Cybermedlife - Therapeutic Actions Dietary Modification - Elemental Diet


Elemental diet moderates 5-fluorouracil-induced gastrointestinal mucositis through mucus barrier alteration.

Abstract Title: Elemental diet moderates 5-fluorouracil-induced gastrointestinal mucositis through mucus barrier alteration. Abstract Source: Cancer Chemother Pharmacol. 2015 Aug ;76(2):269-77. Epub 2015 Jun 6. PMID: 26048344 Abstract Author(s): Rei Kawashima, Fumitaka Kawakami, Tatsunori Maekawa, Hajime Yamamoto, Wasaburo Koizumi, Takafumi Ichikawa Article Affiliation: Rei Kawashima Abstract: PURPOSE: There are reports that elemental diet (ED) ameliorates oral mucositis caused by antineoplastic chemotherapy. Although this effectiveness may be partly due to high nutrient absorption, the effects of chemotherapy on mucosal defense mechanisms remain unclear. We investigated the effects of oral supplementation with ED on mucin in 5-fluorouracil (5-FU)-induced intestinal mucositis. METHODS: 5-FU was administered to rats orally once daily, and ED was supplied orally twice daily for 5 days. The severity of mucositis was assessed by length, dry tissue weight, and villus height of the intestinal tract. Using anti-mucin monoclonal antibody, we compared the immunoreactivity in the gastrointestinal (GI) tract and mucin content by histological and biochemical examinations. RESULTS: Oral supplementation with ED reduced histological damage and loss of length, dry tissue weight, and villus height induced by 5-FU administration. ED markedly altered PGM34 antibody immunoreactivity and mucin contents in the small intestine of rats with 5-FU-induced mucositis. CONCLUSIONS: ED may possibly be more effective for the prevention of antineoplastic chemotherapy-induced mucositis through the activation of GI mucus cells. Article Published Date : Jul 31, 2015

Change of intestinal microbiota with elemental diet and its impact on therapeutic effects in a murine model of chronic colitis.

Abstract Title: Change of intestinal microbiota with elemental diet and its impact on therapeutic effects in a murine model of chronic colitis. Abstract Source: Dig Dis Sci. 2009 Sep;54(9):1892-900. Epub 2008 Dec 5. PMID: 19058004 Abstract Author(s): Takayuki Kajiura, Tomoko Takeda, Shinji Sakata, Mitsuo Sakamoto, Masaki Hashimoto, Hideki Suzuki, Manabu Suzuki, Yoshimi Benno Article Affiliation: Gastroenterology Research, Pharmaceutical Research Laboratories, Ajinomoto Co, Inc, Kawasaki 210-8681, Japan. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Elemental diet (ED) has been used as an enteral nutritional therapy for Crohn's disease. However, the precise mechanisms of ED remain unclear. In interleukin-10 (IL-10)-deficient cell-transferred mice, we investigated the change of intestinal microbiota with ED using molecular terminal-restriction fragment length polymorphism (T-RFLP) analysis and culture method, and evaluated its influence on therapeutic effects of ED. ED significantly suppressed intestinal inflammation. The total amount of bacteria in colitis mice fed the regular diet was higher than in normal mice but decreased in colitis mice fed ED. T-RFLP profiles of the ED group markedly differed from those of the regular diet groups. The diversity of bacterial species in the ED group decreased to 60% of that found in the regular diet groups. Among the cultivated bacteria, the change in lactic acid bacteria composition was remarkable. Lactobacillus reuteri and L. johnsonii decreased and Enterococcus faecalis and E. durans increased in the ED group. The culture supernatant of L. reuteri isolates induced significant tumor necrosis factor-alpha (TNF-alpha) and IL-6 activity in RAW 264 cells, while the culture supernatant of E. faecalis and E. durans barely induced their activity. These data suggested that reduction in amount and diversity of intestinal microbiota and decrease of proinflammatory cytokines via a change in composition of lactic acid bacteria by ED seem to contribute to reduction of bowel inflammation in this model. Article Published Date : Sep 01, 2009

Is rheumatoid arthritis a disease that starts in the intestine? A pilot study comparing an elemental diet with oral prednisolone.

Abstract Title: Is rheumatoid arthritis a disease that starts in the intestine? A pilot study comparing an elemental diet with oral prednisolone. Abstract Source: Phytother Res. 2007 Sep;21(9):889-94. PMID: 17308218 Abstract Author(s): Thrasyvoulos Podas, Jeremy M D Nightingale, Roger Oldham, S Roy, Nicholas J Sheehan, John F Mayberry Abstract: OBJECTIVES: This pilot study aimed to determine if an elemental diet could be used to treat patients with active rheumatoid arthritis and to compare its effect to that of oral prednisolone. METHODS: Thirty patients with active rheumatoid arthritis were randomly allocated to 2 weeks of treatment with an elemental diet (n = 21) or oral prednisolone 15 mg/day (n = 9). Assessments of duration of early morning stiffness (EMS), pain on a 10 cm visual analog scale (VAS), the Ritchie articular index (RAI), swollen joint score, the Stanford Health Assessment Questionnaire, global patient and physician assessment, body weight, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and haemoglobin, were made at 0, 2, 4 and 6 weeks. RESULTS: All clinical parameters improved in both groups (p<0.05) except the swollen joint score in the elemental diet group. An improvement of greater than 20% in EMS, VAS and RAI occurred in 72% of the elemental diet group and 78% of the prednisolone group. ESR, CRP and haemoglobin improved in the steroid group only (p<0.05). CONCLUSIONS: An elemental diet for 2 weeks resulted in a clinical improvement in patients with active rheumatoid arthritis, and was as effective as a course of oral prednisolone 15 mg daily in improving subjective clinical parameters. This study supports the concept that rheumatoid arthritis may be a reaction to a food antigen(s) and that the disease process starts within the intestine. Article Published Date : Sep 01, 2007

Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents.

