Keto Poop Problems: What's Normal And What's Not?

The ketogenic diet is a popular, low-carbohydrate method of eating that involves drastically cutting back on carbs and increasing your fat and protein intake. While it is touted for its weight loss effects, it can also cause some gastrointestinal issues. Many people report experiencing keto poop, which can range from constipation to excessive pooping or diarrhea. This is due to the diet's low fiber content, as well as the inclusion of dairy, and reduced water intake. The high-fat content of the keto diet can also be hard to digest, leading to diarrhea. However, these issues are usually temporary as the body adjusts to the new diet.

Keto can cause constipation

The ketogenic diet is a low-carbohydrate method of eating. It involves drastically cutting back on carbs and increasing your fat and protein intake. While keto has many benefits, such as weight loss, heart health, mental clarity, and clear skin, it can also lead to gastrointestinal issues. One of the most common side effects of starting keto is "keto constipation."

Causes of Keto Constipation

• Low fiber intake: The keto diet often involves cutting out high-fiber foods like whole grains, higher-carb veggies, legumes, and beans. As a result, people on keto may not be getting enough fiber, which is essential for adding bulk to the stool and promoting regular bowel movements.
• Dehydration: The keto diet can lead to a loss of water weight, and if this water loss is not replaced, it can result in constipation. Dry and hard stools are a sign of dehydration.
• Electrolyte imbalance: When you stop eating carbs, your kidneys start expelling sodium, magnesium, and potassium instead of holding onto them. Electrolytes, especially magnesium, are important for pulling water into your intestines, which helps soften the stool and make it easier to pass.
• Dairy consumption: Keto includes a lot of dairy products like cheese, yogurt, and cream, which are high in fat and protein. However, dairy is also high in lactose, which can be hard to digest and lead to constipation.
• Reduced water intake: With a decrease in fruit and vegetable consumption, people on keto may unintentionally reduce their water intake as well. This can contribute to dehydration and constipation.

Treating and Preventing Keto Constipation

• Increase dietary fiber: Aim for around 25g of fiber per day for women and 38g per day for men. Keto-friendly fibrous foods include cauliflower, avocado, and almonds.
• Drink more water: Staying hydrated is crucial for regular bowel movements. Most people should drink between 9 and 13 cups of water per day.
• Cut back on dairy: If you suspect that dairy is causing your constipation, try reducing or avoiding dairy products and opting for dairy-free alternatives.
• Retrain your bowel: Establish a regular time for a toilet break and drink enough fluids. You may also need stimulation such as a fiber supplement or a suppository, but be sure to consult your healthcare provider before taking any over-the-counter medications.
• Ease into the keto diet: If you're new to keto, gradually introduce more fats and protein-rich foods while slowly cutting back on carbs. This gives your stomach time to adjust to the new diet.

Remember, it's always best to consult with a healthcare provider before starting any new diet, especially one as restrictive as keto.

Keto can cause diarrhoea

The ketogenic (keto) diet involves drastically cutting back on carbohydrates and increasing the consumption of fats and proteins. This shift in eating habits can lead to digestive issues, including diarrhoea, which is commonly referred to as "keto diarrhoea".

Keto diarrhoea occurs when the body struggles to adapt to the high-fat, low-carb diet. Here are some reasons why keto can cause diarrhoea:

Low Digestive Enzymes

The liver produces bile and digestive enzymes to help digest fat. However, when starting a keto diet, the sudden increase in fat intake can overwhelm the liver, leading to undigested fat in the stool, resulting in diarrhoea.

Low Fibre Intake

The keto diet often involves reducing or eliminating high-fibre foods like whole grains, legumes, and certain vegetables. Fibre is essential for slowing down digestion and adding bulk to the stool. A lack of fibre can lead to diarrhoea, as food moves too quickly through the digestive tract.

Artificial Sweeteners and Sugar Alcohols

Keto-friendly foods often contain artificial sweeteners or sugar alcohols, such as sorbitol, which are known to cause digestive problems, including bloating and diarrhoea, when consumed in excess.

Disruption of Gut Microbiome

The keto diet can also impact the composition of the gut microbiome. Some studies suggest that after a few months on the keto diet, the bacteria in the gut change significantly, which may lead to diarrhoea and looser stools due to poor digestion.

