Keto Coffee And Diarrhea: What's The Link?

The ketogenic diet is a popular eating plan that involves eating fewer carbohydrates and more fat. While it has been touted as an effective way to lose weight, it can also lead to some unpleasant side effects, including keto diarrhea. This is exactly what it sounds like – people following the keto diet may experience loose, watery stools or frequent bowel movements. This is due to the high-fat content of the diet, which can be hard for the body to digest, as well as the use of artificial sweeteners and potential disruption to the gut microbiome. In most cases, keto diarrhea is a temporary issue that occurs when people are first starting the diet, but for some, it can be a long-term side effect. Staying hydrated and increasing fibre intake can help to alleviate the symptoms of keto diarrhea.

High-fat content

The keto diet is a low-carb, high-fat diet that has become increasingly popular in recent years. The basic idea is to restrict carb intake so that the body switches from burning glucose for energy to burning fat, including stored body fat and dietary fat. This shift in metabolism is known as ketosis.

The high-fat content of the keto diet can be hard for the body to adjust to, and this may lead to keto diarrhoea. Fat takes longer to break down in the body than carbohydrates or protein, so when you suddenly start consuming much higher amounts of fat, your digestive system may struggle to keep up. Some of the fat may be malabsorbed, meaning it is not broken down properly and is excreted in your faeces. This can lead to a type of diarrhoea called steatorrhea, which is typically pale, foul-smelling and coated in a thick, greasy film.

The high-fat content of the keto diet may also lead to an increase in bile production. Bile is a natural laxative, and an excessive amount may push waste through the digestive tract faster than usual, leading to diarrhoea.

In addition, the high-fat content of the keto diet may cause changes to your gut microbiome. The keto diet tends to have a cleansing effect on the gut, starving gut bacteria of their primary source of fuel. This can lead to a decrease in healthy bacteria, which can cause gut-related problems like diarrhoea and inflammation in the gut.

To alleviate diarrhoea caused by the high-fat content of the keto diet, it is recommended to:

• Drink more water and electrolytes to stay hydrated.
• Take bile and digestive enzyme supplements to assist with fat digestion.
• Eat more fibre to help calm diarrhoea.
• Reduce the amount of fat you eat and introduce more vegetables.
• Avoid sugar alcohols and artificial sweeteners, as these can be hard to digest and lead to an upset stomach and diarrhoea.
• Add insoluble fibre, like psyllium, to your diet to prevent diarrhoea and keep your gut healthy.
• Eat more probiotic-rich foods such as yoghurt, kefir, kimchi and kombucha.
• Stay active with gentle exercises like yoga and short, brisk walks, which can help regulate bowel health and frequency.

Lack of fibre

The keto diet is a low-carb, high-fat diet that has become increasingly popular in recent years. It involves restricting carb intake so that the body switches from burning glucose for energy to burning fat, including stored body fat. This shift in metabolism is known as ketosis.

One unfortunate side effect of the keto diet is keto diarrhea. This condition is characterised by loose, watery stools and can be caused by an increase in fat intake, a decrease in fibre intake, and changes in gut bacteria.

The Role of Fibre

Fibre is essential for healthy digestion and regular bowel movements. It adds bulk to stools, making them easier to pass, and helps to prevent constipation and diarrhoea.

The keto diet can be low in fibre, as many fibre-rich foods, such as fruits, legumes, starchy foods, and whole grains, are restricted due to their high carb content. This decrease in fibre intake can lead to diarrhoea and other gut-related problems, such as changes to the gut microbiome and inflammation in the gut.

Preventing and Treating Diarrhoea

To prevent and treat diarrhoea on the keto diet, it is important to ensure adequate fibre intake. This can be achieved by including high-fibre, low-carb foods such as nuts, seeds, leafy greens, and cruciferous vegetables.

It is also recommended to stay hydrated and replenish electrolytes, as diarrhoea can lead to dehydration. In addition, avoiding or limiting artificial sweeteners and sugar alcohols, which can have a laxative effect, may help reduce diarrhoea.

