My partner has chronic IBS, basically to the degree of being non-functional. Going places can be a lot of planning, where to find toilets, what things we can eat or not eat, should we fast before-hand to make sure there is less chance of issues. This has been going on for a few years now and after trying several different diets and medications we decided to do an elemental diet. An element diet is an extremely strict diet in which you can only drink special "medical food" shakes. These consist of amino-acids (en lieu of direct protien), glucose, MCT fats and vitamins. Basically everything you need to functionally survive while eliminating fiber or complex carbs that feed bacteria in the intestine. The idea is that because everything is essentially pre-digested you will absorb it quickly and nothing will make it down to the bacteria in the lower intestine which can overgrow (SIBO) and cause things like gas or inflame the intestine. So you're trying to kill off bad bacteria that has taken up residency by starving it.
We used a brand called Physicians' Elemental Diet. This was mainly because it does not contain dextrose like some other brands do, just another small optimization by removing another source of food for bacteria. A typical course is either 14 days or 21 days. We chose a 21 days course. I of course did it too for support because nobody wants to be the only one on a diet.
Experience
The experience was not quite what I was expecting. At first I thought that saety would be the biggest concern. This was not really the case at all. If you take the recommended amount of scoops it still manages to be ~2000 calories, it's not intended for a weight loss diet. What did become a problem was the sheer impalatability of the shakes. These were absolutely disgusting. I'm not sure if there was an advertised flavor but it smelled like chemical vanilla. It had a gross sweetness, likely from the glucose but you could still get a lot of the bitterness from the amino acids. As you powered through the shake the flavor would change, likely because some material are denser than others. At the bottom it turns sour like spoiled milk or buteric acid (that taste you hate in vomit). I frequently found myself gagging on the last part and just had to throw it away. In fact I wound up reducing the number of times I "ate" because it was so repulsive. It became a bit of a battle, am I hungry enough to drink more of this or just wait? This I think created an interesting adversarial dynamic that I can't say I've ever experienced about eating. This also made me a little nervous as taking less would mean I'd be more at risk for dietary deficiencies.
Also the shake coats the mouth, so you will be tasting it for a bit. These sugars also tends to cause thrush, a yeasty coating on the tongue. To counter act this we took half a teaspoon of baking soda in water and swished it around. I actually looked forward to this because it cleansed the pallate a bit. Also a thorough brushing of the teeth immediately after helped.
They tell you that constipation is common on the diet because of the lack of fiber. I did not find this to be the case, sure I went less, but I wasn't always eating a lot either. What they don't tell you is that the consistency is pretty much the same going out as it was in. If you feel something it's best to get to a toilet immediately because you will not be able to hold it very long. It also makes things smellier in general. My urine had some sort of chemical oder to it. You can suppliment with MCT oil but I quickly found I didn't process that very well, and by the 3rd week I gave up trying because I just felt bad afterwards.
Another thing is that because the shakes are a lot of simple sugars they spike the blood sugar. While I'm not diebetic or needed to specifically test it, the effects were pretty noticable. A few hours after "eating" I would crash and have less energy. This made it a bit hard to do work but it wasn't so bad I had to stop what I was doing.
After 3 weeks passed there was a short transition to solid food. The first day I made congee with soy/ginger salmon which after that was one of the best things I've ever tasted. The day after was chicken soup. By day 3 I think we were both having craving and ordered some food. Overall, that transition went really smoothly.
So did it work? I didn't notice anything in particular, but I also didn't have issues before. My partner at this point is optimistic. Inflamation seems better, flushing seems better, bathroom stuff is still unclear due to bile-acid malabsorption. Before she was one cholesymine but stopped because it wasn't approved for the diet. This may be a trigger, but at least right now we're optimistic that things are getting better.
Observations
One of the things that I was expecting was a desire to eat other foods. I think it got the worst after the half-way mark. At that point I was over the initial "excitement" of a new "project" and just trying to hold on. But realistically it wasn't the cravings that were the most painful. I absolutely wanted other foods that didn't taste awful but it's not like a specifically missed textures or anything. I just wanted something that didn't taste like those shakes. For fun I wrote all the things that I was craving down and what I seemed to gravitate toward were more savory things, probably because the sweetness of the shakes were getting to me. The one thing that really stuck in my mind was a Reuben sandwich. I'm not the type of person who eats many of these and it probably wouldn't make my top 20 foods but the idea of pastrami just sounded really good. In fact I started planning how to make one from scratch with homemade rye bread and pastrami.
Also because I could not physically comply with the scoop recommendations and because overeating was literally impossible I started losing weight. I tracked this just so I could have an idea of how much I was losing in case it because a problem. All in all I lost 15 pounds over 3 weeks.
Recommendations
I don't know if the other brands are much better but I wouldn't recommend the one I got based on taste. Unfortunately there's just no way to tell. I'm sure they are all pretty bad and that other brands will likely cause the same sorts of reactions. Overall, I'd recommend it for anyone suffering from GI issues. It was hard but the experience was positive if for no other reason than it allowed me to examine how food affects me but it did seem to have some impact on other hard-to-treat symptoms for my partner which I'm thankful for.
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