Physician's Elemental Diet Dextrose Free (36 Servings)

RRP £129.88
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Physicians’ Elemental Diet Dextrose Free is an elemental powder medical food formulated to provide dietary management for patients who have limited or impaired capacity to digest, absorb, or metabolize ordinary foods or certain nutrients. Physicians’ Elemental Diet Dextrose Free is a strictly hypoallergenic formula with a well-tolerated flavor and is formulated to provide the same dietary management as Physicians’ Elemental Diet original, but without the dextrose as a carbohydrate source.

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Elemental Diet for Patients with Moderate to Severe Gastrointestinal/Digestive Impairment

Physicians’ Elemental Diet Dextrose Free is intended for use under medical supervision for the dietary management of patients with GI dysfunction.

The elemental diet is designed for the dietary management of:

  • Irritable bowel and Crohn’s disease,1-6
  • Small intestinal bacterial overgrowth (SIBO),7-9
  • Moderate to severe impaired gastrointestinal function.3, 10-12

Physicians’ Elemental Diet Dextrose Free contains a balanced blend of macronutrients fortified with essential vitamins, minerals, and electrolytes to assure comprehensive support as a sole source of nutritional intake for limited periods. It has been:

  • Specifically formulated to contain free amino acids, partially hydrolyzed carbohydrate, and medium chain triglycerides to aid in their absorption from the GI lumen.
  • Designed to maintain nutritional sustenance as a sole source of nutrition for up to four weeks.
  • Produced as a strictly hypoallergenic formula, free from yeast, wheat, gluten, dairy products, fructose, sucrose, lactose, disaccharides, sorbitol, mannitol, xylitol, artificial colors, flavors or preservatives.
  • Formulated with a well-tolerated flavor for improved patient adherence

Dosing by Caloric Need

Physicians’ Elemental Diet Dextrose Free should be used for 2-4 weeks. It was designed to maintain nutritional sustenance as a sole source of nutrition, and can be used as a half-elemental diet making dosing dependent upon the caloric needs of each patient. One scoop of Physicians’ Elemental Diet Dextrose Free = 35 grams, and 150 calories. Each 1,260g bag contains 36 scoops (5,400 calories). 


By Scoop

1 Scoop 35g 150 Calories


By Unit

1260g bag 36 scoops 5400 Calories


 References

1. Gorard, DA, Hunt, JB, Payne-James, JJ, et al. 1993. Gut. 34:1198-202.
2. O'Morain, C, Segal, AW, Levi, AJ. 1984. Br Med J (Clin Res Ed). 288:1859-62.
3. Ueno, F, Matsui, T, Matsumoto, T, et al. 2013. J Gastroenterol. 48:31–72.
4. Verma, S, Kirkwood, B, Brown, S, Giaffer, MH 2000. Dig Liver Dis. 32:769-74.
5. Yamamoto, T, et al. 2005. Inflamm Bowel Dis. 11:580-8.
6. Zoli, G, Carè, M, Parazza, M, et al. 1997. Aliment Pharmacol Ther. 11:735-40.
7. Van Citters, GW, Lin, HC. 2005. Curr Gastroenterol Rep. 7:317- 20.
8. Bures, J, et al. 2010. World J Gastroenterol. 16:2978-90.
9. Pimentel, M, et al. 2004. Dig Dis Sci. 49:73-7.
10. Eiden, KA. 2003. Pract. Gastroenterol. 2003, 33-43, 47-54
11. Fisher, RL 1999. J. Nutr. 129:252S–5S..
12. Devlin, J, David, TJ, Stanton, RH. 1991. Arch Dis Child. 66:93-9
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It's free from...
  • Dairy
  • Eggs
  • Fish
  • Gluten
  • Nuts
  • Shellfish
  • Soy
  • Yeast

