not present pre FMT and I’m not sure how much more damage the elemental did! A recent hydrogen (but not methane) breath test confirmed that the SIBO seems to be gone. But what did it in the end I’m not entirely sure…

  16. I did the Elemental Diet for 4 days (Dr. Siebecker’s homemade) just to see ‘test’ and see if it would be tolerable or do any damage. Well it has!! 🙁 I haven’t been able to have a bowel movement without laxatives since I did it 3 weeks ago. I’m concerned that I killed off ‘too much’ good bacteria while doing this! Does anyone know if this can happen?? I do also have yeast overgrowth in my GI and I took Nystatin while doing the elemental but the yeast seemed to get far worse afterwards despite that! I also went very very light on the honey. Anyone have any suggestions? I’m at a loss.

    • Dang! Unsure but it shouldn’t have made the yeast worse….there’s nothing in it for the yeast to feed on and the carbohydrate source is very fast absorbing so it doesn’t sit in the intestines to feed anything. I suggest seeing a holistic expert on all this. Also, with constipation I wouldn’t use laxatives…..get yourself some SmoothMove herbal tea, much better for you and helps move things along naturally.

      • Thanks for your reply! 🙁 Yeah, it is a bummer for sure. Bowels still aren’t back in working order. Elemental diets are notorious for causing yeast infections but I don’t know why. Chris does say that when you go Ketogenic (which in effect, is what is happening with an Elemental) those Ketogens can feed yeast. The AbsorbPlus diet is the WORST because it has Maltodextrine and that is a huge yeast-feeder. Smooth Move doesn’t work for me anymore unfortunately. I have to use Linzess or MOM. Even high doses of Senna or Cascara Sagrada stop working after a few days. At least I’m not going down the ex-lax or dulcolax road. I hope to never have to. 🙁

  17. You can make an almost-elemental diet that tastes pretty good by using whey protein hydrolysate instead of synthetic amino acids. I mixed that with glucose, and at first, MCT oil. Later I skipped the MCT oil because I was doing better without it. (Of course you need to make sure you get all the other nutrients except phosphor and maybe iron, copper and calcium, depending on your body’s stores.) Since a lot of glucose is required to meet the caloric needs, I drank some of the mix every hour instead of having “meals.” This, in combination with essential oils as natural antibiotics, worked very well for me, not only against SIBO, but also to improve insulin sensitivity.

    • I am doing similar experiments – i mix dextrose and cocoa butter and or coconut oil – it is almost like white chocolate. But i think i have problem with all fats. My next experiment will be dextrose or glucose and gelatin – similar recipe like gummy bears. Gelatin should be healing for the gut. Some people say that gelatin can feed bacteria but i dont believe it.

      • It may not be true for everyone but cartiledge and gelatin are high in FODMAPS and I get horrible symptoms after just a sip or two of broth. I have to lay off the chicken foot and bone-knucle broth for now. Just know that it has been documented scientifically as a trigger for for SIBO, it just may not be a problem with you. Good luck! 🙂

    • I was becoming sensitive and having issues digesting whey, so when I did the elemental I cut way back on the aminos (but I did keep them in the mix, just lower amount because it tastes so hideous) and I used non-GMO pea protein powder for a protein source. Tastes like cardboard, it’s far from delicious, but I could drink it down and it’s a fast absorbing protein as well. Worked well for me. Isn’t expensive either. I used the NOW brand, been using it for bodybuilding for a couple years now and will continue to use it. I also use a vegan protein powder that is non-soy and a mix of various plant proteins. I have wanted to test the waters with whey again but just haven’t gotten up the nerve to try it, don’t wanna risk the bloating and misery involved if I still can’t digest it! LOL!

    • What brand of Whey did you use? So many are loaded with soy or milk. I would need something lactose-free. The Amino Acid blend that Siebecker recommends is definitely making me worse. I can’t stop throwing up after drinking the stuff!

      • I don’t have a brand to recommend but as a bodybuilder I can say that if you want to try whey, make sure you get whey protein isloate. Since I can’t use it I really don’t have any recommendations but you may want to try a bodybuilding site like bodybuilding.com or supplementwarehouse.com. You should be able to get a high quality whey protein there, but again, be sure that it is whey protein isolate. This means that the proteins are islolated and there isn’t any other “stuff” going on like lactose or whatever. And a good whey would never contain soy.

