Liquid diet or elemental diet?

I dunno if Writer Mum is still around, but she would be a good one to answer this.

I'm still on my predominantly liquid diet + low residue carbs such as bread and pasta. Spoke to the dietician on the phone today, however, who wants me to start on a full liquid diet ASAP. I assumed this meant an elemental diet, but she says I can do a Fortisip (ie non-elemental) diet if I want to. She said that recent studies showed that results from a liquid diet were about the same as from an elemental diet. Apparently the elemental drinks taste a lot worse than Fortisip.

I'm still not convinced. Elemental drinks get absorbed in the upper bowel, so wouldn't that be better for bowel rest and (hopeful) healing of the colon than drinks which go all the way through the system? Anyways, I have a bit of time in which to make up my mind, so if anybody has any useful on the subject please let me know!

PS: My consultant seemed to think the elemental diet was better. Got a copy of his letter to my GP today; it wasn't very cheery to be honest :-/

Hi NCOT,

I did some research just a while ago regarding a liquid diet vs. and elemental diet. I don't recall when all the studies were done, but I repeatedly read that elemental diets can promote remission, however the same effects didn't seem to be from the liquid diet. As you stated, the ingredients in the elemental diet drinks are specifically formulated to be easily absorbed in the small intestine and promote bowel rest. They also change your gut flora.

I don't know how your health is right now, but if you're in a pretty bad flare, I would go with the elemental. (That said, I've never tried them, so I don't know how they taste.) I've considered doing this if I get off steroids and get bad again. If you don't mind my asking, will your insurance cover the elemental diet shakes?

I'd go elemental. Apart from anything else, your new consultant sounds brill, and it's what he suggested, and I'd go with the fabulous person rather than the mediocre one .

Also, elemental is another thing you'll be able to cross off, so to speak, on the treatment plan. I doubt they're going to make any solid decisions about your future treatment until they know how you've responded to an elemental diet, so you may as well try it now, while you're so desperate for relief, and see if it helps.

Plus, doing the elemental diet while you're doing the double doses of Rem might kick both treatments along, and give you better results than you would otherwise.

Writing in the middle of a fibro flare and I'm making as many typos as I am real words, so I hope this makes sense .

Ivy.

ps. not sure the dietitian should be undermining the consultant. if she disagrees, she should take it up with him, not you.

Thanks folks :p

I think judging from your answers, I'm veering more towards the elemental diet. Besides which, I have been on a 90% Fortisip diet in the fairly recent past (I say 90%, 'cos I did have a couple of bowls a soup a day as well), and that didn't stop me from ending up in the hospital again this January. So going on a full Fortisip diet just feels like a waste of time, to be honest.

Okay, I've done it: I've twisted my own arm >_>. I'm gonna try the elemental diet for 6 weeks. The only way I won't is if the drinks taste so revolting I literally can't get them down without gagging. Even then, I might be able to use a tube or something to get them down...

@Octobergirl - I live in England (as has already been noted :p), so I get my treatment on the NHS. Luckily I have a good GP who has been happy to prescribe me all the Fortisips I've needed, so he should do the same with the elemental drinks. Feel a tad guilty, 'cos I know how much these drinks cost, but I'm not drinking them for the fun of it... :/

@Sera - My dietician said the elemental drinks had a metallic taste. (I notice that when coming to the end of a Fortisip sometimes.) It's not pleasant, but it's not unbearable. As for Modulen, I've heard of it. If it's non-elemental I presume it wouldn't be any better than the Fortisips. My dietician mentioned a drink called 028, I think it was...

@ivy - Yep, I agree about trying it now. To be honest, I know the elemental diet will be pretty grim and I would quite like to get it out of the way, particularly as once the six weeks is up that won't be the end of it: I'll have to reintroduce solid foods very very slowly, so I'll be drinking the drinks for a long time...

To be fair about the dietician, I'm not sure if she was aware of what the consultant had said until I had told her: cross-department communication is dire in NHS hospitals :-/

PS: I thought I had! But when I checked out the links for Enteral Nutrition, they weren't familiar; I'll read all those.

Thanks, that looks majorly useful! *bookmarks*. I'd even join, but it'd feel weird being a member of two Crohn's forums; I don't know why... <_<.

