The Elemental Diet & SIBO

The Elemental Diet can be used in cases of Small Intestinal Bacteria Overgrowth (SIBO as a diet which helps to decrease bacterial overload in the small intestine. SIBO is defined as an overgrowth of bacteria and archaea in the small intestine where they do not belon. Symptoms of SIBO can include bloating, diarrhea, constipation and more.

SIBO requires a physicians diagnoses- usually from a hydrogen/methane or sulfur breath test ( TRIO SMART). This diet is extreme because it requires just drinking liquid for every meal  for 2 weeks sometimes 3 weeks to provide the basics of nutrition. In this formula is amino acids broken down to their basic form, simple carbohydrates in the form of glucose and maltodextrin and easily absorbed fat, vitamins and minerals. Popular brands on the market are Vivonex Plus elemental Powder and Physicians’ Elemental Diet.

Vivonex Ten Plus TM Elemental Powder
Physicians’ Elemental Diet TM


The concept behind the elemental diet is that it is digested at the beginning of the small intestine so bacteria in the lower part of the small intestine do not get food to thrive on. In other words it is a way to keep the bacterial and methane producing microbes low. Clinical trials show 80-84% success rate in eradicating SIBO (1) as seen in hydrogen breath tests.


  • Medical Supervision is a must!
  • Need to mentally and physically prepare for this diet.
  •             There is a lot of planning and prep as well as being prepared to be very tired and have “off” days.
  •             Need to make time for self-care during this diet
  • The difficulty of this diet is drinking just liquids for 2-3 weeks.
  • Not chewing foods & missing food is a real deficit.
  • There is a risk of hypo-caloric intake and weight loss.
  • High cost.
  • Takes time to re-feed after doing this medically supervised diet.
  • Not recommended for children or eating disorder clients.

Overall the Elemental Diet is a diet that is very restrictive and should not be followed beyond a 2-3 week time frame. Your physician is the person who would prescribe this diet for SIBO. Most importantly, this is not a diet anyone should follow on their own without medical supervision.

[1] Pimentel M, Constantino T, Kong Y, Bajwa M, Rezaei A, Park S. A 14-Day Elemental Diet Is Highly Effective in Normalizing the Lactulose Breath Test. Dig Dis Sci. 2004;49(1):73-77.