elemental diet - to my understanding, - basically pre-digested, ready for absorption, with zero fibre....
The difference between elemental and semi-elimental is that some of the pepides are not already broken into individual amino acids [1]
The way the diet works is by removing anything that the microbiome (gut-bugs) might react to and, probably more importantly, by removing any food for the microbiome. [2]
This leads to a huge reduction in bacterial activity and things settle down.
There are varying recommendations about what foods should be reintroduced and in what order, and what foods should be avoided.
I would personally recommend that only "real" foods should be eaten, no processed foods, no gluten, and no seed oils.
I think Paul Janminet from the "perfect health diet" had a very useful blog posts on bowel disease in general, and very much in line with functional medicine recommendations, -remove toxins and eat nutrition [3]
[1] "Elemental formulas contain individual amino acids, glucose polymers, and are low fat with only about 2% to 3% of calories derived from long chain triglycerides (LCT) (3).
Semi-elemental formulas contain peptides of varying chain length, simple sugars, glucose polymers or starch and fat, primarily as medium chain triglycerides (MCT) (3)"
http://blog.listentoyourgut.com/elemental-vs-semi-elemental-vs-polymeric-diets/
[2] Elemental diet and the nutritional treatment of Crohn’s disease.
"Although in health we live in peace with our microflora, the colonic microflora is abnormal in Crohn’s disease. This may lead to production of toxic chemicals such as alcohols, aldehydes and the ethyl esters of fatty acids. It is believed that this is the reason for the loss of normal immune tolerance to the gut flora in Crohn’s disease, which results in the coating of faecal bacteria by immunoglobulin. Elemental diet has been shown to reduce the production of bacterial metabolites within 2 weeks and significantly to reduce bacterial coating with immunoglobulin."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285926/
[3]
Bowel Disorders, Part I: About Gut Disease
“In our view, various dietary and nutritional tactics are critical, with toxin elimination and vitamin D normalization among the most important steps. Most medical treatments are likely to be ineffective if the diet is bad.”
http://perfecthealthdiet.com/2010/07/ulcerative-colitis-a-devastating-gut-disease/
Bowel Disease, Part II: Healing the Gut By Eliminating Food Toxins
“
Summary of Toxic Foods to Eliminate or Avoid
"In short, bowel disease patients should eliminate toxic foods from their diet:.”
replace with....
" -Healthful plant foods are the safe starches, such as white rice, taro, sweet potatoes and yams, and fruits and berries.
-Saturated-fat rich oils and fats, like beef tallow, clarified butter, coconut oil, palm oil, cocoa butter (yes, chocolate desserts are healthy!), along with modest quantities of olive oil and lard. Make homemade salad dressings with these oils, rather than buying supermarket dressings made with soybean or canola oil.
-Further balance the omega-6 to omega-3 ratio by eating low-omega-6 meats, such as the red meats (beef and lamb) and seafood, and eating 1 lb per week salmon or sardines for fresh omega-3 fats."
http://perfecthealthdiet.com/2010/0...i-healing-the-gut-by-eliminating-food-toxins/
Bowel Disease, Part III: Healing Through Nutrition
Summary
Although not a complete list of the vitamins and minerals which may be helpful to bowel disease patients, these are among the most important – and most often overlooked:”
http://perfecthealthdiet.com/2010/0...iii-healing-through-nutrition/.ugh-nutrition/
Bowel Disease, Part IV: Restoring Healthful Gut Flora
“Conclusion
Fecal transplants are the best probiotic. Tactics to disrupt pathogenic biofilms can assist probiotics in bringing about re-colonization of the digestive tract by commensal bacteria.
http://perfecthealthdiet.com/2010/07/bowel-disease-part-iv-restoring-healthful-gut-flora/[/QUOTE]