# Vivonex PLUS Log



## 14751 (Feb 18, 2006)

So I finally got my two cases of Vivonex PLUS (36 boxes to a case, 72 packets total, 6 packets a day, so it should last around 12-14 days if I can eek by with only 5 packs a day.)Walgreens gave me a helluva of a time when I was trying to buy the stuff. It was $229.99 a case, no shipping charges and no taxes. Total was $459.98. Yeah, I know thats a lot of money, but I would pay ten times that much if I thought it had a good chance of eradicating this condition, so its worth a try.Some notes about Vivonex PLUS:The packet says to mix 250 ml of warm water with the packet and shake. Each packet is 300 calories, so I would need to consume 6 a day for three full meals (1800 calories/day). I am hoping I can get by on 5 packets, so that I can continue for two full weeks.You can make preparations in advance (you dont need a blender) and store for 48 hours in the fridge.I havent tried it yet (I am going out of town tomorrow and will start on Monday), but the taste is supposed to be vile. They sell flavor packs to make it taste better, but the flavor packs are loaded with aspartame, which can cause a yeast overgrowth. I don't want to risk it, so I will go without. I think I'll be able to handle it. When you're on Vivonex, you don't produce any stool (all the contents are absorbed and there is almost no residue--stool--so there should be nothing for the bacteria to ferment in the latter part of the small intestine and the colon). I was diagnosed with having mild inflammation of the small bowel, which I believe may be impairing my ability to digest solid foods. This, in turns, leaves undigested/unabsorbed glucose/fats/proteins for bacteria to consume and grow. Hopefully, the cause of the inflammation is the bacteria overgrowth and not the other way around, and the diet will help eliminate the bacteria and reduce the inflammation.Also, my primary symptom (of complaint) is the excessive gas/bloating that I get whenever I eat anything. Hopefully, the liquid diet will be absorbed early in the SI with no residue for bacterial in the distal small bowel to feed on.I read on another board of someone else who had tried an elemental diet for diarrhea but to no effect. He had tried a different, cheaper, elemental diet though. There is another type of elemental diet, called Vivonex TEN, but if you read the ingredient composition, you'll find that unlike PLUS, the TEN variety has a much higher composition of carbs. PLUS is high in free amino acids and low in fats and lower in carbs, which are the primary food for bacteria. Its why I opted for PLUS (even though the cost per packet is about half for TEN). Also, Pimetel used PLUS in his study, and if you're going to go through with it, you may as well follow it correctly.The only other experience I read about, of someone using Vivonex PLUS specifically for bacterial overgrowth, was from a woman who claimed that she had subsequent yeast overgrowth. Once the bacteria die off, there can be a void filled by yeast. To compensate, I will use probiotics while on the diet.All that said, my expectations are:1) To reduce (or normalize) the bacterial population in the small bowel. If this does not happen (I wont be getting another breath test so I will have to evaluate qualitatively--ie, if I feel 'better', I can presume that the bacterial levels are lower) it will implicate a recurrent source for the presence of the bacteria--the bacteria are entering the small bowel from another region, perhaps the bladder.2) As a byproduct of the reduced bacterial levels, to experience far less bloating, gas, abdominal pain, constipation (well, you could say I will be constipated for two weeks, but not because I cannot evacuate formed stool in my bowel), diarrhea.3) To be able to eat normal foods at the end of the two weeks without experiencing the aforementioned discomforts.I plan to give the protocol a full week before I evaluate. If I am doing better with my symptoms, I will continue with the second box. I may even buy a third box online to finish three weeks (as a precaution since Pimentel's study often had participants continue for a third week to ensure normalization). If I find myself with no improvement whatsoever (still with the same level of bloating/gas at the end fo the first week), I'll return the unused second case to a Walgreens store, which can accept returns for online purchases.I'll try to update this thread as the week(s) progress. If anyone has any suggestions or questions about it, feel free to ask.Wish me luck!


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## 14751 (Feb 18, 2006)

My first report:A little anxious to try it out and see just how bad it really tastes, I tested one. I opened the paper packet and right away the stench of the thing got me. The powder is milk-white and smells very much like dried vomit. It is a very strong, foreboding smell.The liquid is milky with a chalky consistency and tastes like the worst kind of natural organic wheatgrass concentrate you can imagine. It was only 300 ml but I almost threw it up on four occasions before forced it down. I really think the taste and the ominous, terrible feeling surrounding meal time will be the hardest part of this ordeal.Now for the important part:2:30 amI normally experience belching almost immediately following a meal (often during a meal). This is followed by a large volume of flatus (intestinal gas passed anally). I definitely experienced the belching while drinking the mixture, which did not help with keeping it down. So far (20 minutes removed), I experience no flatus. I plan on being up until 6 am, so if I do experience it, I will post back. Usually, when I wake up in the morning, I feel a very large abdominal distension, which is gas that needs to be forcefully passed (voluntarily) by me. If I don't feel that way when I wake, it will be a good sign.What concerns me now is the belching, which means that there are bacteria in the early part of the small bowel that are feeding on the Vivonex. Of course, if my only symptom was belching, I would be the happiest belcher on the planet, but I hope the bacteria in the latter SI don't starve, only to be replaced by the bacteria in the early small bowel (duodenum).4:15 amMy worst fears seem confirmed. I am now experiencing the same flatus that I normally get after eating. It could be due to a previous meal, but it is almost surely because of the vivonex. This indicates that the bacteria are far enough up the small bowel to metabolize the vivonex, which would mean it may not work. <<sigh>>


