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Elemental Diet Guide: Using a Liquid Reset

Written by Dr. Michael Ruscio, DC on May 29, 2025

Written by Dr. Michael Ruscio, DC on May 29, 2025 — Reviewed by Hilary Watts

• What’s an Elemental Diet?|
• Fully Elemental vs Semi-Elemental|
• Why Use One?|
• When?|
• How?|
• Elemental Diet FAQs|
• Reintroducing Food|

What Is an Elemental Diet?

Over 3,500 years ago, ancient healers in Egypt and Greece used tubes—even rectally—to feed the sick 1 2. But real progress in elemental diets didn’t begin until 1910 1. By the 1960s, researchers finally started studying their effects on health, turning ancient improvisation into modern science 3.

An elemental diet is a liquid-only diet designed to provide essential nutrients in a readily digestible form. It is gut-friendly, hypoallergenic, and serves as a complete meal replacement formula.

Formulated to give your digestive tract a rest, an elemental diet can help with a range of health problems. These include issues directly within the gut like gas, bloating, diarrhea, and abdominal pain—as well as more general health concerns, including fatigue, brain fog, and hormonal imbalances.

Elemental diets come in powder form that requires you to just add water. They can be used in different ways, from occasional meal replacements to fully replacing solid food for two weeks or longer.

Before you jump into cutting out solid food, let’s do a deep dive into the evidence for elemental diets so you can have realistic expectations. We’ll also share two steps you should take before going elemental.

Fully Elemental vs Semi-Elemental

Fully elemental and semi-elemental formulas both provide easily absorbable nutrients in a liquid formula, but there are some key differences between them. 

Fully elemental formulas are deconstructed into their most basic, absorbable components. For example, you’ll find individual amino acids like L-arginine and L-glutamine, and simple sugars like dextrose. They are sometimes given via a feeding tube.

Semi-elemental diets generally provide 4:

• Proteins that are partially broken down into peptides (short chains of amino acids)
• Carbs that are partially broken down into a mix of simple sugars and some longer-chain carbs like starches 
• Easily absorbed fats, usually medium-chain triglycerides (MCTs)

Modern semi-elemental diets, especially those with whey protein hydrolysate as the protein source, can taste pretty great too. And in many situations, they are just as effective as the fully elemental version. 

We use both full and semi-elemental diets in the clinic with great results. We’ve created three formulations so people can choose based on flavor and dietary preference: 

• Elemental Heal (Original) → Semi-Elemental
• Elemental Heal Low Carb → Semi-Elemental 
• Elemental Heal Whey-Free → Fully Elemental

Why Use an Elemental Diet?

The elemental diet is potentially helpful in easing the symptoms of: 

• Crohn’s disease (a type of inflammatory bowel disease)
• Eosinophilic esophagitis (a condition in which the esophagus becomes inflamed and does not contract properly)
• Eosinophilic gastroenteritis (similar to eosinophilic esophagitis, except that it affects the stomach and intestines)
• SIBO (small intestinal bacterial overgrowth)
• IBS (irritable bowel syndrome)

The table below summarizes how the elemental diet might help each of these health conditions, including how sure we are of potential benefits:

A common feature across the above conditions is dysbiosis—this is when the gut is inflamed and the microbiome is out of balance. In this scenario, an elemental diet may help by:

• Reducing inflammation 9 10
• Starving bacterial overgrowths 8
• Giving the digestive system a chance to rest, heal, and then repair 9 11

When Should You Introduce an Elemental Diet?

Before turning to an elemental diet, I generally recommend less restrictive dietary changes and probiotics first, then moving on to an elemental diet if needed. Here is the two-step process that we use in the clinic before trying an elemental diet. 

Step 1: Diet for Gut Healing 

The Mediterranean diet is a solid starting point for supporting gut health. It’s anti-inflammatory, rich in whole foods, and helps maintain stable blood sugar.

However, for those with significant food sensitivities, a more targeted elimination diet often leads to faster and more noticeable improvement in gastrointestinal symptoms.

A few approaches we commonly recommend are:

• The Paleo diet, which contains minimal or no grains and dairy
• A low-FODMAP diet, which restricts a range of carbs that can create excess gas
• A low-histamine diet, which restricts high-histamine foods that can cause a range of symptoms for some people  

I recommend working with a doctor or dietitian to find which elimination diet works best for you—and to help you reintroduce foods once your symptoms have died down.

Step 2: Probiotics to Boost Microbiome Health

Any dietary regimen aimed at improving gut health will usually work better if supplemented with probiotics.

Research shows that probiotics can improve leaky gut, reduce inflammation, and correct dysbiosis (imbalances in the gut microbiome) 12. 

Here is the combined, triple-species probiotic approach that we find achieves the best results:

• Lactobacillus/Bifidobacterium species: 1–50 billion CFU daily for 2–3 months
• Bacillus species: 2–6 billion CFU daily for 2–3 months
• Saccharomyces boulardii: 10–15 billion CFU daily for 2–3 months

How to Use the Elemental Diet

If diet changes and probiotics haven’t moved the needle enough, then the elemental diet can be a great next step. I typically don’t suggest an elemental diet unless other treatments have failed to relieve gut symptoms after three months or so. 

