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Keto Constipation: Prevention and Cure

What helps constipation on the keto diet?

Keto constipation can be prevented by consuming the correct ratio of probiotic bacteria, prebiotic oligosaccharides, vitamins, minerals, micronutrients, trace elements, water, and fiber.

Additionally, we need to create a hospitable environment in the gut for our host-microbiota by eliminating toxicity.

Microbiota toxins are antibiotics, proton pump inhibitors (antacids), alcohol, anti-inflammatory drugs, excess sugar, and some artificial sweeteners.

Why causes keto constipation?

A combination of reasons: Lower insulin equals less fluid and electrolyte retention. Adequate levels of fluids and electrolytes are needed to keep the colon working efficiently.

The electrolytes sodium and magnesium in particular work as an osmotic laxative and improve bowel motility. Also those on a keto diet tend to eat less fiber and less resistant starches (prebiotics), which feeds the beneficial bacteria in the gut.

Why do I poop less on keto?

Those on a keto diet aren’t eating as many high carbohydrate foods. High carb foods increase insulin and signal the body to retain fluids. Some of the fluid fills the colon and aids elimination.

Additionally, they eat less poor quality foods. Less waste in, less waste out. Those that follow a ketogenic diet and also conduct intermittent fasting eat less often and subsequently eat less overall food.

Does inulin make you poop?

Inulin has been shown to soften the stools and significantly increase stool frequency compared to a placebo. Inulin can also improve digestive health by stimulating the growth of beneficial bacteria.

What are the 10 best probiotic foods?

What are some prebiotic fiber to help with keto constipation?

An honest explanation of the ketogenic diet should also include the downsides of keto

Besides just feeling exhausted and drained in the beginning, constipation is probably the #1 keto complaint. The good news is the information in this article can help you understand it and prevent and/or eliminate keto constipation complications.

Improving digestive health is dependent on a healthy intestinal microbiota

Making your gut microbiota more diverse is an effective way to remedy keto constipation. Not just more bacteria, but different types of beneficial bacteria.

I briefly touched on keto constipation in my Keto Diet Tips for Beginners resource. However, this issue has come up so often I felt compelled to provide this complete solution to keto constipation.

The first thing we have to understand is that our bodies are different now. On keto we fuel it differently and don’t put as much junk into it. Less junk in, less junk out.

Less frequent bowel movements doesn’t equal keto constipation

So we just aren’t creating as much waste as before and probably won’t have as frequent of bowel movements as what we are used to.

There are some things that you can eat that will get things moving in your colon a little faster, however. Basically, there are three external things we can consume to make our entire digestive system more efficient.

Increasing intake of soluble and insoluble fiber, prebiotic fiber and probiotic bacteria are an effective keto constipation remedy.

Fiber helps to provide bulk and keeps things moving in our colon. The probiotic beneficial bacteria feeds on the prebiotic fiber. Working together in synergistic harmony the bacteria helps us digest the food we eat.

When you sit down and come up with your Keto Diet Grocery list, make sure to include plenty of fiber rich foods. Green leafy vegetables, broccoli, cauliflower and asparagus are ideal.

5 ways to prevent Keto Constipation
5 Ways to Prevent Keto Constipation

It’s a lot more complicated than that and scientist are still discovering new ways the stomach, through its gut bacteria, signal the body and mind. Healthy gut bacteria has positively been linked to a strong immune system.

When an infant is born he/she does not have a built-up immune system and hasn’t developed the proper gut bacteria.

Scientists are now linking the gut microbiome with autism in children

This research paper titled, “Autism and the gut microbiome: Further evidence strengthens the link.

That’s one of the reason breastfeeding is so beneficial, the mother passes beneficial bacteria to the infant through her breast milk, which strengthens the infants’ immune system. Beneficial bacteria can even inhibit harmful bacteria.

How To Prevent Keto Constipation (Video)

How to prevent Keto Constipation

So how does all that keep us from being constipated on keto?

We have to work to keep our gut bacteria healthy and strong. Antibiotics kill all our gut bacteria, so after a round of antibiotics, we have to jump-start our gut bacteria again. Kind of like a starter culture when we ferment kimchi or sauerkraut.

