Keto Diarrhea – Understand Causes, Treatment and Prevention Options

In the last few years we’ve seen a popularity surge in the ketogenic diet. The keto diet is focused on eating meals with high amounts of good fat (75%), medium protein (20%) and a very low carb content (5%). Keto is however not without its side effects especially in the early days of the diet when the digestive system is adapting to this new way of healthy eating.

One of these side effects is keto diarrhea. Whether you’re already on this eating plan and experiencing diarrhea or preparing yourself before fully going keto, you will find this article useful with essential tips. We’ll discuss the causes of keto diarrhea, remedies and prevention.

One other common side effect you may want to know about is keto constipation which we discussed in the linked article.

What Causes Keto Diarrhea?

Here are the factors that can cause digestive issues on the keto diet.

Higher Fat Intake

The keto diet is a massive shift from your Standard American Diet (SAD). Even if you’ve been on other low-carb diets before, the keto diet is a little different in terms of the macro nutrients. The high fat intake of keto may be the only reason why you’re experiencing trouble with your digestive system especially bowel movements.

You body will require time to adjust how it processes food especially so much fat. Bile is the substance produced by your gallbladder to break down fat. It’s likely that you’re pushing down a lot of processed fat much faster than normal. This will cause you to poop a lot on keto than normal.

Give it some time and your diarrhea as a result of switching to keto, should subside or stop within a couple of weeks.

Changes in Your Microbiome

Whenever you change your diet, this affects the composition of your gut bacteria. Diet changes also affect your digestive tract health and certainly affects your poop either hard or watery as in diarrhea. Starting a ketogenic diet plan also leads to effects on your microbiome.

However, there’s some great news. One study found that over a period of 5-6 months, keto dieters have much more diverse microbiome in the colon. The more diverse the good gut bacteria in your GI tract, the better. So if you’re having bathroom issues such as diarrhea in the early stages of the diet, in the long-term, your digestive system will be thanking you for embracing keto.

Diarrhea as Part of Keto Flu Symptoms

“Keto flu” is the flu-like symptoms you experience especially in the early stages of the going keto. The signs include headaches, fatigue, nausea and loss of appetite, and diarrhea. One of the questions people ask is whether diarrhea is a symptom of keto flu? The answer is yes but not always.

When you experience any of these signs along with the loose stools, it’s important to stay hydrated as much as possible. Take in as much electrolytes as possible to ensure you don’t become dehydrated. The initial side effects of keto are unpleasant but the health benefits far outweigh the discomfort.

Other Less Obvious Causes of Keto Diarrhea

The main culprits of ketosis diarrhea in our discussion has been that your digestive system is adjusting to your new eating. However, there are other less obvious causes of keto diarrhea. These are not discussed as much but you need to be aware so you can have a happy GI system.

Sugar Alcohols

Anyone who’s been on this low carb keto diet knows that natural sugars can quickly give excessive carbs than your allowed daily net carbs. Added sugar is not just bad for your gastrointestinal health but your overall well being.

To fix this sugar problem, many keto recipes, eating plans and products resort to sugar alcohols and other artificial sweeteners as substitutes to help balance your net carbs. But not many people’s GI tract is used to these sugar substitutes.

Sugar substitutes such as xylitol, sorbitol and maltitol are difficult for the human gut to digest and absorb. As such they would usually reach the latter part of the digestive tract not being completely broken down. At this point they have a laxative effect and usually cause diarrhea.

If keto diarrhea is happening, look at how much of these sugar alcohols you’re consuming and start to cut down, if you cannot completely avoid them. Maltitol for example has the other negative effect of raising your blood sugar levels. Make sure you’re aware of what you’re consuming.

Lactose Intolerance

Many people have lactose intolerance. I do. A lot of keto recipes employ diary as one of the main ingredients to add the fat. If you don’t have lactose intolerance then this is not a problem at all. One of the primary symptoms of lactose intolerance is diarrhea.

If you experience diarrhea on keto as a result of increased diary intake, it may be that you have an allergy which you want to get tested for. Or you can eliminate it if possible.

Incorrect Macros Ratios

A proper ketogenic diet is a low-carb high-fat diet with moderate protein. Many beginner keto dieters fail to get the ratios right, eating a way more proteins than fats. Eating a high protein diet on keto can not only cause diarrhea but will certainly prevent the body from entering into ketosis.