Ingredients

Serving Size:35 g

Servings Per Container:36

Amount per Serving:
Calories 150
Calories from Fat 30
Total Fat 3.0 g
Saturated Fat 1.5 g
Total Carbohydrate 23 g
Sugars <1 g
Sodium 90 mg
Potassium 150 mg
Protein **
Vitamin A (Beta Carotene) 833 IU
Vitamin C 20 mg
Calcium 85 mg
Iron 1.5 mg
Vitamin D3 66 IU
Vitamin E 10 IU
Vitamin K 10 mcg
Thiamin 0.5 mg
Riboflavin (Riboflavin-5’-phosphate) 0.56 mg
Niacin 3.3 mg
Vitamin B6 (Pyridoxal-5’-phosphate) 667 mcg
Folate (as Quatrefolic® (6S)-5-methyltetrahydrofolate glucosamine salt) 33 mcg
Vitamin B12 (Methylcobalamin) 0.5 mcg
Biotin 50 mcg
Pantothenic Acid 3.3 mg
Phosphorus 82.8 mg
Iodine 16.5 mcg
Magnesium 33.5 mg
Zinc 2 mg
Selenium 18 mcg
Copper 167 mcg
Manganese 332 mcg
Molybdenum 8.25 mcg
Chloride 164.6 mg
Choline 33.35 mg
Ingredients: tapioca maltodextrin, medium chain triglycerides, l-glutamine, l-proline, natural flavour, l-aspartic acid, l-serine, l-arginine hydrochloride, l-alanine, potassium citrate, l-leucine, l-lysine hydrochloride, disodium phosphate, l-valine, l-glycine, l-isoleucine, l-threonine, tricalcium phosphate, l-tyrosine, dimagnesium malate, dicalcium malate, l-phenylalanine, cholinebitartrate, l-methionine, l-histidine, l-cysteine hydrochloride, potassium malate, magnesium citrate, l-tryptophan, l-carnitine l-tartrate, sodium ascorbate, d-alpha tocopheryl acetate, iron gluconate, l-taurine, zinc sulfate, calcium d-pantothenate, beta carotene, niacinamide, sodium chloride, sodium selenite, manganese citrate, phytonadione, pyridoxyl-5’-phosphate, cholecalciferol, riboflavin-5’-phosphate, thiamine hydrochloride, copper sulfate, Quatrefolic® ((6S)-5-methyltetrahydrofolate glucosamine salt), d-biotin, sodium molybdate, potassium iodide, methylcobalamin.

Important information

Background

Elemental diets have been in use since the 1940’s predominantly in hospital settings. More recently, interest in elemental diets has increased for use in various conditions of gastrointestinal/digestive impairment (GDI) under medical supervision in outpatient settings. Physicians’ Elemental Diet and Physicians’ Elemental Diet Dextrose Free were created to meet the needs of patients as well as the unique requirements of integrative medicine specialists. Over the course of five years, thought leaders in the naturopathic and integrative medicine community along with product formulation experts provided guidance throughout development at each and every step to ensure these needs were met.

According to these expert opinions, the ideal elemental diet formula would be strictly hypoallergenic, contain no intact protein, corn or soy derived micronutrients or macronutrients. The formula must be palatable for patient compliance but contain no artificial flavourings. Finally, it must be cost-effective. Modified cornstarch and maltodextrin derived from corn are two commonly used ingredients in elemental diets. Both Physicians’ Elemental Diet formulas instead contain tapioca maltodextrin and no modified cornstarch.

Physicians’ Elemental Diet Original contains both maltodextrin and dextrose, while Physicians’ Elemental Diet Dextrose Free contains only tapioca maltodextrin. Both formulas deliver medium-chain triglyceride (MCT) oil in powdered formulation without preservatives like potassium sorbate, BHA (butylated hydroxyanisole), or BHT (butylated hydroxytoluene). Physicians’ Elemental Diet formulas are strictly hypoallergenic medical foods and further contain neither soybean oil nor soy lecithin. Also, the formulas do not contain yeast, wheat, gluten, dairy products, fructose, sucrose, lactose, disaccharides, sorbitol, mannitol, xylitol, artificial colors, flavors or preservatives.

Physicians’ Elemental Diet formulas contain all essential and non-essential amino acids and includs enhanced levels of glutamine. Rather than containing intact proteins or peptides, only free form amino acids are used, the key building blocks of protein. Additionally, Physicians’ Elemental Diet and Physicians’ Elemental Diet Dextrose Free meet or exceed 100% RDI for 24 micronutrients including active forms of B-vitamins. This balanced approach is crucial as a patient’s sole source of nutritional intake, as needed, for up to four weeks.

