Keto Diet 101: Bowel Trouble. Too Fast or Too Slow

Transition your eating from Standard American Diet to Keto and you can find POO the focus of your conversation. Some patients have their stools slow WAY down, Others find that every time they eat a high-fat meal, they have a date with the toilet. BOWELS:  TOO SLOW [CONSTIPATION] THIS PROBLEM AFFECTS PATIENTS: on day 3-4 THIS PROBLEM LASTS UNTIL: your bowels adapt to your new diet. Drinking salted water prevents the keto flu and also helps with changes happening in your guts. I’m referring specifically to your stool. Constipation and hard bowel movements occur naturally as part of the keto transition process. With less water, your stools become dehydrated and harder. Drinking salty water helps lessen this problem.   For the first couple of weeks, patients struggle with what to eat. My salesmanship for high-fat meat must work very well because they do a great job of loading up on fatty, greasy meat. They produce ketones, but they also get constipated. A few minutes studying the number of carbs found in fruits and vegetables teach you that corn, cantaloupe, peas, bananas, and are all no-nos.    My new keto patients usually aren’t that familiar with many keto-friendly vegetables. For example, cabbage, Brussels sprouts, and fresh spinach are all great additions to a keto diet. Sadly, many patients look at me bewildered that others actually eat that stuff. They ate yummy fatty meats, successfully peed ketones and did a little dance. Everything’s awesome until day 4 when they couldn’t poop.  Some patients got so constipated they gave up. Be prepared for this constipation challenge. Drink salt water.  Add cabbage early. Ingest a spoonful of dry chia seeds with some water every 2-4 hours.  These little seeds swell up into a gelatinous substance and have helped many patients transition. This trick is tried and tested. One tablespoon every 2 hours followed by two cups of water has yet to fail my patients with this problem. Several said they could not keep up with the spoonful of seeds that often and only made it to six tablespoons before they quit. However, the next day: success!! If you’re still having a tough time with constipation, try Milk of Magnesia. This over-the-counter medication is the perfect fit for this problem. In the first weeks of keto, magnesium is the most common salt your body will lose. This magnesium-filled liquid medication helps replenish your missing magnesium while boosting your stools to soften up and move along. BOWELS:  TOO FAST [DIARRHEA] THIS PROBLEM AFFECTS PATIENTS: on day 3-4 THIS PROBLEM LASTS UNTIL: we figure out the cause of the loose stools.   Most people on a keto program experience bowel problems in the form of constipation. Sometimes, people experience the other extreme: diarrhea. This is usually due to a pre-existing problem with their system.   Over the years, the US government and corporations have spent millions of dollars researching ways to help people suffering from all sorts of bowel ailments. These range from irritable bowel to bacterial overgrowth, to leaky gut syndrome. One 1970s study treated irritable bowel syndrome with a high-fat diet. It took six months for the study’s subjects to become regular. Still, the study showed that a high-fat low-carb diet is one of the cheapest and most effective ways to regulate runny stools and other bowel problems. Unfortunately, the study was small and was not funded by a big pharmaceutical company. The study did not promote any medication. The outcomes from that old trial were so promising for this taxing problem that it led me to change how I approached my patients with bowel problems. My experience with patients suffering from irritable bowel has taught me to stick to the plan of peeing ketones for three to four months before they turn the corner. Did you know your small bowel or small intestines are supposed to be sterile? Sterile-as in no bacteria. Your large intestines are packed with bacteria. But your small intestines are supposed to be sterile. Anxiety, stress and chronic illness all lead to poorly functioning bowels. Your small intestines can get so messed up that the bacteria normally found at the end of your intestines, in the large colon, wiggle their way into the upper portion of your digestive tract. The bacteria in the small intestine reproduce without much resistance and grow rapidly. This is called small bowel overgrowth.   When patients have small bowel overgrowth, it is not uncommon for them to lose out on fatty vitamins normally absorbed there. Because their small bowel gurgles with abundant, unwanted bacteria, they can’t absorb any fat-based nutrients. I’ve started patients on a ketogenic lifestyle not knowing that they had small bowel overgrowth. A week into the change and they are miserable with uncontrolled diarrhea. They call the clinic upset and declare, “This just is NOT the diet for me!” After checking their lab results as well as a detailed history, it turns out they often have had loose stools after eating fat for the better part of a decade. These patients report avoiding all fat because it always gives them explosive diarrhea. Such eruptions after each greasy meal kept them malnourished from their avoidance of fat. They go on for years without understanding what was truly happening to their system. One day, they happen to have their Vitamin D checked. Their results were so low that it could only mean they have not been absorbing any fat for years. Fat absorption failure means you absorb no fat-based vitamins. Vitamin D is one of those vitamins. I advise patients of mine who suffer diarrhea after switching to a high-fat diet not to give up. Why? They need this anti-inflammatory diet more than most of my other patients. If you suffer from loose stools or explosive diarrhea after going keto, give your body time to adjust. Don’t give up! Your bowel has grown used to the low-fat life you used to lead.  The mechanism to absorb fats has been sleepy or even shut down altogether. … Continue reading Keto Diet 101: Bowel Trouble. Too Fast or Too Slow