Can A Semi-Elemental Diet Help You Beat Stubborn SIBO?
February 4th, 2019
Small intestinal bacterial overgrowth (SIBO) is an increasingly common gut condition that I get questions about all the time. In my clinic, I found it was especially prevalent in older patients and those with hypothyroidism and other chronic conditions.
SIBO, or small intestinal bacterial overgrowth (SIBO), occurs when the bacteria in your gut get out of balance and overgrow. This can cause whole range of digestive issues, including food sensitivities and difficulty absorbing nutrients. Recovery requires that you follow a restricted diet, and avoid certain foods completely. Many people really struggle with this. It can be difficult to stick to a SIBO-friendly diet that provides adequate nutrition. Others find that even after following the SIBO protocol for 30 days or more, they are still experiencing symptoms. Because of this, I’m often asked for alternative treatments and eating protocols that can help overcome stubborn SIBO.
One option that you may find works for you is the semi-elemental diet. In this article, I’ll explain what a semi-elemental diet is, why it’s been shown to help with severe cases of SIBO, and the pros and cons of the diet. I’ll also cover other key ways you can support your gut health while getting your SIBO under control. Let’s dive in!
What is SIBO?
As I mentioned earlier, SIBO is a condition in which the bacteria in your gut get out of balance and overgrow. This can happen in two ways. Either, the gut bacteria that is meant to reside in your large intestine and colon escapes into your small intestine. Or, the small amount of bacteria that occurs naturally in your small intestine grows out of control. This can be cause by:
- High carb diets
- Nerve and muscle damage from diabetes, scleroderma, or other conditions
- Physical obstructions such as diverticuli, and scarring from surgeries or Crohn’s disease
- Medications such as antibiotics, acid-blocking drugs, and steroids
Once in your small intestine, even “good” bacteria can cause all sorts of digestive drama as they feed off of and ferment the undigested food located there–particularly sugar, carbohydrates, starches, and alcohol. This fermentation process produces hydrogen, methane, or both types of gases as a byproduct, which is why bloating is the #1 symptom of SIBO.
Symptoms of SIBO
- Gas and bloating
- Abdominal pain or cramping
- Diarrhea or constipation (less common than diarrhea)
- Diagnosis of irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD)
- Food intolerances, particularly histamine intolerance
- Chronic illnesses such as fibromyalgia, chronic fatigue syndrome, diabetes, neuromuscular disorders and autoimmune diseases
- Vitamin and mineral deficiencies, including vitamins A, B12, D, and E
- Fat malabsorption (signified by pale, bulky, and malodorous stools)
- Rosacea and other skin rashes
- Leaky gut
Think you might have SIBO? Take my quiz to find out!
A typical SIBO diet is one that eliminates foods that feed the bacteria in your small intestine, including sugar, alcohol, and carbohydrates (both refined carbs such as bread and crackers, and complex carbs such as whole grains and legumes). This protocol also minimizes fruit intake, since fruit is a huge source of natural sugars as well as carbs. Patients are instead encouraged to eat plenty of non-starchy vegetables, leafy greens, lean proteins, and healthy fats.
What is a Semi-Elemental Diet vs. an Elemental Diet?
To understand what a semi-elemental diet is, let’s first look at what an elemental diet is. An elemental diet is essentially a blended or liquid diet made up of nutrient-dense smoothies. Because the macronutrients are already broken down for you, it drastically eases the burden on your digestive system, allowing your GI tract to rest and reset. This diet provides protein in the form of individual amino acids, and is very low in fat, making it ideal for patients with severe motility, absorption, or digestion issues.1 It is typically followed for 14 to 21 days.
A semi-elemental diet is similar to an elemental diet in that it relies on liquid nutrition, though some semi-elemental diets may be supplemented with solid foods if the patient can tolerate them. The main difference, however, is in the protein structure. The semi-elemental diet provides protein that is hydrolyzed into peptides (short chains of amino acids), which are thought to be more readily absorbed than individual amino acids or whole proteins. It also contains fats in the form of medium-chain triglycerides (MCTs), which are more easily digested than other types of fats because of their shorter length.2 This diet is often used for digestive disorders such as SIBO and Crohn’s disease.3
Is the Semi-Elemental Diet Radical?
