Changing your diet can affect your bowel movements. If you’re starting a ketogenic diet, one of its potential side effects is constipation, along with weight loss and keto flu.
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Here’s everything you should know about keto constipation – why it happens when you go low carb, treatments, prevention tips, and when to seek professional help.
Why does the keto diet cause constipation?
Constipation usually occurs within the first few days of a keto diet and may last for weeks, depending on how quickly your body adapts to this eating method and your treatments to relieve it. Here are some of the reasons why you might get constipated.
1. Little dietary fiber
For someone on a high-carb diet, cutting back on carbohydrates can reduce fiber intake.That’s because fiber is most commonly found in carbohydrate sources such as whole grains, rice, pasta, potatoes, apples, and bananas (
Dietary fiber adds bulk to the stool and softens it, making it easier to pass. A meta-analysis showed that fiber increases stool frequency, making it a popular treatment for constipation
However, you may want to check out the high-carb plant foods you’ve been cutting out of your diet lately.
Also keep in mind that a low-carb diet shouldn’t be lacking in fiber. It’s important to make sure you find other sources of fiber that don’t raise your blood sugar levels.
You may find that you lose a lot of water at first when following the keto diet, which can lead to dehydration
A low-carb diet depletes glycogen stores and lowers insulin levels
Glycogen is the storage form of glucose, and each gram of glycogen is stored with at least 3 grams of water. Besides the rapid water weight loss that occurs when starting this new diet, you will experience frequent urination
Proper hydration is essential to ensure your body gets enough water to maintain normal bowel function
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This is especially important for those most prone to water loss such as athletes, people with active lifestyles (as a result of sweating), and the elderly (*, *).
3. Lack of physical activity
However, some people experience low energy levels when starting keto due to the sharp drop in carbohydrates. Keto flu symptoms like headache, nausea, and irritability can make you feel more tired than usual.
Especially when combined with factors like low fiber intake and dehydration, lack of movement can be a reason for not having a bowel movement on the keto diet.If your constipation persists for several weeks, you may want to consider other causes. In this case, you should see a doctor for further evaluation and medical advice.
How to treat ketogenic constipation
While you wait for your digestive system to adjust to your new diet (which it eventually does), try using at-home ketogenic constipation relief strategies.
How to treat ketogenic constipation
1. Add keto-friendly high-fiber foods to your meal plan Fiber is a type of carbohydrate that your body cannot break down during digestion. It is beneficial not only for your feeling of fullness when eating fewer calories, but also for your gut health.
As a treatment for ketogenic constipation, dietary fiber adds bulk to and softens stools and increases bowel movement (
In addition to relieving constipation, prebiotics (a type of fiber) act as food for good gut bacteria. Boosting beneficial bacteria can boost your immune system while also supporting weight loss
Examples of low-carb vegetables that contain prebiotics include asparagus, mushrooms, cabbage, peas, garlic, and onions. There are many keto recipes to try out for these options.
2. Eat snacks sweetened with sugar alcohols
Sugar alcohols, also known as polyols, are used to sweeten keto foods and drinks. You’ll also find it in a lot of keto-friendly products like protein bars, chocolate, and cookies.
Examples of polyols include sorbitol, mannitol, erythritol, and xylitol
. While these calories are low and unlikely to cause a spike in blood glucose (making them a great option for weight loss and blood sugar management) – they can cause diarrhea when eaten in large amounts (*, *).
Sugar alcohols can be used as a treatment for constipation due to its laxative effect. In this case, you may benefit from eating keto desserts sweetened with sugar alcohol.
However, if you have an intolerance to FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), it is best to avoid sugar alcohols, with the exception of erythritol. This is to avoid aggravation of digestive symptoms such as abdominal pain, bloating and flatulence
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3. Increase your water intake
Drinking more water can relieve symptoms of keto flu such as headache, nausea, fatigue and constipation caused by dehydration (*, *, *).
A clinical trial in 117 patients showed that increasing fluid intake to 1.5-2.0 liters per day plus eating a high-fiber diet increases stool frequency in people with chronic functional constipation.
If you are not sure if you should drink more water, check the color of your urine. Lemon juice (or light straws) should be colorless if you’re optimally hydrated. However, if it is dark yellow in color, it is good to drink
4. Add more fat to your diet
As a high-fat diet, you should be eating more fat on the keto diet. Dietary fats will act as an energy source, and healthy fats such as monounsaturated fats and omega-3 fatty acids reduce disease risk (*,*).
