Keto and IBS: Might It Help?


There has been a lot of attention in the media about ketogenic diets recently with respect to weight loss, blood sugar management, athletic performance, heart disease prevention, other various health conditions in the human body and even Irritable Bowel Syndrome (IBS). If you suffer from IBS symptoms, you may have heard about keto and wanted to know more about it to understand if adopting it may help you with those symptoms, in addition to its other touted health benefits.

Can a Ketogenic Diet Help Your IBS? As popular as the Ketogenic diet is, a lot of people are not aware of whether it may be helpful for people suffering from irritable bowel syndrome (IBS).

What is IBS? — Irritable Bowel Syndrome is a very common disorder that significantly affects the large intestine due to a flow-on effect of carbohydrates being poorly absorbed in the small intestine. IBS symptoms vary. They include; bloating, cramping, abdominal pain, gas, diarrhea or constipation, and in some cases both.

IBS is quite common but only a small number of people suffering from IBS actually have severe signs and symptoms. The truth is some people can manage to control their symptoms by improving their lifestyle, avoiding stress, and partaking in certain diets such as a low carb diet for IBS. A common treatment for IBS is a low FODMAP diet, which limits the short-chain, fermentable carbs consumed so as not to over-feed the wrong gut bacteria with high FODMAP foods.

Causes Of IBS

The exact cause of IBS is not known. However, there are a few factors that seem to play a role. Some of these factors include:

Muscle contractions in the intestine

The walls of the intestines are lined with layers of muscle that contract as they move food through your digestive tract. Contractions that are stronger and last longer than normal can cause gas, bloating and diarrhea. Weak intestinal contractions can slow food passage and lead to hard, dry stools.

Nervous system

Abnormalities in the nerves in your digestive system may cause you to experience greater than normal discomfort when your abdomen stretches from gas or stool. Poorly coordinated signals between the brain and the intestines can cause your body to overreact to changes that normally occur in the digestive process, resulting in pain, diarrhea or constipation.

Inflammation in the intestines

Some people with IBS have an increased number of immune-system cells in their intestines. This immune system response is associated with pain and diarrhea.

Severe infection

IBS can develop after a severe bout of diarrhea (gastroenteritis) caused by bacteria or a virus. IBS might also be associated with a surplus of bacteria in the intestines (bacterial overgrowth).

Changes in gut bacteria (gut microbiota)

Microflora are made up of both good and bad bacteria that reside in the intestines and play a key role in health – both positive and negative, depending on the balance of the different types. Research indicates that the balance microflora in people with IBS might differ from microflora in healthy people. The role of FODMAP (fermentable carbs) is key to this balance of gut microflora.

Can The Ketogenic Diet Assist With IBS?

Based on some core principles, the keto diet may be of some assistance to those suffering from IBS but very little specific research has actually looked into the benefits of the keto diet for IBS. However, some studies have shown some positive results of how patients who were put on the keto diet saw improvements in their IBS symptoms.

Keto Is Low Carbohydrate And Low FODMAP

While there is no standardized versions of the modern keto diet, one of the key principles of the ketogenic diet is that it is low carb. The results in a naturally lower intake of the problematic fermentable carbs that cause so much trouble to those with IBS.

Because a ketogenic diet is one of carbohydrate restriction, this reduces the total load of fermentable carbohydrates (FODMAPS) that can cause such symptoms, the reduction in carbohydrates from such a diet can help temporarily ease gut issues such as gas, bloating, abdominal pain, as well as diarrhea or constipation.

In terms of evidence based research, one study found that IBS patients who suffer mainly from diarrhea (IBS-D) experienced symptomatic improvement after going on a very low-carbohydrate diet ( keto diet). These patients experienced improved stool consistency, reduced abdominal pain and improved quality of life.

So the low carb nature of the keto diet may be useful in some situations, but an important question is is there elements of the keto diets that could make someone’s IBS worse?

In some cases, the effect of the diet can actually worsen the symptoms of IBS. This potential worsening comes down to two main elements of a typical keto diet:

  • A tendency to low fiber leves due to the overall low carbohydrate intake.
  • High fat intake which can cause issues with gut microbiota health and over secretion of cholecystokinin (CCK).

This ketogenic diet constipation can lead to sharp stomach pain and lots of irregular bowel movements. The connection between the ketogenic diet and constipation is outlined in the next section.

Ketogenic Diet Constipation

Partaking in a low carb diet like the keto diet in itself will not make you constipated. A low carb diet like the ketogenic diet can still very much supply enough fiber, fluids, and necessary probiotics that help with normal bowel movements.

However, one of the side effects of following a Keto diet is that is sometimes makes meeting one’s fiber intake tends a bit more difficult because it excludes many fiber-rich foods like legumes, whole grains, fruits, and vegetables.

