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Crohn's Disease Forum » Treatment » Enteral Nutrition & TPN » Can an elemental diet really lead to remission and stop diarrhea?


10-18-2017, 11:45 AM   #1
Idiom
 
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Can an elemental diet really lead to remission and stop diarrhea?

I am starting an elemental diet, some sources I read say this can lead to remission whilst others deny it.

Does anyone have any evidence or personal experience they can share to confirm either?

crohns.org.uk claims elemental diets are extremely successful.

The other question I had was...
currently everything I eat gives me severe diarrhea, would consuming only elemental nutrition drinks like Ensure help, despite it being a full liquid diet?

Any other advice on starting an elemental diet would also be appreciated.
10-18-2017, 12:47 PM   #2
Sophabulous
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I canít answer the question re diarrhoea as I donít suffer that symptom, however I did the elemental diet last year and Iím about to do it again. I immediately started Azathioprine after stopping the shakes and unfortunately in the 3 months or so that it takes to work, things flared up again.

Itís tough going without a doubt, but around 6-7 weeks in I felt a massive improvement. The only problem was by that point I felt well enough to actually be hungry again lol. Iíve chosen to do it again this time rather than steroids, as for me it had the same effect (takes a little longer though), without the terrible weight gain, mood swings and general crappyness that comes along with Pred.

Good luck!
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10-18-2017, 03:09 PM   #3
Cat-a-Tonic
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I did a couple weeks of EEN last year. I had flared badly, lost 17 lbs in a month and was having diarrhea 20+ times every day. Could not digest anything - literally anything I ingested, including Ensure, went right through me and caused horrible gut cramps along the way. After a month of that, I ended up being admitted to the hospital for 5 days, and during that time they put me on IV steroids and EEN (Vivonex specifically). I think it was a combination of the steroids and the EEN, but it did get me feeling better. Fortunately I could digest the Vivonex a lot better than the Ensure! After 5 days, they discharged me with oral steroids and a prescription for 2 weeks of Vivonex. Unfortunately, my insurance wouldn't pay for it, and it was over $600 for a 2-week supply.

Because of the exorbitant cost, I couldn't afford to stay on EEN for longer than 2 weeks - if I could have, then I would have preferred to stay on it longer (as it was, my parents gave me the $600 just so I could afford that two weeks' worth). But, even so, I was able to successfully wean myself back onto bland, low-FODMAP solid foods slowly and carefully after the 2 weeks of EEN. The cramping and diarrhea didn't return. I know I can't attribute my success wholely to EEN, because I'm sure the steroids played a part too, but in my experience it was worthwhile and seemed to help a lot.

I will say that elemental formulas tend not to taste delicious. Vivonex tastes... well, not like food. They fool you, the packaging says that Vivonex is made by Nestle, so initially you think it might taste like chocolate. Nope, it's pretty much the exact opposite of chocolate. It's hard to describe the taste but it made me think of horses and wood chips for some reason - it's like drinking a barn, if such a thing were possible. Even so, I grew accustomed to the taste and even came to crave it, so I think that means it was really doing good things for me. I still find that I crave Vivonex from time to time (just writing this post, I'm thinking about the taste and drooling, wish I could have one right now! It's disgusting yet wonderful, it's really odd).

I will also say that I did obsess about food while I was on EEN - the nutritionist or dietician or whatever she was at the hospital, she told me that when I started eating again that I should start with low-FODMAP, so I obsessively looked over what the acceptable foods were and looked up recipes and made shopping lists and looked at ingredients lists. I thought about it all the time during that 2 weeks that I was on EEN. So keep that in mind - it is really hard to stick to a liquid only diet that tastes kind of like a farm, especially when the people around you are eating normal food that looks and smells amazing. My advice would be to stay away from grocery stores, restaurants, and even other people at mealtimes, because it tends to drive you a bit crazy when you're on EEN. I would have to go into another room when my husband was eating, it was so hard just to be in the same room as food. It's hard to stick to EEN, but it's also definitely worth it in my opinion. Good luck and keep us posted if you do EEN!
10-18-2017, 03:28 PM   #4
Sophabulous
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Haha, yes as Cat said other people eating is maddening!! My own mother kept trying to get me to have fizzy drinks because Ďsurely just a sip wonít hurt,í and my other half insisted I go to a BBQ! Work had several corporate lunches and even a dominoes pizza if I remember rightly. I wasnít bothered to begin with as the last thing I wanted was food, but when it starts working itís like torture

It really is worth sticking it out though, as hard as it is at the time the payoff is feeling better than you have in years in my experience.

Not a nice situation to be in, but I much prefer it to steroids
10-18-2017, 05:12 PM   #5
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I am starting an elemental diet, some sources I read say this can lead to remission whilst others deny it.

Then it works for some people; but not for others.

You won't know if it works for you or not......until you try it.

But not trying something because someone denies it will work - is just plain being a sillybilly.

My highly respected and experienced private gastroenterologist, told me not to waste my time with diet experimentation, as diets had absolutely no impact on UC.

Had I listed to that twit, I would probably be dead by now, or at least be living with my bowel surgically removed.

The only main thing with diet, is it takes time to start working, and therefore patience and a positive attitude helps enormously.

I have never done a elemental diet in the sense of taking Ensure or any of those other processed treatments. Personally find they have highly suspect ingredients, but yet they still work for many people.

But I do find that fasting on liquids (i.e.) bone broth, water and vegetable juices, to be the quickest way of stopping diarrhea.

I use to have up to 30 bowel movements a day and lose control daily.

But now (after experimenting with different natural treatments), I have one normal movement in the morning, and cannot remember the last time I lost control.

So maybe give it a go, and see how it goes.

Hope it works for you
10-19-2017, 05:02 PM   #6
Idiom
 
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Thanks for sharing your experiences.