You may be wondering whether it is radical to follow this type of diet. In an age when even healthy people are going on juice fasts or lemon-water and cayenne detoxes, I’d actually argue that a semi-elemental diet is much less extreme than these “fad” cleanses. That’s because the semi-elemental diet is strictly for those with SIBO and other digestive issues that prevent them from fully recovering on a solid diet. Plus, as with the elemental diet, the semi-elemental diet is only meant to be used for 2-3 weeks while the patient repairs their gut. It is a temporary solution, not a lifestyle.
How the Semi-Elemental Diet Can Help Reverse Damage from SIBO
As I mentioned earlier, the semi-elemental diet is thought to be superior to a standard diet or full elemental diet (except in the most extreme cases) primarily due to the digestibility of its proteins. Many people following a strictly elemental diet may experience poor nutrient absorption and an inability to maintain weight and muscle mass because of their reliance on individual amino acids. However, when amino acids “piggyback” on di- or tripeptides, they are found to help patients gain or maintain a healthy weight and improve nutrition status.4 Protein, after all, is the building block of every cell in your body and is essential for repairing your gut and strengthening your immune system—two key steps in overcoming SIBO.
Studies have shown that a semi-elemental diet offers health benefits for the entire digestive process in patients with Crohn’s, pancreatitis, and autoimmune disorders. It can help speed up metabolism, reduce gastrointestinal symptoms, aid nutrient absorption, and improve overall clinical outcomes.5,6,7,8
Semi-Elemental Diet Basics
If you’ve been struggling with SIBO and feel you’ve tried everything to no avail, you might be wondering if the semi-elemental diet is right for you. I want to equip you with all the tools you need to follow this diet safely and restore your health naturally. So now we’ll take a closer look at the details of a semi-elemental diet, including the question on everyone’s mind: what exactly do you drink, and what can you eat should you choose to incorporate some solid foods?
What to Drink and Eat on a Semi-Elemental Diet
Depending on how you define a semi-elemental diet, your food and drink choices might vary slightly. The following options each have their own pros and cons:
- Premade Formulas: There are semi-elemental formulas you can buy that are specifically made for people following this diet. The benefit of choosing these premade formulas is that they take the guesswork out of knowing what to drink or eat, plus many of them come in various formulations specially designed for people with diabetes, autoimmune disease, those with liver or kidney disorders, and other special cases. The drawback of these formulas is that they can be quite expensive, with some costing upwards of $400.9 They are also commonly be made with whey protein, and dairy products that are highly inflammatory and allergenic.10
- The Myers Way® Protein Powder: My paleo protein powders are made with hydrolyzed beef protein sourced from non-GMO, hormone- and antibiotic-free, grass-fed beef. The Myers Way® Paleo Protein comes in four delicious flavors and is 100% soy-free, gluten-free, dairy-free, and egg-free, making it one of the least allergenic protein powders on the market. It is also a good source of MCTs, which have been shown to support a healthy microbiome by fighting bacterial overgrowth and repairing a leaky gut.11,12
- Solid Foods: If you can tolerate solid foods, incorporating small amounts into your semi-elemental diet will help you stay on track and keep you feeling full, satisfied, and well-nourished. You don’t want to eat anything that will be difficult to digest, irritate your stomach, or feed the bacterial overgrowth. Instead, focus on steamed non-starchy veggies, soups and bone broth, and, of course–smoothies!
How Long Should You Follow a Semi-Elemental Diet?
I recommend following a semi-elemental diet for 2 to 3 weeks, and seeing how you feel.13 You can stop once you no longer experience symptoms of SIBO. A good sign that you’ve overcome SIBO is that you don’t experience extreme bloating after eating a meal. You can also track your improvements using my symptoms quiz again, and compare your new results to your old.
Potential Side Effects
While potential side effects are few, there are some important ones to consider:
- Nutrient deficiencies: If you do not emphasize nutrient-dense liquids, you could be risking nutrient deficiency. SIBO already inhibits your absorption, so you want to make sure you’re taking in plenty of vitamins and minerals in their most bioavailable form. I recommend everyone take a multivitamin, but this is especially important during a semi-elemental diet, or while recovering from an illness. The Myers Way® Multivitamin contains the highest quality blend of vitamins and minerals designed for optimal absorption and bioavailability.
- GI issues: For some, switching to an all- (or nearly all-) liquid diet can cause some initial gut distress in the form of diarrhea and abdominal pain.14 To avoid this, go slow. Increase the amount of liquids in your diet gradually over a few days.
