Stomach Sensations On Keto: What To Expect

The ketogenic diet is a popular eating plan for those looking to lose weight and improve their health. However, it is associated with some unpleasant side effects, including gastrointestinal issues. Many people who switch to keto experience constipation, diarrhoea, bloating, abdominal cramps and pain, and other digestive symptoms. These symptoms are often caused by the body's adjustment to a new diet that is very low in carbohydrates and can lead to dehydration and an electrolyte imbalance. While these side effects may cause concern, there are ways to reduce them, such as staying hydrated, adjusting your fibre intake, and taking probiotics or laxatives.

Dehydration and the need to drink more water

The keto diet is a high-fat, high-protein, and low-carbohydrate diet. It involves reducing your daily carb intake to around 20 to 50 grams, which causes your body to enter a state of ketosis. In ketosis, the body burns fat for fuel instead of carbohydrates. While this diet has become popular for its weight loss and health benefits, it can also lead to some unpleasant side effects, including dehydration.

Transitioning to a keto diet means moving from using glycogen and carbs as an energy source to burning fat and ketones. This shift causes dehydration for two main reasons:

• Glycogen, the stored form of carbohydrates, binds to water in the body. When you reduce your carb intake, your body's glycogen levels drop, leading to water excretion.
• High-carb diets are associated with high insulin levels, which cause water retention by inhibiting sodium excretion. The keto diet lowers insulin levels, allowing excess fluid to be released.

As a result of these two factors, you may experience dehydration, which can manifest as stomach pain, headaches, lethargy, nausea, brain fog, and low motivation.

To combat dehydration and its associated symptoms, it is crucial to increase your water intake. When you feel like you've had enough water, drink some more. This will help replenish the fluids lost due to the reduction in glycogen stores.

In addition to drinking more water, you can also:

• Add salt to your foods and drinks to replace lost electrolytes.
• Increase your fat intake to ensure you have enough energy during the transition.
• Be patient and give your body time to adjust to the new diet.
• Gradually introduce exogenous ketones instead of taking a full scoop right away.

By staying properly hydrated and following these practical and mental strategies, you can help alleviate the discomfort associated with dehydration on a keto diet.

Stomach pain and discomfort

There are several ways to help alleviate stomach pain and discomfort when starting a keto diet:

• Drink plenty of water. Dehydration is a common side effect of the keto diet, which can lead to stomach pain.
• Add salt to your food and drinks.
• Be patient and give your body time to adjust to the new diet.
• Eat more fat to ensure you don't lack energy during the transition.
• Slowly introduce exogenous ketones, rather than taking a full scoop immediately.
• Remind yourself why you are starting the keto diet and that the benefits will outweigh the initial side effects.
• Take probiotics to support your gut health.
• Reduce your consumption of MCT oil and sugar alcohols, as these can cause bloating and other digestive issues.
• Increase your fibre intake, especially from whole foods.
• Take a fibre supplement.

Diarrhea

Secondly, artificial sweeteners and sugar alcohols, often used to replace sugar in keto-friendly foods and drinks, are known to cause gastrointestinal distress and a laxative effect, resulting in diarrhea. Sugar alcohols such as xylitol, sorbitol, maltitol, and erythritol are common culprits.

Thirdly, consuming too much protein can also lead to diarrhea. A well-formulated keto diet should be high in fat and moderate in protein, but some people may be tempted to increase their protein intake while reducing carbohydrates. This imbalance can contribute to gastrointestinal issues, including diarrhea.

Additionally, some people may have an intolerance to dairy, which is often consumed in higher quantities on a keto diet. Dairy intolerance can lead to diarrhea, bloating, and gas.

To relieve diarrhea caused by the keto diet, it is recommended to:

• Stay hydrated by drinking water and sugar-free electrolyte beverages.
• Eat more fiber-rich foods such as greens, cucumbers, broccoli, and cabbage.
• Reduce dairy consumption.
• Gradually ease into the keto diet, rather than making sudden changes.
• Add probiotics and prebiotics through supplements or probiotic-rich foods like sauerkraut and kimchi.
• Reduce consumption of sugar substitutes.