However, you may not be eating enough fat, especially if you are just starting out on the keto diet. Eating more fat can reduce constipation because fat triggers the release of bile to aid in digestion, and bile is a natural laxative.
Choose healthy fats like coconut oil, butter, animal fats (lard, tallow, tallow), fatty cuts of meat, olive oil, and avocado oil.
You may also have heard of medium-chain triglycerides (MCTs) that are commonly used as a fat source or supplement to reduce keto flu symptoms, increase ketosis, and promote weight loss (*,*). Consider mixing MCT oil, butter, and coffee to make Bulletproof Coffee.
5. Refrain from intermittent fasting nowIntermittent fasting (IF) involves alternating between eating and fasting. For example, fast for 16 hours and eat your meals within the remaining 8 hours.
Fasting is done for physical and mental benefits, including weight loss, memory improvement, and heart health
. Take a look at this guide to learn more about intermittent fasting for beginners.
While this is a common practice in the keto diet community (as it promotes ketosis and results), the downside is that it can lead to constipation.
. Possible causes include low fiber intake while eating and not getting enough water throughout the day.
If you’re already doing IF and you’re constipated, you may want to pause fasting until your bowel movements resume.
6. Incorporate exercise into your day
Research suggests that reducing sedentary behavior can help relieve constipation
. In other words, simply stirring more allows food to pass through the digestive system smoothly. There are a lot of exercises you can do while on the keto diet, such as light cardio (cycling, swimming, hiking), resistance exercises, and flexibility exercises (yoga or Pilates).
One helpful tip is to take a short walk after each meal. On top of improving digestion, walking after meals curbs blood sugar spikes to keep blood sugar levels in check and promote weight loss
How to prevent ketogenic constipation
Applying the strategies discussed earlier, such as adding low-carb fiber sources, hydration, adding dietary fats, and exercising can prevent constipation.
Another approach is to follow the keto diet gradually. Some people drastically cut carbs to get into ketosis, but you can take the slow route. While this won’t result in immediate ketosis, it does give your digestive system more time to adjust to your new diet.
When to Seek Professional Help for Constipation on Keto
Persistent constipation can lead to abdominal pain, bloating, and complications such as hemorrhoids, faecal impaction, and rectal prolapse, especially if it persists for weeks (
*). Be sure to check with your doctor. Your health professional may recommend a fiber supplement or laxative that does not contain carbohydrates.
Your doctor may also explore other causes of constipation that are not related to the keto diet, such as medications you are currently taking (if any) or a health condition.
Frequently Asked Questions About Constipation On Keto
Keto constipation may also result from dehydration (due to glycogen depletion and not staying hydrated) and lack of physical activity.
Is constipation a sign of ketosis? Constipation is one of the things that can happen while you’re in ketosis as a result of changing your diet. However, constipation should not be the basis for screening for ketosis. The best approach is to test for increased ketone levels in urine, breath, or blood. What helps with keto constipation? Simple home remedies such as eating low-carb, high-fiber foods, ensuring proper hydration, moving more, stopping intermittent fasting, increasing fat intake, and eating keto treats with sugar alcohols will relieve constipation. If you haven’t started the keto diet yet, consider doing it gradually to allow your digestive system to adjust and avoid constipation. Make an appointment with your healthcare provider if you still can’t have a bowel movement and experience unusual symptoms that you’re not sure about. How often should you have a bowel movement? On a keto diet? As a general rule, a normal bowel movement ranges from once a day to three times a week. This can vary from person to person and is affected by factors such as your activity level, age, illness or health condition, a change in your macros and certain medications.Is keto dangerous for your digestive health? There isn’t enough scientific evidence to prove that the keto diet is making a mess in your gut. Furthermore, maintaining a healthy gut while on keto requires eating a variety of foods that feed beneficial gut bacteria and avoiding offenders such as sugar and FODMAPs (if you are intolerant to FODMAPs). Constipation is a side effect of getting back on keto for the first time. This is the digestive system’s response to too few carbohydrates (which may be the primary source of fibre). It can also happen if you don’t drink enough water and move less because water and movement makes things move in your digestive system. And fat gain – you can avoid or relieve constipation in the first place. Make sure to speak with your doctor or health professional if constipation persists. Add more delicious dishes to your inbox Subscribe for new simple, easy, and insanely delicious keto recipes every week. Hey, you! We will send you delicious recipes once a week 🙂33 References