Abstract Title: Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents. Abstract Source: Neurosci Lett. 2006 Sep 25;405(3):172-4. Epub 2006 Jul 26. PMID: 12738455 Abstract Author(s): Jonathan E Markowitz, Jonathan M Spergel, Eduardo Ruchelli, Chris A Liacouras Abstract: OBJECTIVE: Eosinophilic esophagitis (EoE), a disorder characterized by eosinophilic infiltration of the esophageal mucosa, has been defined in large part through published case reports and series leading to ambiguity in both diagnostic and treatment options. Corticosteroids, cromolyn, and elemental diet have all been reported as successful treatments for EoE. In this study, we sought to accurately define a population of patients with EoE and then assess their response to elemental diet. METHODS: A series of patients with chronic symptoms of gastroesophageal reflux disease and an isolated esophageal eosinophilia on esophagogastroduodenoscopy (EGD) were identified. Therapy with a proton pump inhibitor was instituted for 3 months, followed by repeat EGD when symptoms persisted. A 24-h pH probe study was performed, and those with significantly abnormal studies were excluded. The remaining patients were diagnosed with EoE and placed on an elemental diet for 1 month, followed by a repeat EGD. RESULTS: Of 346 patients with chronic gastroesophageal reflux disease symptoms and eosinophils on esophageal biopsy, 51 (14.7%) were ultimately diagnosed with EoE. There was significant improvement in vomiting, abdominal pain, and dysphagia after the elemental diet. The median number of esophageal eosinophils per high-powered field (HPF) decreased from 33.7 before the diet to 1.0 after the diet (p<0.01). The average time to clinical improvement was 8.5 days. CONCLUSIONS: Elemental diet resulted in striking improvement in both symptoms and histologic evidence of disease in children and adolescents with EoE, as identified by strict diagnostic criteria. Article Published Date : Sep 25, 2006

Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis.

Abstract Title: Effect of six-food elimination diet on clinical and histologic outcomes in eosinophilic esophagitis. Abstract Source: Clin Gastroenterol Hepatol. 2006 Sep;4(9):1097-102. Epub 2006 Jul 21. PMID: 16860614 Abstract Author(s): Amir F Kagalwalla, Timothy A Sentongo, Sally Ritz, Therese Hess, Suzanne P Nelson, Karan M Emerick, Hector Melin-Aldana, B U K Li Article Affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND & AIMS: In children, eosinophilic esophagitis (EE) is predominantly, but not exclusively, a food-hypersensitivity disorder. A crystalline amino acid-based elemental diet (ELED) formula currently remains the most effective nutritional treatment in inducing clinical and histologic remission. However, compliance with an exclusive, poor-tasting liquid formulation is difficult. METHODS: This retrospective observational study assessed the short-term clinical and histologic responses of 2 cohorts of children with EE evaluated during 2 different time periods: one was treated with the standard 6-food elimination diet (SFED) and the other was treated with ELED. Of the 60 children who met the inclusion criteria and were compliant with the dietary protocol, 35 were treated with a diet excluding cow-milk protein, soy, wheat, egg, peanut, and seafood while allowing all other table foods and 25 were treated exclusively with ELED. Repeat esophageal biopsy specimens were obtained at least 6 weeks later. RESULTS: Twenty-six of 35 (74%) in the SFED group and 22 of 25 (88%) in the ELED group achieved significant improvement of esophageal inflammation ( CONCLUSIONS: SFED treatment was associated with clinical and histologic improvement in EE in an observational study. It offers advantages of better acceptance, cost, and compliance than ELED and should be considered as an option in the initial management of children with EE. Article Published Date : Sep 01, 2006
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Therapeutic Actions DIETARY MODIFICATION Elemental Diet

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Evaluation of an Amino Acid-Based Formula in Infants Not Responding to Extensively Hydrolyzed Protein Formula.

Related Articles Evaluation of an Amino Acid-Based Formula in Infants Not Responding to Extensively Hydrolyzed Protein Formula. J Pediatr Gastroenterol Nutr. 2016 Nov;63(5):531-533 Authors: Vanderhoof J, Moore N, de Boissieu D Abstract Nearly 2% to 3% of infants and children younger than 3 years have confirmed cow's milk protein allergy with multiple clinical presentations including atopic dermatitis (AD), diarrhea, and vomiting/spitting up. Although most infants with cow's milk protein allergy experience clinical improvement with the use of an extensively hydrolyzed (EH) formula, highly sensitive infants may require an amino acid-based formula. In this observational, prospective study, 30 infants (1-12 months of age) with a history of weight loss and persistent allergic manifestations while on an EH formula were provided an amino acid-based formula for 12 weeks. Mean weight gain (z score change) improved +0.43 ± 0.28 (mean ± standard deviation) after the 12-week feeding period. Improvement was observed for many allergic symptoms including significant decreases in AD severity (P = 0.02). These results indicate the new amino acid-based infant formula supported healthy weight gain and improvement in allergic manifestations in infants not responding to EH formulas. PMID: 27526059 [PubMed - indexed for MEDLINE]