- Falling off track: Depending on what type of formula is used, the diet might not be palatable or financially sustainable. If you not able to strictly adhere to such a diet, your recovery could be delayed.
Pros and Cons of the Semi-Elemental Diet for SIBO
Now that you understand the basics, the following pros and cons can help you decide whether you might thrive on a semi-elemental diet:
- Specialized formulas take the guesswork out of meal planning
- Easy on the digestive system; lets your gut rest and recover
- Nutrients are more easily absorbed than in an elemental diet
- Helps you maintain a healthy weight
- Many premade formulas are allergenic and/or inflammatory
- Poorly planned diets can lead to malnutrition and GI issues
- Strict nature of diet may be difficult to follow
- Can be expensive
Gut-Repairing Supplements to Consider
Are you interested in trying a semi-elemental diet without spending your money on pricey formulations? If so, there are a number of supplements I recommend to ensure you’re getting optimal nutrition while repairing your gut at the same time!
The Myers Way® Paleo Protein will be your go-to meal replacement on a blended diet. Made from hydrolyzed beef, it provides you with the most highly absorbable form of protein and amino acids, as well as gut-friendly MCTs. Plus, when you purchase a bottle of my Paleo Protein, you also get a FREE eBook with mouth-watering protein smoothie recipes that will make following a semi-elemental diet a breeze! Did I mention it tastes delicious?
Whether or not you choose to try a semi-elemental diet, I highly recommend making a daily Paleo Protein smoothie because of its gut-repairing benefits. I drink one every morning! It’s the perfect quick, on-the-go breakfast and gives me plenty of sustained energy to carry me through my busy day.
My Collagen Protein is made from easily-absorbed bovine collagen peptides. It is an ideal complement to Paleo Protein for providing extra protein and amino acids while following the semi-elemental diet. Collagen helps support a healthy gut barrier and mixes easily into any smoothie or other beverage, hot or cold.
Gelatin is essentially collagen that has been cooked, giving it a different texture. Unlike collagen, when you mix gelatin into a liquid, it acts as a thickener or binder. You can use it on a semi-elemental diet to make soups and sauces richer, or to make gelatin-based desserts and other recipes to add some semi-solid foods to your diet. The best part is you get all the health benefits of collagen, while adding satisfying texture to your SIBO-fighting menu!
Leaky Gut Revive™
This is my most comprehensive tool for repairing and maintaining a healthy gut lining. Repairing your gut is the first step in overcoming SIBO and other chronic illnesses, and Leaky Gut Revive™ can fast-track your progress. It contains a potent blend of gut-repairing herbs and nutrients, including L-glutamine. L-glutamine assists in cell turnover to speed up repair of your mucosal lining, curbs sugar cravings to help you beat SIBO, and supports overall intestinal health.
While you have SIBO, I recommend you only take a soil-based probiotic to avoid feeding bad bacteria with the good. My soil-based Primal Earth™ probiotic contains three well-studied strains of spore-forming bacteria that are able to bypass your small intestine without feeding the overgrowth. (You can learn more about the benefits of soil-based probiotics here).
Now that you understand how a semi-elemental diet can help combat stubborn SIBO, you may be wondering if I recommend it. Frankly, as with all diets, it depends on whether you follow it in a way that supports optimal health. Any diet can be followed poorly. For this reason, I recommend enlisting the help of a functional medicine physician to ensure you are meeting all of your nutritional needs. Drink plenty of nutrient-dense smoothies and, if you choose, eat small amounts of soft-cooked, organic foods including leafy greens and other non-starchy vegetables, grass-fed beef, and wild-caught fish. When done safely and optimally, a semi-elemental diet can offer many health benefits for those struggling with SIBO.
Have you used a semi-elemental diet successfully to overcome SIBO? Tell me about your experiences in the comments!
- Eichenberger JR, Hadorn B, Schmidt BJ. A semi-elemental diet with low osmolarity and high content of hydrolyzed lactalbumin in the treatment of acute diarrhea in malnourished children. Arq Gastroenterol. 1984 Jul-Sep;21(3):130-5.
- Voss T, Rowe B, Graf L, Keyes C, Beal J. Management of HIV-related weight loss and diarrhea with an enteral formula containing whey peptides and medium-chain triglycerides. In: Abstract book of the VII International Conference on AIDS., editor. Italy: Florence; 1991.