Upset Stomach When Starting Keto: What's Normal?

The ketogenic diet is a popular way to lose weight and improve health. However, it can cause some unpleasant side effects, including an upset stomach. This is often referred to as the keto flu and is caused by the body adapting to a new diet consisting of very few carbohydrates. The transition to a high-fat, very low-carb diet can be a shock to the body and may cause withdrawal-like symptoms.

The keto flu includes symptoms such as fatigue, muscle soreness, and cravings, as well as gastrointestinal issues. These GI problems can include diarrhea, constipation, nausea, and bloating.

There are several ways to relieve these symptoms, including drinking plenty of water, adding more fiber to the diet, and slowly easing into the keto diet. However, if symptoms are severe or persist for a long time, it is recommended to consult a doctor.

The keto diet can cause stomach pain due to dehydration

The keto diet is a very low-carb, high-fat, and moderate-protein diet. While it is considered safe for most people, it can cause some unpleasant side effects, including stomach pain. One of the main reasons for this is dehydration.

The keto diet can be dehydrating because it involves a significant reduction in carbohydrate intake. Carbohydrates are usually stored with water in the form of glycogen, so when you cut down on carbs, your body loses water. Additionally, high-carb diets are associated with higher insulin levels, which cause water retention. When you switch to a keto diet, insulin levels drop, and excess fluid is released from the body.

To combat dehydration, it is crucial to drink plenty of water and stay hydrated. It is also important to replace lost fluids if you experience diarrhea, which is a common side effect of the keto diet.

Other symptoms of dehydration may include headaches, lethargy, nausea, brain fog, and low motivation. To alleviate these symptoms, it is recommended to increase your intake of water and salt, consume more fat, and give your body time to adjust to the new diet.

It is worth noting that dehydration is not the only possible cause of stomach pain when starting the keto diet. Other factors include the high-fat content of the diet, artificial sweeteners, and changes to the gut microbiome. However, dehydration is a key factor that should not be overlooked.

If you experience persistent or severe symptoms, it is important to consult a healthcare professional.

The keto diet can lead to diarrhoea

The keto diet is a popular, effective way to lose weight. It is a very low-carb, high-fat, and moderate-protein diet. The diet works by sending your body into ketosis, where it burns fat instead of glucose for energy.

However, as with any extreme dietary change, the keto diet can have an effect on your stomach and intestines, causing gastrointestinal (GI) problems. One of the most common side effects is diarrhoea, also known as "keto diarrhoea".

There are several reasons why the keto diet can lead to diarrhoea:

• Fat is hard to digest: The keto diet includes a lot of fat, and fat takes longer for the body to digest. Some people's bodies aren't accustomed to metabolising large amounts of fat, so they try to expel it, resulting in diarrhoea.
• Artificial sweeteners and sugar alcohols: Many people on the keto diet consume artificial sweeteners and sugar alcohols to limit carbs. These sweeteners are not effectively absorbed in the gut, so they can have a laxative effect, leading to diarrhoea.
• Gut microbiome disruption: The keto diet can impact the composition of your gut microbiome, which has implications for digestion. Some studies have found that the keto diet can cause changes in gut bacteria, leading to diarrhoea and looser stools.
• Excessive dairy consumption: Dairy is high in fat, so people starting the keto diet may consume more of it. This can lead to the discovery of an underlying dairy intolerance, with diarrhoea as a common symptom.
• Laxative effect of bile: To break down fat, the liver produces bile, which has a natural laxative effect. On a high-fat diet, the liver releases extra bile, which can push waste through the digestive tract more quickly, leading to diarrhoea.

Keto diarrhoea is usually temporary and will resolve as your body adjusts to the new diet. However, if it persists or is severe, it is important to consult a doctor, as chronic diarrhoea can lead to health complications such as vitamin deficiencies and electrolyte imbalance.

To help relieve keto diarrhoea, you can try the following:

• Add more fibre to your diet: Fibre can help calm diarrhoea, and foods like citrus, berries, avocado, broccoli, and chia seeds are suitable sources on the keto diet.
• Drink more water and electrolytes: Diarrhoea can lead to fluid loss, so it is important to stay hydrated and replenish electrolytes.
• Reduce artificial sweeteners: Cutting back on artificial sweeteners and sugar substitutes may help relieve gastrointestinal symptoms.
• Eat fermented foods: Eating fermented foods like sauerkraut and kimchi can improve digestion and reduce diarrhoea.
• Ease into the diet: Instead of making a sudden change, slowly reduce carbs and increase fats to help your body adapt better.

