Keto Diet: Less Bathroom Trips, More Benefits

The ketogenic diet, or keto, is a popular dieting trend that involves a high-fat, low-carb, and moderate-protein eating pattern. While keto may offer several health benefits, it can also lead to some side effects, including constipation. Constipation is defined as having fewer than three bowel movements a week, and it can be painful and difficult to pass stools. Keto constipation is a common issue due to the reduction in fiber-rich foods, increased dairy intake, and decreased water intake associated with the diet. However, there are ways to treat and prevent constipation while on keto, such as increasing water intake, consuming more high-fiber and low-carb foods, and cutting back on dairy.

Constipation

Causes of Keto Constipation

Change in Fiber Intake

The keto diet is low in carbohydrates, which means that high-fiber foods like whole grains, higher-carb vegetables, legumes, and beans are often cut out. This can lead to a deficiency in fiber, which is essential for maintaining healthy bowel movements.

Dairy Intolerance

The keto diet includes full-fat dairy, and many people end up consuming more dairy than they usually would. Some people may discover that they are lactose intolerant on the keto diet, as their body has trouble digesting the natural sugars in dairy (lactose). This can lead to digestive issues like constipation.

Electrolyte Imbalance

When you stop eating carbs, your body expels sodium, magnesium, and potassium instead of holding onto them. Electrolytes, especially magnesium, are important for pulling water into your intestines, which softens dry stools and makes them easier to pass.

Dehydration

The keto diet can lead to dehydration, as glycogen stores in the body hold onto a lot of water, and when these stores are depleted, a lot of fluid is released. Dehydration can lead to constipation, as it can result in dry and hard stools.

Treating and Preventing Keto Constipation

There are several ways to treat and prevent constipation while on the keto diet:

Increase Fiber Intake

Add more fiber-rich, low-carb foods to your diet, such as leafy greens, broccoli, cauliflower, berries, avocados, and almonds.

Drink More Water

Staying hydrated is essential for maintaining 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 eliminating dairy products from your diet and opting for dairy-free alternatives.

Exercise Regularly

Research has found that being active can help with regularity. Try going for a brisk walk after meals to activate the bowels.

Give Your Body Time to Adjust

When to Seek Help

If your constipation persists or is accompanied by ongoing stomach pain, bloating, gas, or an anal fissure, speak to a healthcare provider. Chronic constipation can also impact your mental health, and it may be a sign that the keto diet is not suitable for you.

Diarrhea

Low digestive enzymes

When you start eating more fat, your liver can take a while to adjust its bile and digestive enzyme production. Until it does, you may experience diarrhea due to undigested fat.

Artificial sweeteners

Many people on the keto diet increase their consumption of artificial sweeteners and sugar alcohols as they look for low-carb alternatives to foods and drinks they previously consumed. However, excessive consumption of certain artificial sweeteners can have a laxative effect, leading to diarrhea.

Low fiber intake

Paradoxically, low fiber intake can cause both constipation and diarrhea. Without fiber to slow digestion, food can pass straight through you.

Too much protein

A well-formulated ketogenic diet should be low-carb, high-fat, and moderate in protein. When cutting carbs, it can be tempting to increase your protein intake, but this can lead to diarrhea.

The wrong source of dietary fats

While omega-6 and omega-3 fats are essential, our digestive systems have a limited tolerance for vegetable and seed oils high in omega-6 fats. Consuming a high-fat diet made with soybean, corn, safflower, or sunflower oils can cause nausea and diarrhea.

If you're experiencing diarrhea on the keto diet, there are several things you can try:

• Take lipase, an enzyme that breaks down fats, for the first week of the diet.
• Eat more low-carb vegetables to keep your digestion moving at a healthy pace.
• Limit your intake of medium-chain triglycerides (MCTs) to a teaspoon at a time when starting out, gradually increasing the amount over a week or so.
• Drink plenty of water and stay hydrated.
• Take a probiotic supplement or increase your intake of probiotic- and prebiotic-rich foods to support your gut bacteria.
• Eat fermented foods such as sauerkraut and kimchi, which can help improve digestion and reduce constipation or diarrhea.
• Cut back on your intake of sugar substitutes and sugar-free products, which often contain sugar alcohols that can cause gastrointestinal distress.
• Eat more fiber-rich foods, such as leafy greens, broccoli, nuts, seeds, and berries.

If your diarrhea is severe or lasts longer than a week, consult your doctor.

Poop appearance

The appearance of your poop can change when you start a keto diet. Here are some ways in which it may be affected:

Stool Size

Due to the lack of fibre in the keto diet, your stool will have less bulk and be smaller in size.

Colour

The high fat content of the keto diet may cause your poop to be lighter in colour.

Smell

The high fat content of the keto diet can also cause your poop to smell worse, as it moves more slowly through your gastrointestinal tract, sitting in your system for longer and putrefying more easily.

Blood

Some people may develop hemorrhoids from being severely constipated, which can cause some blood when wiping.

Poop smell

The ketogenic diet is a very high-fat, very low-carb, and moderate-protein eating pattern that induces a phenomenon called ketosis, where the body burns fat instead of glucose for energy. While the keto diet may help burn fat, it can also cause side effects related to the gastrointestinal (GI) tract reacting to the absence of carbs.

One of the side effects of the keto diet is that it can change the way you poop, including the smell. Anecdotally, some people have reported that their bowel movements are more pungent when on the keto diet. Liz Weinandy, R.D. at The Ohio State University, explains that this is because eating a lot of high-fat foods makes the stool move more slowly through the gastrointestinal tract. As a result, the stool sits in your system for longer periods and can putrefy more easily, especially if you're consuming large amounts of protein.

Additionally, a byproduct of the breakdown of fat and protein into energy is a ketone body called acetone, which is also found in nail polish remover. While a small amount of acetone on the breath has a fruity smell, a larger amount can have a very distinct and unpleasant astringent smell.

To prevent these side effects, it is recommended to drink plenty of water and increase your fiber intake by consuming more vegetables, such as broccoli, cauliflower, and leafy greens. Taking a fiber supplement like psyllium husk can also be beneficial.

It is important to note that these digestive issues are usually temporary, and as your body adjusts to the new diet, they should subside. However, if they persist or become unbearable, it may be best to consult a doctor or consider a different dietary approach.

Hemorrhoids

If you are experiencing hemorrhoids as a result of constipation caused by the keto diet, there are several things you can do to treat and prevent them:

• Increase your fibre intake: Focus on eating more fibre-rich, keto-friendly foods such as non-starchy vegetables (like broccoli, greens, asparagus, and cauliflower), berries, nuts, and seeds.
• Drink plenty of water: Dehydration can contribute to constipation, so make sure you are well-hydrated.
• Take a fibre supplement: A fibre supplement like psyllium husk can help with constipation.
• Get enough electrolytes: An electrolyte imbalance can contribute to constipation, so be sure to salt your food liberally and consider taking a magnesium supplement.
• Exercise: Try going for a brisk walk after meals to get things moving.
• Bowel training: This method involves passing stools at the same time every day.
• Squat: Squatting while on the toilet may help reduce the occurrence or severity of hemorrhoids.
• Clean thoroughly: Use flushable baby wipes to clean up after a bowel movement.
• Don't strain: Avoid straining to pass stools, as this can make hemorrhoids worse.

If your hemorrhoids do not improve with these measures, be sure to consult a doctor. They may recommend prescription medications or dietary changes to help get your gastrointestinal tract back in working order.

Frequently asked questions