Is an Elemental Diet the Answer to Your SIBO?

If you are one of the millions of people who suffer from the debilitating symptoms of SIBO (Small Intestinal Bacterial Overgrowth), know that you are most definitely not alone. SIBO is a condition of the digestive system characterized by an overgrowth of bacteria in the small intestine, resulting in an abundance of debilitating digestive and non-digestive health issues.

When it comes to effectively managing SIBO, diet is one of the most important components. In this article we will delve into the details of the elemental diet specifically, and how it can be used to help eradicate SIBO. 

What is an Elemental Diet?

An elemental diet is a liquid-based diet that provides essential nutrients in the most basic “elemental” form. This means that the contents of the liquid diet are predigested in an easily absorbable formula.

Traditionally, nutrition derived from food consists of complex molecules that require extensive effort from the digestive system to break down. Elemental diets differ in that they provide nutrients in their purest form that are absorbed directly into the system with minimal to no digestion, thereby allowing the GI tract to rest and recover. The nutrients in an elemental diet come from amino acids and simple sugars, as well as vitamins and minerals.

Elemental diets have been utilized for years to address various gastrointestinal conditions, including SIBO, IBD (Crohn’s, Ulcerative Colitis), and Eosinophilic Esophagitis (EoE). The diet intends to provide comprehensive nutritional support as the sole source of nutritional intake for a limited period while allowing the intestinal tract to rest. In the case of SIBO, this also deprives the bacteria in the small bowel of sustenance, thereby causing it to starve, eliminating the bacterial overgrowth from the digestive system. When utilized as a management option for SIBO, patients typically remain on the elemental diet for 2-3 weeks.

Elemental Diet for SIBO

The elemental diet offers many key benefits in the management of SIBO. These include:

• Nutrition: The elemental diet contains easily absorbed nutrients to ensure adequate nutrition even when SIBO may impair regular food digestion. 
• Bacterial Starvation: Because the elemental diet is low in nutrient sources that bacteria like to ferment, they starve and decrease in numbers. 
• Gut Rest: An elemental diet gives your gastrointestinal system a bit of a break because there is no food to digest. This can reduce inflammation and help restore balance to the microbiome. 
• Alternative to Antibiotics: An elemental diet helps to kill off harmful bacterial overgrowth without leading to the side effects or antibiotic resistance that pharmacological antibiotic treatment can cause.

Elemental Diet vs. Antibiotics for SIBO

When it comes to managing SIBO and IBS, reducing the amount of bacteria in the intestines is key to resolving symptoms. Because of this, it’s no surprise that antibiotics have become one of the mainstays of treatment. The most studied antibiotic for this purpose is rifaximin because of its ability to not be absorbed into the bloodstream (it stays mostly inside the digestive tract). 

In a clinical study called the TARGET 3 study, approximately 44% of IBS patients responded to treatment with rifaximin and ⅓ of those who responded had no relapse of symptoms for up to 6 months or more after treatment. This unfortunately means that ⅔ of patients do relapse and require other forms of treatment. 

In comparison, a 14-day elemental diet was approximately 80% effective in eradicating SIBO symptoms in a clinical study. A newer study in 2023 concluded that a palatable elemental diet was 83% effective in eradicating SIBO, based on the normalization of a lactulose breath test after 14 days of consumption. This makes the elemental diet a very viable treatment option for people with SIBO, especially for people who cannot take antibiotics or prefer not to take antibiotics. Another advantage is that the elemental diet will not lead to antibiotic-resistant bacteria or other side effects that might come with antibiotic treatment. However, one of the concerns with elemental diets is patient compliance due to their traditionally unpalatable taste. Because elemental diets have been underutilized up until this point, relapse data is not widely available. New innovations in food science have made more palatable elemental diet options available to patients, and demonstrate clinical effectiveness in managing SIBO with nearly perfect patient compliance rates.

Implementing an Elemental Diet 

The decision to incorporate an elemental diet into SIBO treatment is determined by various individual considerations such as symptom severity and previous treatment failures. An essential aspect of managing SIBO is finding an experienced health care provider who can help decide if an elemental diet works for you.

Preparation for an elemental diet should include familiarizing yourself with available products, understanding your doctor’s recommended protocol, and mentally preparing for the liquid diet and potential side effects.

The duration of an elemental diet is typically between two to four weeks, during which one does not eat solid food, consuming only the elemental power formula mixed with water. To achieve maximum results and deter possible complications, it is necessary to adhere strictly to the given course of treatment.

Returning to Food After an Elemental Diet 

During the elemental diet, the gut essentially shuts down to rest and repair itself. Once you complete the course of elemental diet, you need to wake up the digestive system with normal, solid foods, a process which will take about two weeks to complete. 

We recommend starting with a small group of low-fat, low-fiber foods in their simplest forms. If you're looking for more guidance on returning to food after the elemental diet, check out our comprehensive food transition guide, complete with day-by-day guidelines, a 7-day meal plan, and bonus recipes!