If diarrhea is severe or persists for more than a week, it is recommended to consult a doctor. Chronic diarrhea can lead to health complications such as vitamin deficiencies, muscle deterioration, and electrolyte imbalance.

It is worth noting that there are many causes of diarrhea unrelated to the keto diet, so it is always a good idea to consult a healthcare professional if you have concerns.

Constipation

Decreased Fibre Intake: The keto diet restricts many high-fibre foods, such as whole grains, legumes, and some vegetables and fruits. Fibre is essential for colon health, as it adds bulk to the stool and helps the colon move things through more easily. A lack of fibre in the diet can lead to constipation.

Dehydration: The keto diet can be dehydrating because it reduces glycogen stores, and glycogen is stored with water. Additionally, the keto diet lowers insulin levels, which can lead to the release of excess fluid. Dehydration can contribute to constipation.

Gut Flora Imbalance: The keto diet involves a significant change in the types of foods consumed, which can disrupt the balance of gut bacteria. This imbalance can lead to an overgrowth of bad bacteria, which is a known trigger for bloating and constipation.

Food Intolerances: The keto diet introduces many new foods, and some people may be intolerant to certain keto-friendly foods, such as artificial sweeteners or high FODMAP foods like cauliflower, broccoli, and onions. Food intolerances can cause digestive issues, including constipation.

Electrolyte Imbalance: The keto diet can lead to an electrolyte imbalance, particularly a deficiency in magnesium, which is important for bowel function.

• Increase Fibre Intake: Focus on high-fibre, keto-friendly foods such as non-starchy vegetables (e.g., broccoli, artichokes, collard greens), avocado, and nuts.
• Fermented Foods: Include fermented foods like sauerkraut and kimchi, which contain natural probiotics to support gut health.
• Probiotics and Prebiotics: Consider taking a probiotic or prebiotic supplement to support digestive health and promote the growth of good bacteria.
• Drink More Water: Adequate water intake is crucial for preventing constipation. Aim for 91 ounces of total fluid intake per day for women and 125 ounces for men, including water and other beverages.
• Mineral Water: Choose mineral-rich waters, especially those with magnesium, as this can help soften stools and improve constipation without the risk of diarrhoea.
• Reduce Coconut Products and MCTs: Coconut oil and other medium-chain triglycerides (MCTs) are common on the keto diet but can cause abdominal cramps and diarrhoea, especially if you're not used to them. Try easing up on these and slowly reintroducing them.
• Laxatives: If needed, speak to your doctor about using a short-term laxative or stool softener to relieve constipation.

Remember, it's important to listen to your body and make adjustments as needed. If constipation persists or becomes severe, consult your healthcare provider for personalised advice.

The keto flu

The "keto flu" is a collection of symptoms that some people experience when they start a ketogenic diet. The ketogenic diet is very low in carbohydrates, high in fat, and moderate in protein. This drastic reduction in carbohydrates can be a shock to the body, and may cause withdrawal-like symptoms, similar to those experienced when quitting an addictive substance.

• Stomach or intestinal pain
• Diarrhea
• Fatigue
• Muscle soreness
• Cravings
• Nausea
• Dizziness
• Cramping
• Irritability
• Trouble sleeping
• Poor focus and concentration
• Brain fog
• Headaches
• Constipation

These symptoms can range from mild to severe and can last from a few days to several weeks, or even a month in extreme cases.

• Drink plenty of water to stay hydrated. The keto diet can cause a rapid loss of water stores, increasing the risk of dehydration.
• Replace electrolytes by salting your food to taste and including potassium-rich, keto-friendly foods like leafy greens and avocados.
• Get enough rest and improve your sleep hygiene by reducing caffeine intake and creating a dark, relaxing environment in your bedroom.
• Avoid strenuous exercise and opt for light activities like walking, yoga, or leisurely biking instead.
• Eat enough fat, the primary fuel source on the ketogenic diet, to reduce cravings and keep you feeling satisfied.
• Cut out carbs slowly over time, rather than all at once.

Frequently asked questions