Don't worry, I always keep HW updated ;p

I can't bear to watch a group of people eating a delicious meal when I can't join in :/ Thusly being on a liquid diet makes me less, not more, sociable :/

That said, when I'm at home I find my present diet tolerable enough. But then again, as limited as it is, it's like Masterchef compared to what the elemental diet will be. For example, I always kickstart the day with a couple of cups of tea with milk. I really enjoy that and I will really miss it. And no matter how many times I try them, I just don't like herbal teas. In desperation I bought myself some green Chinese tea today, in hopes it will taste like the tea in Chinese restaurants... (The only tea I'll drink black.)

You've got me a bit worried about the taste of elemental drinks again. The Fortisips are fairly palatable, really, unless you get a rank flavour (pro-tip: avoid vanilla, which tastes like unsweetened custard with strongly artificial vanilla, and fruits of the forest, which tastes like cough medicine). Certainly the mocha flavour almost makes it to 'nice'. Oh well, as long as the 028 doesn't actually make me gag or retch, I'll just have to suck it up - probably quite literally, through a straw :p

Just one last question, which is probably a highly obvious one. I have heard of people putting milkshake mix or syrup into elemental drinks to make them taste nicer. I asked my dietician about that and she said it was a no-no. I'm sure she's right, but is there any chance she could be wrong? Increased palatability can't be a bad thing... :-/

ps. Also, the point is to get better. What's worse? Drinking liquids for six weeks, or dealing with horrible obstructions and painful d for months and months and months at a stretch?

I'm not saying it's not going to be difficult, but it's also helpful to keep it in perspective. It does help not to have to run to the loo so much.

Good luck with the elemental drinks NCoT. Ds' favourites are chocolate and fruits of the forest :) The ones that he is on come in about 13 flavours including mocha if I recall correctly as well as cola, tomato, strawberry, vanilla etc etc. He was initially given samples of all of them to find out the ones he liked. If you have a problem drinking the standard size they also do it in a more concentrated(less liquid) bottle. There is also a brand in the hospitals that come in a small tub(like a mousse/yogurt)
He was only allowed water to drink and rather strangely Foxes glacier mints(not the fruit ones though for some reason)

He actually quite likes the drinks although he will only drink them cold from the fridge. Think you should also drink them slowly because if you swig the whole lot in one go it can make you dizzy.

If you find the taste of them off putting maybe pinch your nose when taking them ;) as they say this inhibits the taste(somehow)

Post Edited (vixen) : 2/11/2012 2:54:12 AM (GMT-7)

Haven't started the elemental diet yet; waiting to speak to my GP on Tuesday, plus I'm still using stuff up - that's my excuse at any rate >_>. As a treat, my mum did roast chicken and mashed potatoes yesterday; I skipped lunch to give my intestines a few extra hours to clear themselves, a tactic which luckily paid off. Loved the meal - so nice, one of my favourites. On a quite different culinary note, I mixed rosewater syrup, saffron and cardamom into a 500g tub of Greek yoghurt, along with lots of icing sugar to sweeten - that was delicious, too.

@tinxabella - Thanks :p

@vixen - Do you remember what brand of elemental drink your son was drinking?? It seems better, due to the wide variety of flavours. As far as I can tell, 028 only seems to have 3 flavours and one of those, grapefruit, I'm not keen on :/

I've tried the pinching my nose tip for MoviPrep and let me just say it didn't work... <_<.

@killcolitis - I came across Absorb Plus a while ago. It looks like a good product, but way beyond my price range. Most likely I'll just have to stick with 028 or whatever else the NHS prescribes. However, I do feel grateful to get the drinks at all, as I've heard that insurance companies in the US won't prescribe them and there's no way I could afford any of these drinks - 028, Fortisip, Absorb Plus - out of my own pocket.

Thanks! *googles*. There's quite a few different types, including a massively high energy one at 500 calories per 100ml. At any rate, I'll mention it to my GP and ask if I can have a sample.

Fortisip is lactose-free as well, apparently.

I'm not sure :-/ I seem to be all right with with milk in small doses, such as in tea, but have more trouble when it comes to larger things, like custard, milkshakes, milk-based puddings, and even yoghurt. But then again, I have trouble digesting everything really, so it is almost impossible for me to tell.

Hopefully the reintroduction diet after the elementary diet will make it clearer...

Edit: I feel so grotty a lot of the time (including now) that I am almost looking forward to starting this diet if it makes me feel better. I say 'almost', 'cos I would probably murder for real food once I am on it <_<. Bit worried about feeling hungry, even though that was not a problem with the Fortisips.

Post Edited (NiceCupOfTea) : 2/12/2012 5:22:23 PM (GMT-7)