It is essential that you consume your macros in the correct ratios to prevent keto diarrhea especially in the early days of going keto. If you’re not sure how to start the keto diet properly, subscribe to a paid service so that you can have a proper meal plan and eat the right foods in the right amounts.

Too Much Magnesium

If you’re new to the keto diet, you’re more than likely to experience electrolyte imbalance. This happens as your body flushes out stored water weight and acclimatizes to use fats as your energy source. As more water weight is removed a lot of electrolytes including magnesium get eliminated too.

To resolve this side effect of the keto diet, many people resort to supplement magnesium intake to balance their electrolyte supply. Unfortunately, magnesium increases stool frequency, the exact opposite effect of what diarrhea sufferers want.

To naturally fix the problem, stop magnesium supplement intake and get your daily allowance through your diet.

Steps to Stop Keto Diarrhea

Now you know the possible source of what ails your GI system. But what steps can you take to stop keto diarrhea? I’m glad you asked. There are as many options as the source and cause of the digestive problem. So determine the source of the diarrhea and try the appropriate remedy.

For microbiome imbalance, probiotic, keto-friendly foods are your best friend. Examples of these foods include sauerkraut, cultured yogurt and kefir. These probiotics will help improve the microbiome and reduce inflammation.

Stay hydrated to avoid additional complications. Loose stools can contribute a lot to dehydration. It’s important to consume as much water as possible.

Although not clinically proven, research shows that many people experience diarrhea (alongside other bowel problems) when they consume raw vegetables. Avoid raw veggies and see if it will stop keto diarrhea.

Reduce caffeine intake. It’s proven that caffeine is something that speeds up gastrointestinal activity. Take as less of it as you can as your body adjust its processes.

Reduce coconut oil and MCT oil intake. These are known to throw your GI system out of whack. Cut back on these until diarrhea subsides.

Taking digestive enzymes can help speed up diarrhea reversal and help your GI tract to return to its normal levels of operation.

Steps to Prevent Diarrhea on Keto

The addition on bone broth to your diet is a great way to support the health of your digestive tract.

If the macros ratios are incorrect, increase the amount of healthy fats in the diet. Good healthy fats sources include avocado and olive oil.

Make sure that probiotics are being consumed as part of your diet.

As part of your overall keto nutrition and eating plan, ensure you’re getting adequate amounts of vegetables. A lot of your dietary fiber intake would come from veggies, so look out for low carb options to ensure you still with the limits of your daily net carbs.

Watch the amounts of your diary intake per day. Overloading on diary means more likelihood to getting diarrhea.

Be on the lookout for the amount of sugar alcohols substitutes. These include sorbitol, xylitol and maltitol (maltitol in particular being linked to raising blood sugar levels).

They may not seem much but these little adjustments would go a long way in getting you feeling better in the early days and cutting down on the unpleasant keto diet side effects.

Other Keto Diet Digestive Tract Issues

This article will be incomplete without mention of other poop related side effects of keto diet. Besides diarrhea, the other most common issue is ketosis constipation. You might or may not experience it at all. Constipation on keto diet is largely attributed to insufficient dietary fiber intake.

However, it may not always be the case. Read our article that fully discusses the topic.

With that said, it makes complete sense to blame being constipated on the keto diet on the reduced fiber intake in this high fat diet low-carb diet. It’s common that you will have low amounts of fiber in your diet when you’re switching from our standard diet to keto.

Most people already aren’t getting enough fiber in their foods. The 15 percent of the recommended daily fiber consumption that the average American gets is already in jeopardy when you get into keto. So it’s easy understand why keto dieters may experience constipation.

Once your body gets adjusted to the amount of fiber that comes from macros, you should be fine.

If you get constipated, you may try fiber supplements to see if it helps. The recommendation is that you get your fiber from vegetables such as broccoli, flax seed, bell peppers and leafy green vegetables so you can sustain the new lifestyle for the long haul.

It’s also important to make small changes over time instead.

Conclusion

It’s clinically proven that the keto diet is an effective low-carb weight loss solution that will lead to a healthy lifestyle in the long run. There’s plenty of great things to look forward to that will help motivate you past the initial bathroom blues.

However, if you continue to experience diarrhea whilst on keto after following the above mentioned remedy tips, it’s advisable to stop the diet altogether and speak to your doctor. Our digestive tracts may react differently. Your doctor will be able to work with you to find a healthy meal plan that works with your body.