Elemental diet

An elemental diet is a diet that proposes the ingestion, or in more severe cases use of a gastric feeding tube or intravenous feeding, of liquid nutrients in an easily assimilated form. It is usually composed of amino acids, fats, sugars, vitamins, and minerals. This diet, however, lacks whole or partial protein due to its ability to cause an allergic reaction in some people.

Effectiveness

There is no good evidence that elemental diets are effective in treating chronic pouchitis.[1]

Description

The elemental diet consists of a mixture of essential amino acids with non-essential amino acids, fat, and sugars. Water-soluble vitamins, fat-soluble vitamins, and electrolytes are often added.[2] The elemental diet is commonly introduced over a period of three days to patients, successively increasing in strength on each day to reduce the likelihood of diarrhea and abdominal colic.[3][4] It can be given orally or through nasogastric tubes if patients are intolerant to the liquid.

Patients are restricted of all foods; however, certain exceptions in some patients are made for tea and coffee (without milk) and given Vivonex as the elemental diet. Other elemental diets such as Elental can be used that provide similar results.[5] The elemental diet provides a high nitrogen source for patients from amino acids and acts as a medical bypass. Because the diet consists of the individual dietary components of food in their simplest form, the body does not have to do work to digest them. They prevent the food from "reacting" with the gut, preventing the occurrence of symptoms.[4]

Adverse effects

Many patients are unable to tolerate the taste, even if the diet is flavoured, and choose to receive it through intragastric administration.[2] Possible nausea and diarrhea can result from the high sugar content which can also complicate hyperglycaemia in patients with pre-existing diabetes.[2] As a result of suppression of healthy bacteria, via a loss of bacterial food source, prolonged use of an elemental diet elevates the risk of developing clostridium difficile infection/colonisation.[6]

References

  1. ↑ Segal JP, Ding NS, Worley G, Mclaughlin S, Preston S, Faiz OD; et al. (2017). "Systematic review with meta-analysis: the management of chronic refractory pouchitis with an evidence-based treatment algorithm". Aliment Pharmacol Ther. 45 (5): 581–592. doi:10.1111/apt.13905. PMID 28008631.
  2. 1 2 3 Russel, R I (1975). "Elemental diets". Gut. 16 (1): 68–79. doi:10.1136/gut.16.1.68. PMC 1410941. PMID 806492.
  3. ↑ O'Morain, C; Segal, A W; Levi, A J (1984). "Elemental diet as primary treatment of acute Crohn's disease: A controlled trial". BMJ. 288 (6434): 1859–62. doi:10.1136/bmj.288.6434.1859. JSTOR 29515542. PMC 1441790. PMID 6428577.
  4. 1 2 O'Morain, C (2007). "Elemental diets in the treatment of Crohn's disease". Proceedings of the Nutrition Society. 38 (3): 403–8. doi:10.1079/PNS19790064. PMID 531031.
  5. ↑ Elental Elemental Diet
  6. ↑ O'Keefe SJ (January 2010). "Tube feeding, the microbiota, and Clostridium difficile infection". World J. Gastroenterol. 16 (2): 139–42. PMC 2806551. PMID 20066732.
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