  18. Hello All,

    I have gone 13 years with the on and off symptoms of IBS, reflux, bloating and what some doctors thought was gallbladder pain. Numerous tests and medications have not fixed this problem. About three years ago I was finally diagnosed with H-Pylori and did a 14 day treatment of 2 strong antibiotics which seemed to make some what of a difference but recently I had to start taking new medications for a pinched lumbar nerve which then seemed to stir up some stuff in my gut again. With a recent negative test for H-Pylori I find myself wondering what is going on in there and now I am sicker then ever. I cant or don’t feel like eating much and when I do get my appetite back for a day and eat I become very sick again. Went to a new gastro and he basically said he had no clue and didn’t think we would ever resolve my issues. So I have taken it upon myself to self diagnosed this SIBO and am going to try this diet to see if it helps. I was wondering if anyone else has skin problems due to this condition? I get hives and extreme dry skin. I am also planning to try the iodine because I have a thyroid condition as well. Any advice or positive outcome stories are much appreciated and I will keep you all updated on my progress as well. Thank you all for your info on here it may have changed my life!

    • I feel your pain! Try contacting a naturalpath doc that specializes in SIBO. Unfortunately I had contacted three and never got responses from any of them so I self diagnosed, which for me was my only option but it’s better if you can get professional help. I’m convinced that regular docs and gastro docs won’t help much. I don’t think they have the training and knowledge but this is my opinion only. I tried contacting a gastro and they wanted to charge me vast amounts of money for consultations to decide if I needed a SIBO test. Then were going to charge me again to come in and take the test. So I just ordered my own and skipped the doc! Also ordered my own stool test that showed overgrowth of three bad strains of bacteria. Also addressing estrogen dominance and I started taking the iodine as well as selenium for the thyroid. In my case, everything is coming together but your case may be vastly different. I do think you should try a natualpath that specializes in SIBO, they just have more knowledge and look into underlying issues, not just treat symptoms.

      This discussion list has been a huge help to me so use it! Keep us posted and do your homework until you are sick to death of reading about SIBO! Also check out this website http://digestivehealthinstitute.org/2012/08/17/sibo-diet-and-digestive-health/ and the IBS version of the book they refer to (Fast Track Digestion IBS). I got the book used on amazon and the diet approach is a lot better than the popular diets recommended for SIBO. I’m having very good success with it so far and it seems like it’s been the best approach, the other popularly recommended diets like FODMAP and the carb specific diets aren’t quite right for the condition. If you have an Amazon Prime membership you can “borrow” an e-copy for free too. Also, the FAQ section on that website will answer a lot of questions not addressed in the book.

      • Ok so here we go today is day one on the elemental diet. I hope this works. My plan is to do this for 3 weeks. I will keep you all updated on how I am feeling in a few days. 🙂

        • Good luck and stick with it! It’s hard at first but worth it. And be sure you are taking a biofilm disruptor and the right herbals, rotate the herbals every four days to prevent resistance. If you start feeling flu-ish and sick, drink lots of water, this is toxins from killing off bacteria and it’s not fun! But stick with the diet! It’s a sign that it’s working! Get plenty of sleep too. Keep us updated on your progress!

          • So I started my first day on the 21st, took the first drink of my mixture and then threw up 4 x. I realized I wasn’t going to be able to drink that stuff unfortunately. I waited till after the weekend and started my own fasting diet. I consumed one to two cups of chicken broth with coconut oil added to it and tons of water. I also have also been taking the multivitamin’s I purchased for that god awful drink. Now I am on day four and I feel horrible. I cant drink anything but water and I feel exhausted. I hope this will work still because I cant go on living with these stomach issues like I have for 13 years. I am going to try to do this fast for 14 days but if I don’t start feeling better soon I fear I wont make it that long. Also Shasta I am not familiar with the biofilm disruptors or herbals you are talking about. If they are costly its going to be hard for me to get them because I already wasted $160 on stupid amino acid powder I will never use. How long were you extremely sick for? I am really hoping this gets easier tomorrow or the next day. Any other advise is much needed and welcomed.

            Thanks Again!

            • Hi Shayna,

              Have you tried dextrose or glucose – according to Fast Tract Diet for sibo – it is rapidly absorbed and bacteria dont have time to feed on it – it rises blood sugar rapidly but can be taken in small doses. It tastes very good and gives you carbs – without carbs your thyroid will slow down. I think dextrose is the main source of energy in some elemental formulas. Also if you have sibo probably your small intestine is damaged and you can not digest fats – so maybe coconut oil make you feel so bad.

