Instructions for following an elemental diet

Why have I been prescribed an elemental diet?

You have been prescribed an elemental diet for the treatment of your Crohn’s Disease.

What is an elemental diet?

An elemental diet is an exclusive liquid diet. Following the diet involves drinking only ‘Elemental 028 Extra (E028E)’ supplement drinks. These contain nutrients including protein and carbohydrate that have undergone the digestion process. This means that your body does not have to work to break them down and can absorb them straight away.

E028E will provide you with all the nutrition you need when taken at the recommended quantities.

How many E028E supplements should I have?

E028E is packed in either 250ml ready made cartons or 100g powder sachets, which need to be made up with water (see later for instructions). You can have either cartons or sachets or a mix of the two.

Your dietitian has calculated your daily requirement of E028E as follows:

________ cartons or ________ sachets.

Please note that each sachet is equivalent to two cartons.

Can I eat or drink anything else?

You will not be able to eat or drink anything other than E028E and water unless your doctor or dietitian has told you otherwise.

Your dietitian has also recommended that you drink an extra ________ ml (equivalent to ­­­________ bottles or ________ glasses) of water per day/ drink to thirst as the E028E will provide sufficient fluids. You can have either bottled or tap water.

How should I begin to take EO28E?

You will need to build up the number of cartons/sachets you have gradually over three days. On day three you should be having the full number of drinks recommended (as stated above). You should not have any other food or drinks except for water as soon as you start an elemental diet.

Day one: ________ cartons or ________ sachets.

Day two: ________ cartons or ________ sachets.

Day three: ________ cartons or ________ sachets.

What is the best way to drink EO28E?

• People tend to prefer to drink EO28E chilled but it can be drunk at room temperature.
• The cartons can be frozen and taken as a ‘slush’.
• It is best to sip the drinks slowly, for example over 30 minutes and spread them out over the day. Have one, for example every one and a half to two hours. This will help stop you feeling hungry and help prevent possible diarrhoea, which may occur from drinking EO28E too quickly (see side-effects‑, below).
• If you find the drinks too concentrated you may dilute them with bottled or tap water.

How do I make up E028E drinks from the powder sachets?

• Empty the contents of one 100g sachet into the shaker.
• Add a small amount of bottled or tap water and mix it with the powder to form a paste.
• Fill the shaker up to the 500ml mark with bottled or tap water.
• Fix the lid to the top and shake it well.
• If you do not drink it straight away, it can be stored in the fridge for up to 24 hours, but try to make it up as close as possible to the time you want to drink it.

Where will I get E028E from?

Your dietitian will give you a sample pack of E028E supplements to see which flavours you prefer. You should try these and let your dietitian know your preferred flavours as soon as possible. Your dietitian will then arrange a prescription for an appropriate supply of E028E via your GP.

If you usually pay for your prescriptions you will need to pay one prescription charge for all the EO28E prescribed. If you have a mixture of sachets and cartons, you will need to pay two prescription charges (one for all of the cartons and one for all of the sachets).

Will I experience any side-effects‑ and how can I manage these?

There are no long term side-effects‑ from following an elemental diet.

You may experience some short term side-effects‑ while taking EO28E. See table below‑.

Please do not hesitate to contact your dietitian if you are experiencing any of these or any other side-effects‑ that you are concerned about.

How long will I need to follow an elemental diet for?

Your dietitian will recommend how long you should follow an elemental diet for.

You would usually need to follow an elemental diet for four weeks initially, after which your dietitian will discuss further plans with you.

Depending on how your symptoms are, your dietitian will recommend that you stop an elemental diet or continue it for a further period of time.

What do I do after an elemental diet?

If after following an elemental diet you have a significant improvement in your symptoms, it is recommended that you follow a LOFFLEX diet. Your dietitian will discuss this with you.

If there has been very little or no improvement in your symptoms after following an elemental diet, your dietitian, consultant gastroenterologist and specialist nurse will discuss alternative options for treating your Crohn’s disease with you.

If you have any queries you can contact your dietitian on 01223 216655.