Keto Diet Diarrhea : Causes And Remedies

keto diet diarrhea

Going from a standard American diet to a keto diet creates significant changes to your digestive system. The keto diet provides your digestive system with more fat than it is used to while changing your gut microbiome. While fat is a quality fuel and unhealthy gut flora is dying off, these positive changes may require a period of digestive adjustment. A common side effect is keto diet diarrhea. 

What is Keto Diarrhea?

Although keto diarrhea is a common side effect, it is different for everyone.

Often, keto diarrhea is actually steatorrhea, which is a specific type of diarrhea caused by excess fat in the stool. Steatorrhea is usually pale, smelly, and may be coated with a thick, greasy film.

It is also possible that the keto diarrhea you are experiencing is just regular diarrhea, characterized by loose, watery stools with no excess fat content.

Some people develop keto diarrhea within the first few days of starting the diet, while others may begin diarrhea weeks or months later.

What Causes Keto Diarrhea?

Some people, but not all, experience the unpleasant side effect of keto diarrhea when switching to a keto diet. Following are some of the possible causes of keto diarrhea:

1. Food intolerances or sensitivities may bring the trouble.

Going keto means new foods may be on the menu. Unfortunately, you may have sensitivities to some of these foods.  

Food sensitivities are an underappreciated cause of GI symptoms

 on keto, paleo, or any other diet. An example will help illustrate. 

Let’s assume that avocados give you trouble. You may be sensitive to soluble fiber, the high histamine content, or something else about this nutrient-rich food. 

And every time you experience symptoms, it’s likely to prompt more inflammation in your gut. (Inflammation means unwanted immune activity). This inflammation can lead to abdominal discomfort and loose stools. It can also further damage the gut and cause more food intolerances. 

Do not despair. Avoid the food, let the intestines rest, and perhaps reintroduce the food later.

2. Fat can be hard to digest.

In general, fats take longer for the body to digest. On a high-fat diet like keto, you suddenly eat a lot of avocados, nuts, seeds, meat, olive oil and other fats, which can disrupt digestion. When you switch to this high-fat diet, it may cause diarrhea.

3. Artificial sweeteners and sugar alcohols can be rough on the stomach.

In addition, people often eat higher amounts of sugar alcohols and other artificial sweeteners while on a keto diet. These sweeteners, while low-carb and generally considered safe, have the potential to cause bloating and diarrhea if consumed in excess. Therefore, if someone eats a lot of keto foods that are high in sugar alcohols, they may struggle with keto diarrhea.

4. Keto may disrupt the gut microbiome.

The keto diet can also affect the composition of your gut microbiome, which has an impact on digestion as well. There have been some small studies that have found considerable changes in the bacteria in the gut after three months on a ketogenic diet, which can lead to diarrhea in some people. If your body isn’t used to eating more fat, this can change the gut bacteria, leading to looser stools caused by diarrhea and indigestion. However, more studies need to be done before this is considered a decisive issue.

5.Lack of fiber

Another cause of keto diarrhea is the sudden lack of fiber as carbohydrate intake is drastically reduced. Fiber is used to treat constipation, so it can be confusing to consider low fiber intake as the culprit for diarrhea. But insoluble fiber, the type that turns into a gel when mixed with liquids, actually causes your stool to swell and helps prevent diarrhea.

How Long does Keto Diarrhea Last?

Thankfully, like keto flu, keto diarrhea is not a permanent problem. It ideally occurs around the time you change your diet the most, so in the beginning, it may be the first one to four weeks until your body is able to adapt.

However, if a high-fat diet is not easy for your body to digest, or if you do have a change in your gut microbiome, diarrhea can be a long-term side effect. If keto diarrhea occurs long after you have started and adapted to the keto diet, there may be negative changes in the gut microbiome. Therefore, it may be beneficial to seek the help of a dietitian to review things like variety, fiber, and fermented foods in your diet.

How to Overcome Keto Diarrhea?

If some person on the keto diet is suffering from GI issues, they can relieve their signs by:

  • Consuming less dairy: Whole dairy products are rich in fat. As a result, individuals on a keto diet may eat more of them than they did before. This dietary modification may reveal an intolerance to dairy products. Common signs of this intolerance are acidity, diarrhea and bloating.
  • Consuming more fiber: Fiber helps relieve diarrhea. High fiber foods can be green leafy vegetables, cucumbers, broccoli and cabbage. They are an appropriate addition to any keto diet.
  • Hydration: Drinking can help improve constipation problems. If a person is experiencing diarrhea, it is vital to practice fluid replacement. Drinking water and sugar-free electrolyte drinks can replace these fluids and lost electrolytes.
  • Reducing the consumption of sugar substitutes: Reducing certain foods and beverages that contain keto-friendly sugar substitutes may help relieve digestive symptoms.
  • Including prebiotics and probiotics: Using probiotic supplements or increasing the intake of foods containing probiotics and prebiotics can help promote gut bacteria during the keto diet. This helps to reduce the GI effects of the keto diet.
  • Simplifying the diet: Any sudden change in the diet may disturb the gastrointestinal bacteria. Easing into the keto diet by gradually reducing carbohydrates and increasing fats may help the body adapt.
  • Consuming fermented foods: Consuming fermented foods (sauerkraut and kimchi) may help improve digestion. This, in turn, reduces the risk of constipation or diarrhea.

When to See a Doctor?

It is always well worth consulting a healthcare professional before making any major lifestyle or dietary changes.

Anyone experiencing severe diarrhea or lasting longer than a week should consult a healthcare professional.

For most people, following a diet as extreme as the keto diet is not necessary to lose weight or improve health.

People interested in trying a low-carb diet may consider working with a qualified dietitian to see what dietary changes will work best for their lifestyle. Less restrictive dietary patterns can often produce similar benefits without the risk of uncomfortable side effects.


Studies have shown that a keto diet may help with weight loss. However, because this diet can lead to changes in the digestive tract, it may also cause adverse digestive effects, such as diarrhea.

To alleviate diarrhea caused by a keto diet, people should consider taking steps such as consuming less dairy products, eating more fiber, taking probiotic supplements, and staying hydrated.

If symptoms of GI upset are severe, prolonged, or painful, it is best to seek medical attention.

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