Typical use is 2-3 weeks in duration. 

How They Work Physicians’

Elemental Diet formulas are elemental diet medical foods designed for integrative medicine physicians and are intended for adult patients diagnosed with gastrointestinal/digestive impairment (GDI), that are under medical supervision and have distinct nutritional requirements. Elemental diets can be used in a variety of clinical applications. Elemental diets are used as part of dietary management for SIBO (small intestinal bacterial overgrowth). Physicians’ Elemental Diet formulas are intended to provide dietary management for patients with an abnormal hydrogen or methane breath test using either glucose or lactulose challenge material. Lactulose is the only sugar not digested by the body, meaning that it is able to travel all the way through the small intestine. Glucose, on the other hand, is completely absorbed by the body, typically within the first one or two feet of the GI tract. The lactulose breath test thus allows detection of abnormally increased numbers of bacteria located in the distal small intestine. Patients consume lactulose or glucose syrup and samples of their breath are collected over a 3 hour period. The lactulose is taken up by bacteria in the small intestine which digest and ferment it, producing different types of gases such as carbon dioxide, hydrogen, and methane. Similarly, when dietary intake includes fermentable carbohydrates such as lactulose and poorly digested oligosaccharides, it feeds bacteria present in the small intestine producing gases that can be measured in the breath.

Elemental diets like Physicians’ Elemental Diet and Physicians’ Elemental Diet Dextrose Free do not contain such fermentable carbohydrates and provide well-tolerated nutrition for the patient. Elemental Diet and Clinical Research Pimentel and his team at Cedars-Sinai Medical Center provided patients with gastrointestinal symptoms and an abnormal lactulose breath test with an elemental diet formula (Vivonex® Plus† ) as a sole source of nutrition based on individualized caloric needs for two weeks, at which point the subjects were retested. Those subjects who still had abnormal tests were provided an additional week of the elemental diet. Of the 93 patients assessed, 85% normalized the breath test and this correlated with symptom improvement.9 This same group previously found in a double-blind randomized controlled clinical trial that normalizing lactulose breath tests improved symptom status in patients with irritable bowel.13 Much of the clinical research on elemental diets was performed on the elemental diet product Vivonex® Plus. Vivonex® Plus differs from both Physicians’ Elemental Diet formulas in macronutrient ratios. All formulas are considered elemental diet products. † Vivonex® is a registered trademark of Société des Produits Nestlé S.A., Vevey, Switzerland.

Another group provided an elemental diet as a sole source of nutrition to 28 consecutive patients with active Crohn’s disease. Mucosal biopsies were obtained from the distal small intestine and colon and compared against a control group. Seventy-one percent of patients were reclassified in regards to disease status after four weeks.5 A half elemental diet was found to be a promising dietary management approach to Crohn’s disease. A half elemental diet is one in which half of the patient’s caloric needs are met with an elemental diet formula and the remaining are met with tolerated foods. In one clinical trial patients were recommended a half elemental diet for, on average, 11.9 months and found to be better managed than those who ate typical foods.14 The duration for typical dietary management using an elemental diet formula is 2 weeks for most patients and 3-4 weeks for some potentially more complex cases. Some patients with less severe gastrointestinal/digestive impairment may report benefit with shorter duration than 2 weeks. An elemental diet can be used as an initial dietary management tool or used periodically15 or when the physician deems the patient may benefit from easily digestible sources of nutrients. A half-elemental diet for longer periods of time, up to a year in some cases, may be prudent.

Conclusion Physicians’ Elemental Diet formulas are intended for adult patients who have been instructed how to use the products properly. It is formulated to provide dietary management for patients with gastrointestinal/digestive impairment who require easy assimilated nutrition through the delivery of free amino acids and partially-digested carbohydrate.

Dosage information

The duration for typical dietary management using an elemental diet formula is 2 weeks for most patients and 3-4 weeks for some potentially more complex cases. Some patients with less severe gastrointestinal/digestive impairment may report benefit with shorter duration than 2 weeks. An elemental diet can be used as an initial dietary management tool or used periodically15 or when the physician deems the patient may benefit from easily digestible sources of nutrients. A half-elemental diet for longer periods of time, up to a year in some cases, may be prudent.