Keto Plus: Diarrhea And Other Possible Side Effects

The ketogenic diet is a popular eating plan that involves eating a high-fat, moderate-protein, and very low-carbohydrate diet. While it has been praised for its weight loss and health benefits, it has also been known to cause some unpleasant side effects, including keto diarrhea.

Keto diarrhea is a common issue that occurs when the body is unable to keep up with the breakdown and absorption of the high amounts of fat consumed on the keto diet. This can result in loose, watery stools, and frequent trips to the bathroom. The condition is often caused by an increase in fat intake, a decrease in fiber intake, and changes in gut bacteria.

So, does keto plus cause diarrhea? The answer is that while not everyone who follows the keto diet will experience diarrhea, it is a common side effect, and the severity and duration of symptoms can vary.

High fat content

The keto diet is a low-carb, high-fat diet. This high-fat content can cause diarrhea, as the body struggles to adjust to the new diet. Fat takes longer to break down than carbohydrates or protein, so when you suddenly start eating lots of fat, your digestive system can struggle to keep up.

When you switch to a high-fat diet like keto, your body needs to produce more bile to break down the fat. Bile is a natural laxative, so an excess of it may push waste through the digestive tract faster than usual, leading to diarrhea.

The high-fat content of the keto diet can also cause bile malabsorption. Bile acid production is a costly process, and if your body is struggling to adjust to the higher fat intake, it may result in bile malabsorption, where the bile lingers in the small intestine instead of being recycled. This can cause diarrhea.

The high-fat content of the keto diet may also be problematic if you have a low tolerance for fat-rich foods. People with a history of gastrointestinal disorders such as Celiac disease and irritable bowel syndrome are at greater risk of suffering from keto diarrhea.

If you are experiencing keto diarrhea, it is important to stay hydrated and replenish your electrolytes. You may also want to consider reducing the amount of fat you eat and introducing more vegetables.

Lack of fibre

The keto diet is a low-carb, high-fat diet that promotes weight loss by shifting the body's metabolism into a state of ketosis, where it burns fat for energy instead of glucose. While the keto diet has gained popularity for its potential benefits, one common side effect is keto diarrhea, characterised by loose, watery stools.

One contributing factor to keto diarrhea is a decrease in fiber intake due to the restriction of carbohydrates. Fiber, especially insoluble fiber, is important for bulking up stools and preventing diarrhea. By cutting back on carbs, people on the keto diet also reduce their intake of fiber-rich foods like fruits, legumes, starchy foods, and whole grains. This decrease in fiber can lead to diarrhea and other gut-related problems, such as changes in the gut microbiome.

The gut microbiome refers to the microorganisms in the gastrointestinal tract, primarily bacteria that are crucial for maintaining digestive health. A diverse and abundant population of good bacteria in the gut promotes healthy digestion and reduces the risk of diarrhea. However, a low-carb diet can disrupt the balance of gut bacteria, leading to a decrease in beneficial bacteria and potentially causing diarrhea and gut inflammation.

To alleviate keto diarrhea caused by a lack of fiber, it is recommended to:

• Increase fiber intake: Include more high-fiber foods in your diet, such as greens, cucumbers, broccoli, cabbage, citrus fruits, berries, avocado, and chia seeds. These foods can help add bulk to stools and relieve diarrhea.
• Consume more prebiotic fiber: Prebiotic fiber serves as food for the healthy probiotic bacteria in the gut. By including prebiotic-rich plant foods, such as fruits, vegetables, and whole grains, you can support the growth of beneficial bacteria and improve digestive health.
• Take probiotic supplements: Probiotic supplements or probiotic-rich foods like yogurt, kefir, kimchi, and kombucha can help support the gut bacteria and reduce gastrointestinal symptoms associated with the keto diet.
• Ease into the keto diet: Instead of making abrupt changes, gradually reduce your carb intake and increase healthy fats. This gives your body and gut bacteria more time to adjust to the new diet, potentially reducing the severity of diarrhea.
• Stay hydrated: Diarrhea can lead to fluid loss, so it is important to drink plenty of water and sugar-free electrolyte beverages to replace lost fluids and electrolytes.