If diarrhoea persists, it may be necessary to make further adjustments to the diet or consult a healthcare professional. Chronic diarrhoea can lead to health complications such as vitamin deficiencies, muscle deterioration, and electrolyte imbalance.

The keto diet can be effective for weight loss, but it is important to ensure adequate fibre intake to prevent digestive issues such as diarrhoea. By including fibre-rich, low-carb foods and staying hydrated, individuals can help promote healthy digestion and reduce the risk of diarrhoea while on the keto diet.

Artificial sweeteners

Keto dieters may also experience diarrhoea due to the high-fat content of the diet. The body can struggle to keep up with the breakdown and absorption of fat, and this can lead to malabsorption. When unabsorbed fat reaches the small intestine and colon, it pulls in more water, resulting in watery diarrhoea.

The keto diet can also cause diarrhoea by disrupting the gut microbiome. The diet starves gut bacteria of their primary fuel source, leading to a "die-off" of certain bacteria. This can cause changes in the composition of the gut microbiome, which can lead to poor digestion and diarrhoea.

To alleviate keto diarrhoea, it is recommended to:

• Drink more water and electrolytes.
• Add more fibre to the diet, such as citrus, berries, avocado, broccoli, and chia seeds.
• Avoid artificial sweeteners and sugar alcohols.
• Ease into the diet, rather than making a sudden change.
• Stay hydrated.

Gut microbiome changes

The gut microbiome refers to the microorganisms in the gastrointestinal (GI) tract, which mainly consist of bacteria that are important to health in many ways, including helping the body digest food and absorb nutrients.

Keto and Gut Microbiome Changes

When starting a keto diet, the body experiences a sudden lack of fibre due to the drastic reduction in carbohydrate intake. This can lead to an imbalance in the gut microbiome, as fibre is essential for maintaining a healthy balance of gut bacteria.

Additionally, the high-fat content of the keto diet can also impact the gut microbiome. The body may struggle to adjust to the increased fat intake, leading to malabsorption and diarrhoea.

Coffee and Gut Microbiome Changes

Regular coffee consumption has been linked to changes in some intestinal microbiota groups, with dietary polyphenols and caffeine playing a potential role. Coffee contains phytochemicals and minerals that can positively impact the gut microbiome and overall gut health.

Combined Effects of Keto and Coffee on Gut Microbiome

The combined effects of a keto diet and coffee consumption on the gut microbiome have not been extensively studied. However, it is possible that the high-fat content of the keto diet and the stimulating effects of coffee may work together to increase intestinal motility and reduce intestinal transit time, which can impact the gut microbiome.

Tips to Support Gut Health on Keto

• Gradually transition to the keto diet by slowly reducing carbohydrates and increasing fats to give your body time to adjust.
• Stay hydrated by drinking plenty of water and electrolytes.
• Increase your fibre intake by consuming keto-friendly high-fibre foods such as greens, cucumbers, broccoli, and cabbage.
• Add probiotics and prebiotics to your diet through probiotic supplements or probiotic- and prebiotic-rich foods like sauerkraut and kimchi.
• Reduce your intake of artificial sweeteners and sugar alcohols, as these can have a laxative effect and contribute to diarrhoea.
• Consult with a dietitian or healthcare professional to ensure your diet meets your nutritional needs and supports a healthy gut microbiome.

Bile acid malabsorption

Diagnosis

There are two tests available in the US for diagnosing BAM:

• Fecal bile acid test: A 48-hour stool collection test that checks for higher levels of primary bile acids associated with IBS-D.
• Serum 7αC4 test: Requires fasting and uses a serum to reveal increased bile acid in the stool. However, this test may yield false positives or negatives if the patient has liver disease or is taking statins.

Treatment

The primary medication prescribed for BAM is Cholestyramine, which helps to break down bile in the colon and improve chronic diarrhea symptoms. If lifestyle changes and medication don't help, surgery to remove the gallbladder may be recommended. Additionally, diet changes can be beneficial, such as consuming less fat and increasing fiber intake.

Frequently asked questions