That said, there’s no harm in using an elemental diet earlier if you want, as we know that it’s a generally safe treatment 13. You can also use an elemental diet now and again to soothe a gut symptom flare, or as a convenient way to get nutrition on the run.

There’s flexibility in how you use a liquid elemental diet, but in our clinic, we’ve found three main approaches:

• Short-term reset: Replace all meals for 1–4 days to calm the gut.
• Intensive protocol: Use for 1–3 weeks to target bacterial or fungal overgrowths—please do this with clinical supervision.
• Meal replacement: Swap in one or two shakes daily during flares or busy periods.

Let’s talk about the differences between each of these options.

Elemental Diet as a Gut Reset

This method is ideal for calming digestive symptoms when other diet changes haven’t worked or after periods of poor eating. A brief reset can help reduce inflammation, ease symptoms like bloating or fatigue, and support a return to healthier habits.

For help navigating this approach, download my free Gut Reset Guide. 

Elemental Diet as a Remedy for Microbial Gut Overgrowths

This 1–3 week regimen is used to address issues like SIBO or Candida, where the goal is to starve microbial overgrowths by fully replacing meals. Because this method is more intensive, it should be done under clinical supervision to monitor for potential side effects or die-off reactions.

Elemental Diet as a Meal Replacement

Elemental shakes are great for busy days, travel, or symptom flares. Replacing one or two meals a day with an elemental shake can offer relief without you having to fully commit to a restrictive protocol. Even partial use—just 50% of daily calories—has shown benefits for some gut conditions 11.

Elemental Diet as a Gut-Friendly Ingredient 

After the initial elemental diet or gut reset, elemental powder also makes for an excellent addition to your daily smoothie, oatmeal, baked goods, and more. Check out my favorite elemental diet powder recipes here.

Elemental Diet FAQ

How much elemental formula should I drink per day?

Drink as much formula as your body needs to meet your daily energy needs and avoid unwanted weight loss. If you’re using Elemental Heal, try our dosing calculator to estimate how much to drink and how many bottles to purchase.

Can I prepare my shakes in advance?

Yes! Many people find it helpful to mix up their total daily formula in the morning and store it in the fridge. This makes it easier to stay on track throughout the day.

What if I have a dairy sensitivity?

No problem—opt for a whey-free elemental formula. There are also lower-carb options available if you’re watching your carbohydrate intake.

Do I have to drink my shakes as full meals?

Not at all. You can sip your elemental shakes throughout the day instead of consuming them as set meals.

How can I make the shakes taste better?

Elemental shakes taste best cold. Add ice cubes and blend them for a smoother, frothier texture.

Should I keep taking my medications and supplements?

Yes, continue taking any prescription medications as directed. Many supplements are optional and can be paused unless your healthcare provider advises otherwise.

Can I drink anything else while on the elemental diet?

Yes. You can drink water, tea, or black coffee. Caffeine is fine for most people, but avoid adding cream or sugar, and cut back if you’re caffeine-sensitive.

Food Reintroduction After Long-Term Elemental Dieting

If you’re doing a full elemental diet for more than a few days (especially the longer-term bacterial overgrowth protocol), it’s best to introduce solid food slowly.

Reintroducing foods carefully is easier on the immune and digestive systems and will help you identify whether certain foods may be contributing to your symptoms.

To help with food reintroduction, our clinic has adapted a protocol from a 2021 literature review that you might find helpful 14. It’s detailed in the infographic below.

This protocol starts with you reintroducing foods least likely to trigger sensitivities. Over several days, you’ll begin to identify what your body tolerates. From there, gradually add in foods with a higher likelihood of causing reactions, watching closely for symptoms, and removing any problematic items.

This gradual approach prevents an abrupt stop and helps you transition smoothly from the elemental diet, maximizing its benefits. Below is an example of how your solid food intake might increase over 1 to 3 weeks, with simple meal ideas to guide the process.

In week 4, you’d try the most common allergens, such as fish, dairy, peanuts, or wheat. Remember that one of the main points of doing this reintroduction slowly is so you can better identify any foods that may trigger your symptoms.

If you notice that a certain food is causing symptoms, I recommend working with a registered dietitian or functional practitioner to develop a gut-healing plan. 

Elemental Diets Have Lots of Potential

To recap, these liquid diets can be a powerful tool for addressing stubborn gut-related symptoms and offer a convenient, safe option during flares or busy periods. Whether used for a short reset, a longer protocol, or occasional meal replacement, it works best when built on a foundation of gut-friendly nutrition and probiotics.

If you and your doctor decide to use it long-term, be sure to follow a gradual food reintroduction plan to maximize benefits.

Is it time for you to implement an elemental diet? Shop our Elemental Heal.

For a deeper dive, check out my book Healthy Gut, Healthy You, or connect with us at the Ruscio Institute for personalized support.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.