While keto diarrhea is a common side effect of the keto diet, it is important to monitor your symptoms and seek medical advice if diarrhea persists or becomes severe. Consulting with a registered dietitian can also help ensure that your body is meeting its nutritional needs, including adequate fiber intake, while following the keto diet.

Artificial sweeteners

One of the most common artificial sweeteners is aspartame, which has been linked to a range of health problems, including type 2 diabetes, obesity, cancer, and disruption of the gut microbiome. Other common artificial sweeteners include sucralose, neotame, saccharin, and sugar alcohols like erythritol and xylitol.

While artificial sweeteners offer a low-calorie alternative to table sugar, they may have their own health consequences. For example, according to Havovi Chichger, an associate professor of biomedical science, artificial sweeteners can damage the lining of the intestine and the good bacteria in our guts. This can lead to a range of health issues, including diarrhea, intestinal inflammation, and even infections if the bacteria enter the bloodstream.

Research has also found that excessive consumption of certain artificial sweeteners can cause a laxative effect, leading to diarrhea. This is especially true for people on the keto diet, as they tend to consume more artificial sweeteners and sugar alcohols than usual when looking for low-carb alternatives to sugary foods and drinks. Keto desserts, in particular, have been linked to diarrhea due to the high amount of artificial sweeteners they contain.

Additionally, artificial sweeteners can be hard to digest and may cause bloating and diarrhea when consumed in large amounts. This is why people on the keto diet may experience "keto diarrhea," as the diet often includes large amounts of artificial sweeteners and sugar alcohols.

To avoid potential negative effects, it is recommended to limit the intake of artificial sweeteners and opt for natural sweeteners like stevia, monk fruit, or yacon syrup, which are considered safer alternatives.

Gut microbiome changes

The keto diet can cause changes in the gut microbiome, which can lead to gastrointestinal issues such as diarrhea. The gut microbiome refers to the microorganisms in the gastrointestinal tract, mainly consisting of bacteria that play an important role in health.

Changes in Gut Bacteria

A 2020 study found that switching between a keto and a standard diet caused shifts in Actinobacteria, Bacteroidetes, and Firmicutes, which are common gut microbial phyla. Specifically, the beneficial Bifidobacteria species decreased the most in response to reductions in carbohydrates rather than reduced fat intake. This decrease in Bifidobacteria species was linked to a reduction in Th17 immune cells, which help fight infections but can also promote inflammation in autoimmune diseases.

Impact on Gut Health

The changes in the gut microbiome caused by the keto diet could have both positive and negative effects on the body. On the one hand, these changes may help explain how the keto diet aids weight loss and improves blood sugar control. On the other hand, the decrease in Bifidobacteria and the increase in Fusobacteria and Escherichia may be associated with an increased risk of colorectal cancer.

Long-Term Effects

It is important to note that there is limited research on the long-term effects of the keto diet on the gut microbiome. The available studies have mostly focused on people with epilepsy or elite athletes, and the findings may not be generalizable to the general population. More research is needed to understand the long-term impact of the keto diet on gut health.

Bile acid malabsorption

BAM is not a standalone condition and is often associated with other health issues, such as Crohn's disease, large intestine inflammation, and irritable bowel syndrome with diarrhea (IBS-D). It is estimated that around one-third of people diagnosed with IBS-D also have BAM.

There are two main tests available for diagnosing BAM: the fecal bile acid test and the serum 7αC4 test. Treatment options for BAM include medication such as cholestyramine, surgery to remove the gallbladder, and dietary changes to reduce fat intake.

BAM is a manageable condition, and with proper diagnosis and treatment, individuals can find relief from their chronic diarrhea and improve their quality of life.

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