a person experiencing keto constipation

Can the Keto Diet Cause Constipation?

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Key Takeaways:

  • Constipation on the keto diet can result from reduced fiber, as well as changes in digestion.
  • Constipation might improve within a few days or weeks as the body adjusts.
  • Strategies for relief include adding keto-friendly fiber sources and exercising regularly.

Constipation can be a possible experience for people who are new to the ketogenic diet. It may arise due to changes in your eating habits, such as shifting your food choices and macronutrients from high-carb to low-carb. 

Experiencing constipation can be quite uncomfortable and may lead to additional symptoms such as bloating. If you’ve been dealing with constipation on the keto diet, this article discusses management strategies, which may also help you adjust to this way of eating.

Can the Keto Diet Cause Constipation?

The ketogenic (or keto) diet can potentially lead to constipation in some individuals. It often involves cutting back on carbohydrate-rich foods, including many fruits, vegetables, and whole grains that are high in fiber.

Additionally, the diet’s low carbohydrate and high-fat content, combined with changes in gut microbiota, can also impact bowel function. 

Below, we will explore how each of these factors contributes to constipation. 

Low fiber intake

Fiber adds bulk to stool and facilitates its movement through the digestive tract [*]. Because the keto diet limits carbohydrates, which are key sources of dietary fiber from fruits, vegetables, and whole grains, individuals on keto may consume fewer fiber-rich foods. 

This decrease in fiber can result in harder, drier stools and slower bowel movements, which can result in constipation.

Low carb, high fat intake

Switching to a low-carb, high-fat diet can disrupt the balance of gut bacteria, which may negatively affect digestive efficiency and bowel regularity [*]. Your body may need more time to adjust to its new diet, and during this period, digestive processes can be less efficient.

How Long Does Keto Constipation Last?

For many people, symptoms may improve within a few days or weeks as the body adapts and dietary adjustments are made. However, if constipation continues beyond this initial period or becomes a recurring issue, it may require ongoing management.

How to Treat Keto Constipation

Treating keto constipation often requires making several small, daily adjustments to your routine. Here are some effective strategies:

Drink more water

Drinking enough water helps soften the stool by increasing the moisture content. This makes the stool more pliable and easier to pass through the intestines.

Set daily goals, such as 16 cups per day (for men) or 12 cups per day (for women) [*]. Keep a water bottle with you throughout the day. Having it readily available makes it easier to remember to drink water regularly. 

If plain water feels too boring, add natural flavors like a slice of lemon, lime, cucumber, or a few fresh mint leaves! 

Add more keto-friendly fiber-rich foods to your diet

Including low-carb, high-fiber foods in your diet helps you obtain the necessary fiber to maintain digestive health while adhering to keto guidelines. 

Excellent options for this include leafy greens such as spinach and kale, as well as chia seeds, flaxseeds, and avocados. These foods provide essential fiber and support regular bowel movements without compromising the keto diet.

Opt for magnesium-rich foods 

Magnesium plays a role in maintaining normal bowel function, and a magnesium deficiency can contribute to constipation [*]. This is because magnesium helps regulate muscle contractions in the digestive tract, including those involved in bowel movements.

Here are some magnesium-rich foods that are compatible with the keto diet and can help alleviate constipation:

  • Almonds
  • Spinach
  • Pumpkin seeds
  • Broccoli 
  • Brazil nuts 

Exercise regularly

Physical activity enhances intestinal motility. Exercise enhances gut health by improving the contractions of the intestines, known as peristalsis. These are wave-like muscle contractions that move food through the digestive tract [*]. 

Regular physical activities you can engage in include walking, jogging, or strength training.  These can be particularly effective in both preventing and relieving constipation.

Retrain your bowel

Bowel retraining involves scheduling specific times each day to attempt a bowel movement, ideally after meals when the digestive system is most active. This practice helps your body develop a regular pattern and respond to these natural signals, which allows for more consistent bowel movements. 

In some cases, stimulation methods, like fiber supplements, can be used to help manage constipation. However, consult with a healthcare provider first. They can help determine if these products are safe for your situation. 

When to See a Doctor for Keto Constipation?

You should see a doctor for keto constipation if it persists despite trying dietary and lifestyle adjustments. Significant abdominal pain, cramping, or bloating that does not improve are also reasons to seek medical advice. 

New or worsening symptoms, especially if you have recently started the keto diet, should be evaluated. 

The Bottom Line

Experiencing constipation on a keto diet is often a temporary issue as your body adjusts to your dietary change. Strategies like staying properly hydrated and incorporating keto-friendly fiber sources can support healthy bowel function. 

Your body will typically adjust, and constipation should resolve, which then allows you to enjoy the benefits of the keto diet (such as weight loss and mental clarity) more comfortably.

References:

  1. Akbar, A., & Shreenath, A. P. (2023, May 1). High Fiber Diet. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559033/
  2. Jaagura, M., Viiard, E., Karu-Lavits, K., & Adamberg, K. (2021). Low‐carbohydrate high‐fat weight reduction diet induces changes in human gut microbiota. MicrobiologyOpen, 10(3). https://doi.org/10.1002/mbo3.1194
  3. Water: How much should you drink every day? (2022b, October 12). Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256
  4. Murakami, K., Sasaki, S., Okubo, H., Takahashi, Y., Hosoi, Y., & Itabashi, M. (2006b). Association between dietary fiber, water and magnesium intake and functional constipation among young Japanese women. European Journal of Clinical Nutrition, 61(5), 616–622. https://doi.org/10.1038/sj.ejcn.16025735. Clinic, C. (2024b, April 30). How Exercise Can Lead to a Healthy Gut. Cleveland Clinic. https://health.clevelandclinic.org/gut-health-workout

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