Keto involves drastically cutting back on carbs and increasing your fat and protein intake. It's not a huge surprise if you're following the keto diet and your bowel movements become infrequent. The diet is void of fiber-rich foods that help keep you regular—resulting in keto constipation.
Thankfully, there are ways to follow the keto diet—like drinking enough water and adding more fiber-rich foods that are low-carb—to reduce constipation. Here's more about the causes of keto constipation, tips for treating and preventing it, and when to see a healthcare provider.
People may experience keto constipation for a few reasons. The keto diet is typically low in fiber, but individuals following the diet may consume more dairy and drink less water occasionally. The combination of these factors can lead to constipation.
1. Low-Fiber Diet
Keto is lean on carbs—under 50 grams (g) a day to be precise. Instead, it consists mainly of fats and protein. Therefore, you run the risk of under-consuming fiber-rich foods.
Consuming fiber is important. Soluble fiber works by absorbing water and encouraging the movement of food through your digestive tract. Insoluble fiber, on the other hand, acts as a bulking agent.
Reducing your fiber intake may also alter your intestinal microbiota, which is partly responsible for the breakdown of food. This lack of fiber means up to 50% of people following a keto diet will experience constipation at some point.
2. An Increase in Dairy
Dairy lovers may enjoy keto for its inclusion of cheeses, yogurts, and creams, which are hefty fats and protein sources. Due to its lactose (the type of sugar in milk) content, dairy is a common reason for constipation. Lactose can be hard to digest for many people and can lead to bloating, gas, nausea, and constipation.
A 2020 study evaluating the effects of high-versus-low dairy consumption on gut microbiome found that people following a high dairy diet experienced a reduction in specific butyrate bacteria, a bacteria that’s produced when you break down and digest fiber, which helps keep you regular.
3. Reduced Water Intake
Drinking plenty of water is important for all bodily functions, including staying regular. With reduced consumption of fruits and vegetables, your water intake may decrease without you realizing it.
A sudden drop in your carb intake makes dehydration and an imbalance of electrolytes all the more prevalent on a keto diet. That’s because each gram of glycogen—the stored form of sugar that’s your body’s main source of energy and is found primarily in carbs—is stored alongside 3g of water within your muscles.
How to Treat It
Following a keto diet is extremely strict and can be very difficult to maintain. To stick with a keto diet and sidestep constipation, try the following:
1. Add More Dietary Fiber
Women should aim for around 25g of fiber daily, and men should aim for 38g of fiber daily. Luckily, there are a variety of keto-friendly, fibrous foods:
- A cup of cauliflower: 2.2g of fiber per 64g serving
- Sliced avocado: 6.7g of fiber per 100g serving
- A sprinkle of chopped almonds: 3.5g of fiber per 28.35g serving
2. Exercise
Research has found that being active can help keep you regular. Aerobic exercise in particular can improve constipation by encouraging your intestines to contract. A brisk daily walk, light jog, or high-intensity fitness class may help regulate your bowel movements.
3. Retrain Your Bowel
Reestablishing frequent bowel movements can eradicate bouts of constipation and improve stool consistency. Retraining your bowel may be as simple as drinking sufficient fluids and establishing a regular time for a toilet break.
Stimulation, such as a fiber supplement or a suppository, may also be required. Before turning to over-the-counter (OTC) medications, speak with your healthcare provider to learn if these products are right for you.
4. Increase Your Water Intake
Sufficient hydration is essential to rid your body of waste. Your recommended water intake will vary based on your sex, height, weight, and if you are pregnant or breastfeeding. As a rule of thumb, drink before thirst sets in and use the color of your urine as a hydration indicator. The darker it is, the more dehydrated you are.
5. Cut Back on Dairy
If you suspect dairy is causing your constipation, experiment with reducing or avoiding your intake. You can also consider swapping out dairy products for dairy-free alternatives.
Going on the keto diet can also result in other short-term side effects beyond keto constipation. Constipation, along with the following symptoms, is considered keto flu:
- Dizziness
- Fatigue
- Headache
- Low exercise tolerance
- Nausea and vomiting
How to Prevent Keto Constipation
While on the keto diet, many treatments for keto constipation can also serve as preventative measures. Other ways to prevent keto constipation include:
- Adding more high-fiber and low-carb foods permitted on keto—such as artichokes and blueberries
- Easing in by slowly introducing more fats and protein-rich foods, while cutting back on the carbs, if you're new to the diet
- Giving keto cycling a try to give your stomach time to adjust its digestion
Also, make sure you go to the restroom if you feel you have to go. By holding or restricting yourself from having a bowel movement, you can negatively affect how your muscles work, making it harder for bowel movements to happen.
It's recommended you speak to a healthcare provider before you try a new diet like keto. Speak with a healthcare provider if you're experiencing constipation but have already started on the diet. Ongoing stomach pain, bloating, gas, and even an anal fissure (a small tear in the lining of the anus) from excessive pushing are common complaints of constipation.
Chronic constipation can also impact your mental health. A 2020 study involving 240 patients with constipation-predominant irritable bowel syndrome (IBS) found almost a third showed symptoms of depression, more prevalent among women.
Additionally, the keto diet could cause low blood pressure, kidney stones, constipation, nutrient deficiencies, and an increased risk of heart disease. Following strict diets like keto could also cause social isolation or disordered eating. Keto is not safe for those with any conditions involving their pancreas, liver, thyroid, or gallbladder.
A Quick Review
Keto is a fad diet known for its potential weight loss effects. While keto may help you lose weight, it can also reduce the frequency of your bathroom visits, largely due to a lack of dietary fiber.You might also experience constipation because of more dairy intake and less water intake. Still, you can treat and prevent keto constipation in a number of ways, like staying hydrated and eating low-carb, high-fiber foods.