While the keto diet can be an effective way to lose weight, it is important to be aware of potential side effects like diarrhoea and take steps to manage them. If symptoms persist or are severe, it is best to consult a healthcare professional.

Artificial sweeteners and sugar alcohols can be rough on the stomach

Artificial sweeteners and sugar alcohols can cause bloating and diarrhea when consumed in excess. This is because they are not effectively absorbed in the gut and often reach the large intestine undigested, resulting in an unpleasant laxative effect. Sugar alcohols, such as sorbitol, maltitol, and xylitol, are commonly found in sugar-free and low-carb products, and have been known to cause gastrointestinal distress.

People on the keto diet often turn to artificial sweeteners and sugar alcohols as low-carb alternatives to satisfy their sweet tooth. However, consuming large amounts of these sweeteners can lead to digestive issues.

Additionally, the keto diet itself can impact the composition of the gut microbiome, which has implications for digestion. While more research is needed, some studies suggest that the keto diet may cause changes in gut bacteria, leading to diarrhea and looser stools due to poor digestion.

Therefore, it is important for those following the keto diet to be mindful of their consumption of artificial sweeteners and sugar alcohols. Reducing the intake of these sweeteners may help alleviate gastrointestinal symptoms.

The keto diet can disrupt the gut microbiome

The gut microbiome refers to the bacteria, archaea, and eukaryotes residing in the gastrointestinal tract. The majority of these colonize the colon, with bacterial numbers estimated at 3.8 x 10^13. The gut microbiota is predominantly made up of two phyla, Bacteroidetes and Firmicutes, with Actinobacteria, Proteobacteria, and Verrucomicrobia present in smaller proportions.

The extreme macronutrient profile of the ketogenic diet instigates compositional shifts in the gut's microbial community. The diet is very low in carbohydrates, high in fat, and moderate in protein. This reduction in carbohydrates reduces bacterial abundances. Carbohydrates are classified as either digestible or non-digestible, with the latter reaching the colon in large quantities for fermentation. Non-digestible carbohydrates have variable and complex impacts on the gut microbiome depending on their type.

The ketogenic diet can also reduce the abundance of key Firmicutes butyrate-producing bacteria, which are considered beneficial to colonic health. Butyrate is the primary energy source for colonocytes and supports intestinal barrier structure and function. It also protects from external harm by facilitating epithelial tight-junction assembly, stimulating mucin production, and inhibiting pathogenic bacterial adhesion.

The ketogenic diet can also reduce the abundance of Bifidobacterium, which is important for colonic health, intestinal barrier function, and facilitating a healthy microbial composition. Bifidobacterium is a prolific GABA producer, and its metabolites have direct benefits. Certain strains produce conjugated linoleic acid, which is anti-inflammatory and inhibits colon cancer cell growth and proliferation.

The reduction in Bifidobacterium may be due to the reduced non-digestible carbohydrate intake of a ketogenic diet. Bifidobacterium strictly metabolises carbohydrate substrates as its energy source. In addition, ketones produced by the diet may directly inhibit Bifidobacterium growth.

The reduction in Bifidobacterium may have additional detrimental impacts, with obesity, type-2 diabetes, and depression as key risks.

The keto diet can cause constipation

The keto diet can also lead to other gastrointestinal symptoms, such as nausea and bloating. This is due to the high fat and low carb content of the diet. The transition to a high-fat, very low-carb diet can be a struggle for some people, and their bodies may need time to adapt to this new way of eating.

There are some practical steps that can be taken to relieve constipation caused by the keto diet. These include:

• Drinking plenty of water
• Adding salt to foods and drinks
• Eating more fat
• Eating more fibre-rich foods such as greens, cucumber, broccoli, and cabbage
• Eating less dairy
• Taking a probiotic supplement or eating more probiotic-rich foods
• Easing into the diet by slowly reducing carbs and increasing fats

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