Tips for Success 

Working closely with a health care provider experienced in managing SIBO is essential to success with a special diet. Guidance can be given on ingredient choices, dosages, and progress monitoring throughout the diet.

Getting help from others who have undergone the elemental diet themselves can also be invaluable. Online support groups, forums, and social media communities can provide encouragement, advice, and practical advice to deal with the challenges of basic nutrition.

Tracking symptoms and progress throughout the diet is important to monitor effectiveness and make necessary adjustments. Keeping a journal or diary to track symptoms, bowel movements, and overall well-being can help identify patterns and inform discussions with your healthcare provider.

Follow up testing with your health care provider is also important. In the case of SIBO, a follow up breath test should be administered at the conclusion of the elemental diet to determine if bacterial levels have successfully normalized.

What is the mBIOTA Elemental™ Diet? 

Our Story 

For over 50 years and across hundreds of clinical studies, doctors and scientists have demonstrated the clinical effectiveness of elemental diets for a variety of health conditions. However, due to the unpalatable taste of elemental diets, it was close to impossible to achieve meaningful patient compliance... until now.

Driven by her own struggle with SIBO, Krystyna Houser founded Good LFE and mBIOTA Labs to provide improved solutions and support for sufferers of gut issues. Her determination and vision have propelled us to develop scientifically formulated products catering to diverse GI challenges, making mBIOTA Labs a leading innovator in the field and creating a new breakthrough in SIBO management.

Just a few years ago, Krystyna found herself in a place that you may be familiar with; struggling with the debilitating effects of a GI disorder. The constant discomfort, the endless visits to doctors, and the frustration of not finding relief were overwhelming and exhausting.

In her quest for answers, Krystyna was very fortunate to meet two pioneering gastroenterologists, Dr. Mark Pimentel and Dr. Ali Rezaie. Thanks to their guidance, she learned about elemental diets; a dietary management option that held the promise of relief. Krystyna embarked on this path with determination, but like so many others, she encountered a significant obstacle: the unpalatable taste of the available elemental diets. The thought of consuming something so unpleasant made an already challenging situation even more daunting. 

It was at this moment that Krystyna knew there had to be a better way, and that she would try to find it. After partnering with Dr. Pimentel and Dr. Rezaie and assembling a team of dedicated food scientists, she set a simple yet profound goal; to develop an elemental diet that was not only effective, but also tasted good. We are proud to introduce you to mBIOTA Elemental™ -  the result of our collective dedication, years of research, and the unwavering commitment of our team to making your journey toward better health easier and more enjoyable. 

About mBIOTA Elemental™

mBIOTA Elemental™ revolutionizes oral nutrition, making a new breakthrough in the world of SIBO management. The unique elemental diet powder is a medical food and is a 100% free-form-amino-acid product that delivers essential nutrients, vitamins, and minerals in a readily absorbable formula. mBIOTA Elemental™’s superior taste offers a highly palatable flavor profile while remaining a fully elemental diet, designed for the dietary management of patients with GI dysfunction.

Elemental diets by nature are comprised of 42-76% carbohydrates in the form of monosaccharides. You might be thinking, "wait, I thought sugar was bad for SIBO?" This is actually a bit of a misconception - and here's why: Carbohydrates are necessary for baseline nutrition and energy, and, while processed sugar most definitely feeds the bacteria associated with SIBO, the natural, unprocessed sugar as is used in mBIOTA Elemental™ is absorbed within the initial 2-4 feet of the small intestine. This means it does not get far enough into the small bowel to  feed bacteria contributing to SIBO. The bacteria are deprived of the sustenance needed to thrive for the ~2 week period you are on the elemental diet, and as a result, starve, causing a reduction in the overall bacterial levels in the small intestine.

Developed in partnership with world-leading gastroenterologists, Dr. Mark Pimentel and Dr. Ali Rezaie, and an innovative team of food scientists, mBIOTA Elemental™ completed clinical trials at Cedars-Sinai (November 2023) with data points exceeding initial expectations.

• 83% of all patients with SIBO (regardless of IMO status) eradicated with normalization of their breath test after 2 weeks 
• 100% of SIBO-only (hydrogen dominant) patients eradicated
• 75% of SIBO/IMO patients eradicated
• 58% of IMO-only (methane dominant) patients eradicated 
• 100% of patients preferred the taste of mBIOTA Elemental™ in comparison to the leading market competitor on all 6 taste metrics

mBIOTA Elemental™ is the only fully elemental diet to see 100% clinical trial compliance - meaning all participants were able to complete two full weeks of elemental diet without the consumption of other food and drink. 

Understanding the range of patient dietary restrictions, mBIOTA is also the only elemental diet to adhere to the following requirements: 

• Fully Elemental
• Multiple Flavor Options 
• Vegan
• Soy Free
• Kosher
• Lactose Free
• Gluten Free
• Artificial Sweetener Free