Sophabulous said:
my other half insisted I go to a BBQ!
Although I'm unwell, seeing people around me eating still drives me insane! But if this helps it will be worth it.
I would certainly snap if I got asked to go to a BBQ

I saw a gastro dietician today who has put me on Fresubin drinks.
I'd never heard of these but I think they're similar to Ensure.

Interestingly, she told me that these are not actually elemental drinks as research in recent years (UK) has shown elemental drinks to be no more effective.

My limited understanding is that the proteins in elemental drinks are completely broken down.

The plan is to do it for 6-8 weeks, if it works I'll reintroduce foods through the Lofflex diet. I had actually done this diet before and found no success. However I didn't do a liquid diet beforehand so perhaps that will make the difference if everything is more healed.

I'll keep you posted.
10-19-2017, 06:12 PM   #7
Sophabulous
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Thanks for sharing your experiences.



Sophabulous said:

Although I'm unwell, seeing people around me eating still drives me insane! But if this helps it will be worth it.

I would certainly snap if I got asked to go to a BBQ



I saw a gastro dietician today who has put me on Fresubin drinks.

I'd never heard of these but I think they're similar to Ensure.



Interestingly, she told me that these are not actually elemental drinks as research in recent years (UK) has shown elemental drinks to be no more effective.



My limited understanding is that the proteins in elemental drinks are completely broken down.



The plan is to do it for 6-8 weeks, if it works I'll reintroduce foods through the Lofflex diet. I had actually done this diet before and found no success. However I didn't do a liquid diet beforehand so perhaps that will make the difference if everything is more healed.



I'll keep you posted.


Thatís interesting, Iíve never heard of Fresubin either. Are you in the UK? Itís lovely to speak to my British counterparts on here

I hope this works as well for you as it did for me, hopefully even better as itís different to Ensure!

Please do let us know how you are x
10-21-2017, 07:40 AM   #8
Idiom
 
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Thatís interesting, Iíve never heard of Fresubin either. Are you in the UK? Itís lovely to speak to my British counterparts on here
Yes Iím in the UK; I appreciate hearing different approaches from my international neighbours I think fresubin may be used more for bulking. Itís German so may only be available in Europe.

Iím glad you had some success and Iíll post an update.
10-23-2017, 03:51 AM   #9
Guerrero
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I had great success with oral diet (modulen) when I was 15.
Doctors say it is not as effective when you are an adult, but it is proven it work for child. Studies on adult showed lack of efficacy.

I agree with MaryCherub, I think it worth a try
10-23-2017, 01:38 PM   #10
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Second what Guerrero says; I was put on it back when I was 17, and immidiatly I went into remission. I lasted for two weeks, I think, then the social settings at school and in my family just made it too hard for me to continue.
I recently asked my current GI about if it would be a possibility if I go into a bad flare, but he had never prescribed it and did not sound too keen on it.
11-08-2017, 04:28 PM   #11
Idiom
 
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I said I would give you an update so here goes...

After being on the liquid diet of nutrition drinks for 2 weeks my diarrhoea stopped and I began putting on weight I had lost.

I then became constipated for a week. I presume because there is no fibre in these drinks.

However, in the past few days the diarrhoea has began to come back. I don't know if it's the drinks. But I suspect it's just my Crohn's being its unpredictable self.

I'm not really sure where to go from here.
11-08-2017, 05:25 PM   #12
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Hi Idiom,

Yes, I have done the elemental drinks, and they did stop my flare - it is a totally valid method and it works.

So, have you finished the phase of sole elemental drinks? While you're on them, and get loose motion, it can be a case of liquid in, liquid out.

Where are you in the food reintroduction process? Could it be a food reaction?
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11-10-2017, 01:31 PM   #13
Guerrero
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I said I would give you an update so here goes...

After being on the liquid diet of nutrition drinks for 2 weeks my diarrhoea stopped and I began putting on weight I had lost.

I then became constipated for a week. I presume because there is no fibre in these drinks.

However, in the past few days the diarrhoea has began to come back. I don't know if it's the drinks. But I suspect it's just my Crohn's being its unpredictable self.

I'm not really sure where to go from here.
Hi idiom hanks for the update.
I think 2 weeks is too short to really heal or calm down a flare. You probably need a couple of months, maybe mixing liquid diet with one solid meal a day. That's what i've been doing these last 4 months... i was on a 1 solid meal by day during the week and more than one solid meal during the weekends. I can't say it has been that succesful as i've still high inflammatory markers, but I'm sure it would have been worst. I noticed some positive outcomes like my chronic anemia is much better for example my hemoglobin is much higher than before.
11-10-2017, 04:44 PM   #14
my little penguin
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Een (exclusive enteral nutrition- formula only no solid food )
Is done for 6-8 weeks in kids to induce remission
Elemental formula has next to no waste so it can cause constipation followed by diarrhea

Some do better on semi elemental or polymeric formula
The type of formula does not affect the resultsjust no solid food
For 6-8 weeks
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11-11-2017, 06:58 AM   #15
Idiom
 
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I'm 3 weeks into the liquid diet. The plan is after about 6 weeks I'm going to do the Lofflex diet.

At the moment it does seem to be a case of liquid in, liquid out. I've spoken to my hospital but they are hesitant to change anything until the 6 weeks is up.
11-16-2017, 05:31 PM   #16
ncman
 
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I did 2-3 weeks liquid diet in the past, and this was enough to settle things. Nevertheless, follow your hospital's guidance, and keep us updated! Which country are you based in out of interest?
11-17-2017, 02:18 PM   #17
Idiom
 
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Which country are you based in out of interest?
I'm in the UK. I spoke to my dietician and I think it's just my Crohn's refusing to settle.
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