Keto diarrhoea is usually a temporary issue as the body adjusts to the new diet. However, if it persists or is accompanied by other symptoms, it is recommended to consult a healthcare professional.

You may experience less flatulence

The keto diet can be a significant change for your body, and it may take some time for your gut to adjust to this new way of eating. Many people report an increase in flatulence during the initial stages of the diet, but this is usually temporary as your body adjusts to the higher fat content.

One reason for this may be that the keto diet can be low in fiber, especially if you're not careful about including enough low-carb, high-fiber vegetables in your meals. Fiber is essential for promoting healthy digestion and regular bowel movements. It adds bulk to your stool and helps keep things moving through your digestive tract. However, when you first start keto, you may find yourself cutting out many high-fiber foods such as whole grains, legumes, and some higher-carb veggies. As a result, you may end up deficient in fiber, which can contribute to constipation and increased flatulence.

To combat this, focus on including plenty of low-carb, high-fiber vegetables in your diet, such as broccoli, cauliflower, bok choy, fennel, kale, collards, and cabbage. These vegetables are not only rich in fiber but also low in net carbs, making them ideal for a keto diet. Additionally, berries, such as blackberries, raspberries, and strawberries, are excellent sources of fiber and low in sugar.

Another reason you may experience flatulence when starting keto is the increase in fat consumption. Your body needs time to adjust to this higher fat intake, and during this transition, you may find that some fat passes through your system undigested, leading to loose, fatty stools and increased flatulence. This issue should resolve itself as your body becomes more efficient at digesting and absorbing the higher levels of fat.

To help your body adjust, it's recommended to gradually increase your fat intake rather than going all-in right away. This gives your body time to adapt and can help reduce digestive issues. Additionally, consider taking a lipase supplement during the first week of keto, as lipase is an enzyme that helps break down and digest fats.

While the keto diet can initially cause some digestive issues, these are usually temporary. By focusing on adequate fiber intake, staying hydrated, and gradually increasing your fat consumption, you can help your body adjust and may even find that your gut health improves over time, resulting in less frequent and more comfortable bowel movements and reduced flatulence.

Poop may smell worse

The switch to a keto diet can cause your bowel movements to smell worse. This is due to the high-fat content of the diet. When you eat a lot of high-fat foods, your stool moves more slowly through your gastrointestinal tract. As a result, the stool sits in your system for longer and can putrefy more easily, especially if you're eating lots of protein.

Some people report that their bowel movements are more pungent when they first start the keto diet. This change in odour is due to the increased time it takes for the body to process high-fat foods. The longer the stool remains in the gastrointestinal tract, the more time there is for bacteria to act on it, leading to a stronger smell.

In addition to the slower movement of stool, the keto diet can also impact the composition of your gut microbiome. Some studies have found that after three months on the ketogenic diet, the bacteria in the gut change significantly, which could also contribute to changes in the smell of your bowel movements.

The high-fat content of the keto diet can also be hard to digest for some people, leading to digestive issues such as bloating, gas, and constipation. These issues can further contribute to the putrefaction of the stool and the stronger smell.

If you are experiencing pungent bowel movements on the keto diet, it is important to ensure that you are staying properly hydrated and getting enough fibre in your diet. Drinking plenty of water and eating high-fibre, low-carb foods can help to regulate your digestion and may improve the smell of your bowel movements.

Poop may look different

The keto diet can cause changes in the appearance of your stool. Due to the lack of fibre in the keto diet, your stool will have less bulk and be smaller in size. Dr. John Whyte, M.D., MPH, and Chief Medical Officer at WebMD, explains that your poop may be lighter in colour due to the high-fat content.

Liz Weinandy, R.D. at The Ohio State University, describes the ideal poop as "soft but formed, not too loose and not too solid." However, when starting the keto diet, your poop may become hard and dry, which is a sign of constipation. This is a common issue for people on the keto diet due to the reduction in fibre-rich foods, decreased water intake, and increased dairy consumption.

To address these issues, it is recommended to increase your intake of fibrous, low-carb foods such as vegetables, avocados, and almonds. Drinking plenty of water and taking a fibre supplement can also help regulate your bowel movements.

It is worth noting that these changes in poop appearance are typically temporary as your body adjusts to the new diet. However, if the issues persist or become a concern, it may be advisable to consult a healthcare professional.

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