Keto And Abdominal Pain: What's The Connection?

The ketogenic diet is a popular, very low-carb, high-fat, and moderate-protein diet that is known to cause weight loss and improve health. However, it is associated with some unpleasant side effects, including abdominal pain. This is because the keto diet can lead to dehydration and changes in the digestive tract, causing gastrointestinal issues such as constipation, diarrhea, bloating, and abdominal cramps. The high-fat content of the keto diet can also lead to other symptoms like nausea and bloating.

Dehydration

The process of getting into ketosis can be dehydrating for two reasons. Firstly, glycogen, the stored form of carbohydrates, binds to water in the body. When you reduce your carbohydrate intake, your body's glycogen levels drop, and water is excreted from the body. Secondly, high insulin levels caused by a high-carb diet inhibit sodium excretion, leading to water retention. Lowering insulin levels on the keto diet allows this excess fluid to be released.

To combat dehydration, it is recommended to drink a lot of water. It is also suggested to add salt to your food and drinks, as this can help the body retain more water.

Other symptoms of dehydration caused by the keto diet include headaches, lethargy, nausea, brain fog, and low motivation. These symptoms are usually temporary and will decrease as your body adjusts to converting ketones into energy.

It is important to note that while the keto diet can be a safe and effective way to lose weight and improve health, it may not be suitable for everyone. Always consult a healthcare professional before making significant dietary changes.

Lack of fibre

The keto diet is a very high-fat, low-carb, and moderate-protein eating plan. While it may help with weight loss, it can also lead to abdominal pain due to constipation or diarrhoea caused by a lack of fibre.

The keto diet restricts many fibre-rich foods, such as fruits, whole grains, legumes, and starchy vegetables. This lack of fibre can lead to constipation, which is defined as having three or fewer bowel movements per week, with hard and lumpy stools that are difficult to pass.

The recommended daily fibre intake for people up to the age of 50 is 25 grams for women and 38 grams for men. However, the average American adult consumes only 10 to 15 grams of fibre per day.

Fibre is essential for maintaining regular and healthy bowel movements. It adds bulk to the stool and helps the colon work like a muscle to move things through more easily. A high-fibre diet also promotes diversity in the gut microbiome, which has been linked to improved health.

To prevent and treat constipation caused by a lack of fibre on the keto diet, it is important to include high-fibre, keto-friendly foods. These include:

• Non-starchy vegetables such as broccoli, artichokes, collard greens, greens, asparagus, and cauliflower
• Avocados and nuts, which are fat sources that also contain a lot of fibre
• Fermented foods such as sauerkraut and kimchi, which contain natural probiotics to support gut health
• High-fibre supplements or whole-food "supplements" like chia seeds and ground flaxseed

In addition to increasing fibre intake, staying hydrated is crucial for preventing and treating constipation. Adequate water intake helps move things along in the digestive tract. It is recommended that women consume 91 ounces of total fluids daily, while men should aim for 125 ounces, with 20% coming from food.

Excessive fat intake

• Bloating, burping, and belching: Excessive fat intake can lead to digestive issues, including bloating and indigestion, which may manifest as frequent burping and belching.
• Lack of weight loss: One of the main goals of the keto diet is weight management. However, if you're consuming too much fat, you may find that you're not losing weight despite adhering to the diet. This is because consuming too much fat can lead to an excess of calories, hindering weight loss.
• Pain under the right rib cage: This can be a sign of liver or gallbladder issues, as excessive fat intake may overwhelm these organs, leading to discomfort and potential dysfunction.
• Black, tarry, and oily stools: Oily stools can be a result of excess fat in the digestive tract, which may indicate that your body is struggling to process and absorb the high amounts of fat you're consuming.
• Reduced appetite: Consuming excessive amounts of fat can lead to prolonged feelings of fullness, reducing your appetite and potentially leading to inadequate nutrient intake.

It's important to remember that the keto diet is not just about consuming large amounts of fat. It's crucial to focus on healthy fats and ensure they make up the recommended percentage of your daily calorie intake, which is typically around 60% to 80% for most individuals. Additionally, it's important to consult with a healthcare professional before starting a keto diet, especially if you have any pre-existing health conditions or are taking medications.

High-fat content in the keto diet

The keto diet is a high-fat, moderate-protein, and very low-carbohydrate diet. It is considered safe for most people but is associated with some unpleasant side effects, often referred to as the "keto flu." One of the most common side effects is gastrointestinal (GI) issues, with abdominal pain being a frequent complaint.

The high-fat content of the keto diet can be a challenge for the body to adjust to. The body needs to produce more bile to break down the increased amount of fat, and as bile is a natural laxative, this can lead to diarrhea. This is especially true if the transition to the keto diet is sudden, as the body may not have time to adjust to the new diet properly.

To help alleviate abdominal pain and other GI issues caused by the high-fat content of the keto diet, there are several strategies that can be employed:

• Ease into the diet: Gradually reducing carbs and increasing fats can help the body adapt better. This gives the body time to adjust to the higher fat intake and may reduce the severity of abdominal pain and other GI issues.
• Reduce fiber intake: While fiber is important for a healthy digestive system, some people may benefit from reducing their fiber intake, especially if they are switching to keto from a diet high in processed foods. Fiber-rich foods, such as grains and legumes, can irritate the colon and lead to GI issues. However, it is important to note that this advice is for those who increased their fiber intake when switching to keto. For those who were already consuming a high-fiber diet, increasing fiber intake further may help alleviate GI issues.
• Tone down coconut products and other MCTs: Coconut oil and other medium-chain triglycerides (MCTs) are often consumed in large amounts on the keto diet due to their ability to aid in ketosis. However, these can cause abdominal cramps and diarrhea, especially if the body is not used to them. Reducing the amount of MCTs in the diet may help alleviate abdominal pain.
• Stay hydrated: Drinking plenty of water, especially mineral water, can help with constipation. Fluids are just as important as fiber in preventing constipation, and mineral water can provide additional benefits due to its electrolyte content.
• Probiotics and prebiotics: Taking probiotic or prebiotic supplements or consuming fermented foods, such as sauerkraut and kimchi, can help support gut health and improve digestion.
• Reduce dairy intake: The keto diet may lead to an increase in dairy consumption, as dairy products are high in fat. However, this can reveal a dairy intolerance, with diarrhea, bloating, and gas being common symptoms. Reducing dairy intake may help alleviate abdominal pain and other GI issues.

Electrolyte loss

When following a ketogenic diet, insulin levels decrease, and as insulin is a hormone that helps the body absorb glucose from the bloodstream, this decrease causes the kidneys to release excess sodium from the body. This can be remedied by salting food to taste and including potassium-rich, keto-friendly foods like leafy greens and avocados. These foods are also high in magnesium, which may help reduce muscle cramps, sleep issues, and headaches.

Drinking sugar-free electrolyte beverages can also help replace lost electrolytes.

In addition, the keto diet increases your need for electrolyte minerals, so drinking mineral water is a great way to get these while also staying hydrated.

Frequently asked questions