Elemental Nutrition contains everything that it is not supposed to.

[kiny]

Researchers know very little about diets and crohn's disease.

We know Elemental Nutrition is helpful for crohn's disease.

But not only do we not fully understand why, Elemental Nutrition contains everything that is supposed to worsen the disease, yet it does the opposite.


Here are just two examples where theory and practice collide, but there are plenty more.

-Maltodextrin (glucose syrup) has been linked to expansion of several pathogenic intestinal bacteria. Yet Elemental Nutrition is around 60% to 70% maltodextrin (glucose syrup).

-Emulsifiers are supposed to worsen crohn's disease. Emulsifiers help bacteria translocate accross the mucus barrier. Elemental Nutrition contains plenty of emulsifiers.

 

[Pangolin]

This is the main reason I don't trust most dietary generalizations in relation to Crohn's. No theory properly reconciles this yet. For example, the theory behind the SCD has to do with eliminating certain carbohydrates (including sugar), yet EN is packed full of sugar. Clearly to the extent the SCD works, it's not because it's fundamentally correct about sugars. Pretty much the only generalizations I trust are:

Something about common Western diets contributes to Crohn's
More fruit seems to be helpful

I do listen to specifics like "food x really helped me", though. In my experience, I have not noticed any trouble from sugars. However, fried foods, wheat, and possibly meat are all suspect but not definitively ruled out.

 

[lukesjr]

maybe the connection could just be the fact that SCD and elemental give the gut a certain type of "rest". People have had success with intermittent fasting also as well as elimination diets.

 

[Pilgrim]

This is frustrating. It has always bothered me. My daughter's first round of nothing but EN (exclusive) and water was at age 4 for 6 weeks. She did this twice.
Being a label reader, it seemed ridiculous to feed her with this.
It did calm her inflammation, though.
Now she has duodenal activity and we are supposed to supplement with 3 per day.

 

[Jo-mom]

I'm a label reader too and I've always wondered why these drinks are considered so good when the ingredients are so terrible. At least it's only temporary and she will eat all the great foods that you provide her.

 

[my little penguin]

Een can be polymeric semi elemental and elemental
They all work
As far as ingredients there are
Organic polymeric and semi elemental formulas
Minus the “bad “ stuff
One example is
Kate farms

https://www.katefarms.com/
https://www.nestlehealthscience.us/brands/compleat-organic-blends

 

[kiny]

They all work

Right. Konstantinos Gerasimidis has written about this. 61 different elemental formulas were indexed, all 61 of them were used with success to treat crohn's disease.

All 61 contained copious amounts of maltodextrin, in quantities far higher than a normal diet would contain.

 

[kiny]

maybe elemental give the gut a certain type of "rest".
People have had success with intermittent fasting also as well as elimination diets

Rutgeerts showed that diverting fecal content heals the bowel. Bringing fecal matter into contact with the bowel results in disease, even in previously unaffected portions of the intestine.

Harper elaborated on that. By filtering fecal content through a 22-nm ultrafiltrate, he showed that the fecal matter resulting in inflammation was larger than 0.22 micron. Fecal matter that first went through the ultrafiltrate results in no inflammation, yet unfiltered fecal matter resulted in the exact same type of inflammation Rutgeerts was able to show.

There are many dietary particles in regular diets larger than 0.22 micron, particles that wouldn't be present in EN.

Of course, there are other things in fecal matter larger than 0.22 micron than just large dietary particles, bacteria are larger than 0.22 micron, fungi are much larger still.

 

[kiny]

It is hard to distinguish offending agents in crohn's disease, because macrophages don't distinguish, they take up large dietary particles, bacteria and fungi.

The straightforwardness of finding the offending agent in a tuberculosis granuloma has become a decades long quest in crohn's disease.

Thankfully we have moved beyond the autoimmune lunacy, we know macrophages are being triggered by a foreign antigen, not by a self-antigen.