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## 17176 (Mar 31, 2005)

Hello and welcome


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## 14751 (Feb 18, 2006)

I guess I am keeping this log for my own amusement, but I'll update nonetheless, so that at least I have a record of how this therapy is working.I had a really bad day today, not in terms of my symptoms, which were lowered across the board, so that was good. The problem is the horrid taste of the packets, which I am trying unflavored. I am trying to avoid them as much as possible, and since Saturday when I tried my first one, I have been taking less than 1200 calories a day, so I have constant headaches.Tomorrow I have a major exam and cannot risk getting a bad grade, so I broke down today and ordered a large pizza and a coke. The good news is, I do not have a very large volume of gas immediately after eating it. Normally, I would bloat up like a baloon. But now, although the gas is there, it is much less. I am going to have to give in and try it with the flavor packs. Even though they have tons of aspartame, I will wait until the flavor packs arrive and try again then.So far, I am hopeful. I was on vivonex only for approximately 42 hours, and during that time, I would say my symptoms were about 70% better--which is better than any antibiotic or other remedy I have ever tried. I cant wait for the flavor packs to arrive so I can give it another shot.


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## gilly (Feb 5, 2001)

I hope you can stick at it,may as well,you've spent the money and its not really for that long!!Imagine if it works!Dont worry that you ate the pizza,but if you really have to break it again try proteins or some foods that Pimentels book recommends.Will be very interested to see how you go.Have you tried antibiotics?(should look up past posts,but lazy!)Good luck Gilly


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## 14751 (Feb 18, 2006)

I ordered the flavor packets yesterday, so they will probably arrive by Thursday or Friday. I will give it another go then. I suspect, with my level of bacterial overgrowth, that I will need at least three weeks of Vivonex, or maybe four. If I think its going well, I will order another two weeks worth, as insurance (I would hate to remove 90% of the overgrowth, only to start eating again and find that the other 10% have recolonized). In my case, I experience a lot of belching after meals, which probably means bacteria have colonized as far up as the early jejunum, and even possibly the duodenum. This means even with Vivonex, I wont be able to eradicate those bacteria. But vivonex is a start, and hopefully removing the distal bacteria will eradicate the bloating/gas/constipation. The belching I can live with, for now.


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## 14751 (Feb 18, 2006)

No-news update:UPS sucks! They were supposed to deliver the flavor packets but the driver never got here. To compound matters, they wont be delivering it until Monday. I had only bought enough food to get me through today, so I now have to scramble to get some more groceries--not an easy task when you live in an urban area miles from a grocery store and with no car.Anyway, I have had the worst constipation of my experience. I havent had a bowel movement in 3 days, which is far longer than anytime in the past. Heres what I have noticed:I began Vivonex on Friday, but continued to have small bowel movements throughout the weekend.After stopping Vivonex on Sunday and beginning to eat regular foods, I did not have a bowel movement on Monday. Then, 48 hours after beginning to eat whole foods, on Tuesday, I have severe, watery diarrhea--very uncommon for me.Since then, I have been constipated. No bowel movements--also very uncommon.Normally, I have bowel movements every day, although most of the time it will be small amounts and small, hard, and pebble-like.I think this probably indicates that it takes a very long time for food to move through my small intestine, allowing a build up of bacteria due to stasis. So that there is an excessive delay between when I consume food, and when it arrives at the colon. My bowel movements are probably stool formed from meals eaten more than 30 hours earlier. For reference, normally, food takes 8 hours to travel from one end to the other. I would never have thought of this had it not been for my cycle on and off Vivonex, because I never went days without a bowel movement like most people with C. I feel like I am making progress since:1) I have a very strong indication that bacterial overgrowth is causing the majority (if not all) of my symptoms.2) I understand why I could possible have developed the bacterial overgrowth in the first place.What I'm curious about now, is to find out what is causing the new constipation.


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## 14751 (Feb 18, 2006)

So the flavor packets finally arrived yesterday evening. Today, I tried it for the first time with the packets and the taste was a lot better. However, it still barely passes are palatable. I still fee a little nauseous and the headaches are back. Also, I experience quite a bit of belching. More so than on regular foods. I guess thats because the available nutrients for the upper small bowel are so readily digestible.I still think its going to be a challenge to stay on it for two or more weeks though. The taste is still on the nasty side. The flavor packets (I chose orange-pineapple) make it slightly better but its still horrible. On the upside, I experienced virtually NO bloating today (after 3 packets so far)! That is remarkable considering I normally blow up after any meals. The only side effects that are more than normal, are the heacahes and the belching.


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