Consuming 25-35 grams of fiber per day – the daily recommended intake on a typical ketogenic diet is very challenging. Without sufficient fiber, it would very likely worsen symptoms for those with IBS-C and putting those with additional gut dysfunction at risk.

Also, low carb diets like the keto diet can lead to an unstable gut flora due to higher fat intake over the long term. Another issue with the keto diet is the popularly know sickness called the keto flu. It is not a sickness or flu, just a common side effect of going low carb. This set of flu-like symptoms usually happens during the induction phase ( ketosis week one) of a ketogenic diet and includes headaches, fatigue, muscle cramping, brain fog, nausea, and keto bloating and constipation.

The keto flu occurs as a result of the strong diuretic effect of the keto diet during the first weeks, which means you tend to urinate more. With this increased urine output, you also tend to lose electrolytes, and this increases your risk of dehydration, and dehydration often leads to, as you expected, constipation.

Keto Constipation Relief

If you’re looking for keto diet constipation help, then you would need to get to the root cause. This is the kind of situation where getting professional help from dietitians can be valuable. It is advisable you check with your doctor to see if there is any post that an underlying health condition is contributing to your keto constipation. However, anything other than that, this few steps below should help you actualize some keto diet constipation relief;

Adequate Fiber Intake

Taking the right amount of fiber and drinking the proper amount of fluids can impact great difference on your digestive health. Some current guidelines recommend 25 to 30 grams of fiber per day, with particular emphasis on soluble fiber. When on a keto diet you can get plenty of sustainable fiber from avocado, almonds, coconut flour, broccoli, celery stalks, flaxseed, etc. You can also support these with fiber supplements from your local pharmacy.

Eat More and Stay Hydrated

As good as a lower calorie intake is for your weight loss goal, you don’t want to go overboard. A simple calorie reduction of 300-500 kcal/day is all you need to initiate fat burning ( light ketosis) on a keto diet. When on the keto diet, you need to make sure you are getting in enough nutrients to maintain, good health and obviously regular bowel movements.

Stay Active

Some studies have shown that one of the most common causes of severe constipation amongst adults is as a result of inactivity. Not being active enough reduces blood flow to your GI tract, thereby slowing down digestion. While physical activity, on the other hand, stimulates the digestive tract. This clearly explains why when you are inactive and bedridden it tends to lead to constipation, and why when you exercising often you feel an intense urge to pass out poop.

Current research recommends 150 minutes of moderate aerobic activity every week for optimal health and regular bowel movements. But you don’t have to limit yourself to aerobics. Any type of activity that gets your heart pumping and your muscles working will do just fine. This may include weight lifting, yoga, and high-intensity training.

Remove All Allergens

Many people who are active keto dieters can testify that limiting dairy products consumption such as ice cream can help with keto constipation. This is possible because research shows a strong link between cow milk allergies and severe constipation. Milk allergies tend to lead to inflammation in the intestines which prevents normal bowel functioning. Also, aside from milk, there are other common allergens inside foods like soy, seafood, eggs, and peanuts. Note that many of these foods are high in protein, which makes sense given that a good allergy is, by definition, an adverse reaction to food proteins.

Probiotic Supplements

Naturally, probiotics are live bacteria and yeast found in fermented food. However, they can be sold as supplements for those who need them. Some excellent sources of this probiotic are sauerkraut, miso, and cultured yogurt. Mixing fiber-rich sources with fermented foods can cause elk boos probiotic survival in the gut. One large systematic review found that probiotic balance gut microflora and help normalize bowel functioning. The most common probiotic strains studied are Lactobacillus and Bifidobacterium.

Treating the Keto Flu

The popular keto flu is typical for keto dieters. Although the keto flu is short-lived, it can still be very uncomfortable. That’s why to experience some keto constipation relief, you should drink enough fluids, take electrolytes supplements and rest adequately.

Proper Diet For IBS

Fiber Diet

Consuming fiber helps add bulk to your stool, which will in turn help in proper bowel movements. According to research, it is expected that the average adult should eat between 20 – 25 grams of fiber a day. However, research estimates show people only eat between 5 – 14 a day.

Gluten-Free Diet

As you probably already know, gluten is a protein found in grain products such as bread and pasta. This protein can damage the intestines in people who are gluten-intolerant. The most severe form of this is when people have celiac disease. Some people with a sensitivity or high intolerance for gluten tend to experience IBS. In this way, foods containing gluten are one of the key trigger foods for those with IBS. In such cases, a gluten-free diet may reduce symptoms.

There are more diets available that can help people with IBS, but everyone is different. So, take note of your symptoms and consult a doctor before starting a new diet. Carefully evaluate the way your body reacts to various diets, as you may need to tweak the foods you eat. You should also consult a medical professional such as a doctor or a registered dietitian who specializes in IBS if your symptoms are severe enough.

Good luck and all the best!

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