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Hi,

I decided to try the elemental diet to see if I could get some persistent improvement in my IBS. I had a positive breath test on one occasion and have a positive breath test response to fructose also.

I ordered some Vivonex and have been taking it for the past 2 days. I notice that from the very first dose, within 10-15 minutes of taking the Vivonex, all of my IBS symptoms start to flare. I get bloating, cramping, some diarrhea and mucous.

I was warned that some people don't tolerate the ingredients in VIvonex well. Are my symptom flares and timeframe relative to taking the Vivonex indicative of this type of intolerance? Or is this par for the course? It seems a bit early for die-off, but is that possible already?

I wonder if I should consider switching to the "Homemade" elemental diet that Dr. Siebecker has posted on her website?

http://www.siboinfo.com/uploads/5/4/8/4/5484269/homemade_elemental_diet_options.pdf

Has anyone used the homemade version and had success? Is it generally better tolerated? I know the papers have been published about Vivonex (which is why I started with that), but are there any reports of breath tests normalizing and symptom improvement on the homemade version?

thanks for any help!
 

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There are many accounts on this site of Vivonex use. Some have been helped, others not. I know of one person who used Siebecker's DIY version and benefited. I did two bouts of Vivonex Plus and it never helped me and gave me worse diarrhea the entire time. I also made my own DIY concotion, different from Siebecker's, and it did not help.

I applaud and encourage all self-experimentation. One thing that concerns me about the various DIY versions that I have seen on the internet is that it is theoretically possible that they could cause more problems than they solve. Vivonex is formulated so that it has what is called a balanced "osmolality." I think that Kathleen or someone with a deeper scientific background could explain this better. Basically, you don't want to have a concoction that is so concentrated that it causes fluids to rush into the intestines, the way, for example, they do for a colonoscopy prep.

That said, I would never again take Vivonex unless my life were truly at risk. First, if one has bacterial overgrowth high up in the small intestine, in the duodenum right next to the stomach, Vivonex feeds them with tons of easy-to-digest carbs. Second, Vivonex is almost pure carbohydrate, along with just enough protein to keep your muscles and other organs from wasting, and almost no fat.

Many IBSers, as Pimentel discusses in his book, do better eating a diet that minimizes carb consumption. I am one of them. Going from low carb to Vivonex can be a severe shock. At the times that I tried Vivonex I was not measuring my blood sugar. Now that I do measure my blood sugar regularly, I am sure that I was getting unhealthy hyperglycemic episodes after every Vivonex "feeding" (a Vivonex "feeding" is what people who eat real food call a "meal").

My DIY versions of an elemental diet consisted of separate amino acids powder combined with lots of fat and supplementary vitamins and minerals. Maltodextrin, the main ingredient in Vivonex, is not essential for human survival and flourishing. The essential amino acids, essential fatty acids, and some micronutrients are requirements for human health.
 

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An elemental diet sounds really extreme. I agree with Moises that Dr Pimental's diet might be a less dangerous option. There's a lot of conflicting advice on the best diet for IBS/SIBO. The best thing is to experiment with normal foods and see if a particular type of food causes more symptoms. I've found generally that well cooked, low FODMAP vegetables seem to be the best possible diet and at least is nutritious and relatively healthy. My worst foods seem to be high starches, and even though potato is a high starch food generally, the method of cooking can change the starch level dramatically. French fries are much higher in starch than mashed, well-boiled potatoes. The other thing is that the specific carbohydrate and FODMAP diets don't disallow constipating foods like meats etc. Constipation could be the unifying factor that most of us have. It's possible IBS-C can gradually grow more severe and become diarrhea predominant IBS. So whatever your IBS type, we all benefit from reducing constipating foods as much as possible. For me, anything that isn't a vegetable or fruit is constipating and that includes all grain products no matter how high in fibre, meat etc. There are a ton of IBS diets out there and they all have their own pet theories but the science if any is limited to their narrow focus. Most of them contradict one another. The specific carb diet limits certain simple sugars while the FODMAP diet limits complex sugars.But both allow high fibre which feeds bacteria as well. Most of us probably can't tolerate high starch, high fibre or high FODMAP foods. I can tolerate meat if I'm prepared to spend another hour on the toilet. If you're not prepared to do this then you can't really tolerate meat either. You need a practical diet that you can sustain for years, not a fad diet with dubious science behind it. Try the well-cooked low FODMAP veges first, with proteins like fish or eggs instead of meat. I think a lot of us have underlying neural signalling disorders and I'm not sure if these can be unlearned or not. A long-term low flatulogenic diet which involves eating easily digested food might possibly cure these neural disorders if they are caused by bacteria as bacteria can behave like neurotransmitters.
 

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Thanks for the responses. I was not planning on doing the elemental diet for more than the 2 weeks. I do benefit from the low FODMAP diet in general. I was hoping that after doing the elemental diet for the two weeks I'd be able to expand my diet - that is if it worked to get rid of the bacteria.

Some more history - I was already treated with Rifaximin and although it improved my test initially, the symptoms remained.

I wondered how to differentiate between the so called "intolerance" symptoms (presumably to maltodextrin) vs just feeling generally crappy adjusting to the elemental diet? How would one know they need to switch to the DIY version? Also, I wonder what happens to the bacteria in your colon while you are on an elemental diet? Do they recover? Presumably they also aren't getting "fed" during this time.
 

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Discussion Starter · #5 ·
Well an update. I finished the elemental diet and I did my breath test. Its still positive. Not sure what to do at this point. My understanding is thats a pretty uncommon occurrence.
 
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