Keto And Gas Pain: What's The Connection?

The ketogenic diet is a popular, effective way to lose weight and improve health. However, it is associated with some unpleasant side effects, including gastrointestinal issues. Many people who switch to keto experience gas pain, along with constipation, diarrhoea, bloating, abdominal cramps, and other digestive symptoms. This is often due to the diet's lack of fibre and hydration, as well as the body's adjustment period to ketosis.

Dehydration

The keto diet involves entering a state of ketosis, where the body burns fat instead of glucose for energy. This process leads to a loss of water and electrolytes, which can cause dehydration. Carbohydrates help the body retain water and sodium, so eliminating them from your diet can lead to dehydration. In addition, the body loses water weight quickly during the initial stages of the keto diet, which can further contribute to dehydration.

• Muscle cramps
• Headaches
• Fatigue and weakness
• Constipation
• Increased thirst
• Dry mouth and throat
• Dizziness and lightheadedness

To avoid dehydration on the keto diet, it is important to increase your water intake and consume electrolyte-rich foods and drinks. Some tips to avoid dehydration include:

• Start your day with a glass of water and drink around eight glasses of water throughout the day.
• Keep a full glass of water nearby to remind yourself to drink regularly.
• Use a tracking cup or download a water-tracking app to monitor your daily water intake.
• Consume other hydrating liquids such as low-sugar broths, juices, sports drinks, and popsicles.
• Eat whole foods such as leafy vegetables, nuts, seeds, avocados, cucumbers, and celery, which have a high water content and are rich in electrolytes.
• Aim to drink at least half of your body weight in ounces of water per day. For example, if you weigh 150 pounds, aim for 75 ounces of water.
• Set reminders to drink water every hour.
• Infuse your water with fruits or herbs to add flavor.
• Drink water before and after meals.
• Avoid sugary drinks and alcohol, as these can contribute to dehydration.

Lack of fibre

The keto diet is a low-carb, high-fat diet that limits daily non-fibre carbohydrate intake to 20 to 50 grams, which is far less than the Dietary Guidelines' recommendation of 225 to 325 grams of carbohydrates, based on a 2,000-calorie diet. This drastic reduction in carbohydrate intake can lead to a deficiency in essential nutrients, including fibre.

Fibre is essential for maintaining healthy bowel movements. It keeps us regular by softening and adding bulk to our stools, and it aids healthy digestion and nutrient absorption by feeding the good bacteria in our gut. However, many fibre-rich foods are also carb-heavy, and the keto diet restricts the consumption of common sources of fibre, such as fruits, whole grains, legumes, and starchy vegetables.

As a result, it can be challenging to get enough fibre on the keto diet, and this fibre deficiency can lead to gastrointestinal issues such as constipation, gas, and bloating.

To prevent these issues, it is important to include fibre-rich, keto-friendly foods in your diet. Examples of such foods include:

• Non-starchy vegetables like greens, broccoli, asparagus, and cauliflower
• Berries, in limited amounts
• Avocados
• Nuts and seeds
• Flaxseed
• Chia seeds
• Wheat bran

In addition to increasing your fibre intake, staying properly hydrated is crucial when following the keto diet. The transition to a low-carb, high-fat diet can have a diuretic effect, leading to water loss and dehydration, which can contribute to constipation, bloating, and gas. Therefore, drinking plenty of water is essential to maintaining a healthy digestive system while on the keto diet.

Gut flora imbalance

The gut microbiome is the collection of bacteria and other microbes that live in the gut. Carbohydrates, especially non-digestible ones like fibre, resistant starch and non-starch polysaccharides, are the primary fuel source for these microbes. These non-digestible carbohydrates are found in plant foods such as whole grains, legumes, fruits and starchy vegetables.

The keto diet restricts carbohydrates and is, therefore, low in these non-digestible carbohydrates. This means that the gut bacteria have less fuel, which can lead to an overall reduction in the abundance of gut bacteria.

A reduction in the abundance and diversity of gut bacteria is associated with an increased risk of various diseases, including inflammatory bowel disease, obesity, type 2 diabetes, cardiovascular disease and cancer.

A study found that the keto diet was associated with an increase in the bacteria Desulfovibrio, which is linked to inflammatory bowel disease. Another study found that the keto diet reduced the abundance of beneficial Bifidobacteria species, which are associated with reduced fasting glucose and total cholesterol.

The keto diet can also increase intestinal permeability, causing 'leaky gut'. This is because the diet turns off the genes that code for proteins that comprise tight junctions, which are the 'seals' between neighbouring intestinal cells. This can allow undigested proteins and bacterial toxins to leak through the gut wall and into the bloodstream, triggering inflammation.

Overall, the keto diet can cause gut flora imbalance, which may have negative health consequences.

Excess sugar alcohols

Sugar alcohols are commonly found in sugar-free or low-carb sweets, such as chocolate bars, ice cream, and even some toothpastes and chewing gums. Some common sugar alcohols include erythritol, xylitol, sorbitol, and maltitol. While these sugar alternatives can be a great way to satisfy a sweet tooth while on the keto diet, it is important to consume them in moderation.

Some people may be more sensitive to sugar alcohols than others, and may experience digestive issues such as bloating, gas, and diarrhea after consuming only a small amount. If you are experiencing these symptoms, it may be best to reduce your intake of sugar alcohols or avoid them altogether.

It is worth noting that sugar alcohols are not the only cause of gas and bloating on the keto diet. A low-carb diet can also lead to dehydration, which can cause bloating and constipation. Additionally, a lack of fiber in the diet can contribute to gastrointestinal issues.

Food intolerances

When starting a keto diet, you will be trading in carb-heavy foods for proteins and healthy fats. During this trial and error phase, you may encounter digestive issues or allergic reactions, including inflammation, swelling, itching, and bloating. These symptoms could indicate a potential food intolerance.

Some keto food selections that you could be intolerant to include artificial sweeteners. To determine which foods are the culprits, start by eliminating all the potential triggers and then slowly reintroduce them one by one. Once you've identified the problematic food, eliminate it from your diet and document any noticeable differences. If you want a quick answer, you can get tested by an allergist.

FODMAP foods are another subset of foods that many people have sensitivities to. FODMAP stands for "fermentable oligosaccharides, disaccharides, monosaccharides, and polyols." While many people's gut biome can process these foods, others experience excessive fermentation, leading to bloating and stomach pain. Examples of high FODMAP foods include cauliflower, broccoli, garlic, onions, and cabbage. See if avoiding these high FODMAP foods improves your bloating issues. Consult a registered dietitian to help you gradually reintroduce these foods and ensure you're getting proper nourishment for your beneficial gut bacteria.

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