              • Hi VB,

                I am on day 5 now of basically fasting because I have been so sick to my stomach I don’t want to eat or drink anything but water. I thought by now some of my gas and nausea would subside but I am still having a lot of both. I am trying really hard to just stick to this fasting till next Friday and then I am going to start introducing some food back into my diet. I think I am going to try fish and veggies that are low carb and don’t cause gas. I find the more I read about SIBO the more complicated it seems and I feel really down because I think I will never feel better, maybe I feel that way because of the lack of food but it is a real fear for me. I desperately want to feel like I used to when I didn’t have all these issues. If this doesn’t work I am going to go back to the doctors to see what they can do but I don’t have much faith in them either as I have been dealing with this for 13 years with no resolutions.

                Thank you for checking on me all of you 🙂 and happy Friday!

                • Hi Shayna,
                  If you have SIBO/IBS-C there is a supplement that was developed by a GI based in Plano, TX that you might try. It’s called Atrantil. It was just released this summer. You might check it out. I’ve been on it 6 days. I felt worse after I started it but am a bit better now. SIBO is so overwhelming on so many levels. The Dr.’s just don’t know enough yet.
                  http://atrantil.com/
                  I do hope you feel better.
                  Kim

                • Not feeling better at all and I am getting very discouraged. Going to wait another week before I call my Dr. 🙁

                • Shayna,
                  You WILL feel sick for a couple weeks, depending on how much bacteria was overgrown in your small intestines. You’re probably experiencing die-off, which is all the toxins released from killing those nasties off. Hang in there. I was knocked on my butt for a full two weeks when I did the elemental. Hang in there. It means it’s working. Are you taking herbals to help kill stuff off?

                • I am really trying and I am going to try to make it through the week and see how I feel but the pain I’m getting in my diaphragm area through to my back is getting so bad. Does anyone else get his pain? I am not taking any herbals but a friend of mine gave me the name of a specialized herbal store in my area and she said the guy that works there is very knowledgeable so I am going to try to get over there sometime this week and see what he says. I just really need to start feeling better because this is starting to ruin my life 🙁

                  Thank you for the pep talk Shasta. I am going to try my hardest.

                • Try to find a doc familiar with SIBO before setting an appointment. I had to see a doc on Friday for a different issue and mentioned the SIBO and he looked at me and said “What’s that?”. Never heard of it in his life. I suggest a naturalpath, they seem to know more. Ask questions before going though, make sure they know what they’re doing. The medical industry doesn’t seem to recognize the condition yet. As for the herbals, do your homework. I rotated herbals every four days, and used two at a time. This helps keep bad bacteria from adapting to it.

                • Shasta,

                  I just feel exhausted by all this my head is spinning from all the info I have read and talked to you all about. I don’t understand why there isn’t a easier way to get better 🙁

                  I will definitely take your advice about the dr because I went to one who was a complete moron and tried to get me to take a stronger antacid that cost $195 a month, after insurance, even thought I told him I wasn’t having reflux symptoms. I will never go back there.

                  Thanks again!

        • hi shayna you must be on day 7 of the elemental diet (vivonex?)
          my niece is starting it today for SIBO that didn’t respond to antibiotics very well.
          We are doing it through a tiny nasogastric feeding tube to avoid the taste.

          how are you doing so far?

          • I have suspected that I have SIBO for some time – frequent digestive problems, food sensitivites and arthritis – so I recently tried the Absorb Plus Elemental diet for about a week to see if it would alleviate the symptoms. I felt great, lots of energy, clearer skin – but by the 3rd or 4th day I started to get constipated and can’t figure out how to alleviate it. Has anyone else noticed an onset of constipation when doing an elemental diet?

            • I did the elemental for 4 days as a trial run. I ended up having constipation for a good month afterwards. It was tough! The elemental is basically starving out bacteria in your small intestine. It’s only supposed to starve the ‘bad’ bugs but we know that’s not the case. It starves out the good as well. You will have to take something to get things ‘moving’ for quite awhile after.

    • Check out FODMAPS- Monash Uni and Sue Shepherd are the best sources- there is a lot of misinformation on the internet, they scientifically test

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