The best way to jump-start and maintain our beneficial gut bacteria is through the consumption of fermented foods such as natto, sauerkraut, kimchi, beet kvass or milk kefir.

Try Kefir to add probiotics to your digestive tract

I drink milk kefir on an almost daily basis and it’s one of the most nutritious foods on the planet. I recommend using organic, grass-fed, whole milk to grow the culture.

They call the culture “grains” and you can get them from a friend or buy them off Amazon. The (culture) grains consume most of the lactose and make it Keto friendly. After about 24 hours of fermentation, the milk turns into a tart, creamy delicious drink, kind of like liquid yogurt.

The (culture) grains consume most of the lactose and make it Keto friendly. After about 24 hours of fermentation, the milk turns into a tart, creamy delicious drink, kind of like liquid yogurt.

Each batch varies, but Kefir has about 6-8 grams of carbohydrates, 6-8 grams of protein and 12-15 grams of fat. Calcium, Vitamin D, K2, B complex vitamins, magnesium, phosphorus, bioactive compounds, digestive enzymes, organic acids, and peptides.

The organic acids (acetic acid) in kefir are similar to what makes apple cider vinegar so healthy. But the star of the show is the symbiotic culture of bacteria or better known as probiotics.

How to make Keto Kefir

Kefir has 61 different strains of bacteria, far more than any other fermented dairy product

As a comparison yogurt has between 4 and 6 different strains of bacteria. It also contains a probiotic called Lactobacillus kefir, which is only found in kefir.

This unique probiotic has been shown to inhibit bacteria including salmonella, Helicobacter and E. coli. Kefir is regarded as one of healthiest superfoods on the planet.

Eat Natto to improve bowel regularity

Natto (fermented soybeans) will single-handedly prevent Keto Constipation. The combination of high fiber, probiotics and prebiotics does wonders to increase bowel movements.

If you can get by the smell and taste of Natto you’ve got it licked. Read this article for everything you wanted to know about The health benefits of Natto are breathtaking. It (Natto) will absolutely get your bowels going and stop your keto constipation in its tracks.

Natto will help you have bowel movements
Keto-friendly Natto will help you poop

If you don’t want to ferment your own Natto you’ll have to look for it in a specialty or large Asian supermarket. It is found in small Styrofoam containers in the frozen section. Normally it’s in a 3-pack as shown above.

Eating Japanese sweet potatoes will help with Keto Constipation

Yes I know sweet potatoes are a little high in carbohydrates to be keto friendly. However, the red, oblong Japanese variant is fairly low in Carbs. One small Japanese sweet potatoes is about 27 grams of carbohydrates. So, eating a small one, (or a half), with your one meal a day (OMAD) every now and then will drastically help get the bowels moving.

Sweet potatoes contain about 2 grams of fiber, but more importantly they contain resistant starch. Resistant starch is a powerful prebiotic. This study outlines how resistant starch stimulates the growth of beneficial bacteria.

The secret is to boil the sweet potato and not bake it. Boiling keeps the glycemic (GI) index down and protects the resistant starch. A boiled sweet potato has a low GI value of about 46. So it will raise your blood sugar very little.

Japanese-sweet-potatoes-will-help-you-poop
Japanese Sweet potatoes help keto constipation

One of the cures for constipation on the Ketogenic Diet is the Prebiotics: Inulin and oligofructose

Inulin is an oligosaccharide and a noncaloric carbohydrate that is found in a variety of other carbohydrates called fructans. The beneficial bacteria need some food to eat while it’s in your stomach.

That’s where prebiotics like inulin comes in. Prebiotics are non-digestible food ingredients that feed the microbiota of the large intestine.

Both inulin and oligofructose have been shown to be the most powerful prebiotics. Oligofructose and inulin, from chicory root, have been shown to stimulate the growth of beneficial bacteria.

Inulin help keep you regular by ensuring your stomach bacteria remain healthy. Additionally, this study shows that inulin/oligofructose and the subsequent fermentation process reduces the risks for colon cancer.

Read this promising study that shows inulin improves lipid metabolism. Inulin can reduce triglycerides and lower very-low-density lipoprotein (bad cholesterol).

Here is an example of supplemental inulin you can get on Amazon.

Prebiotic fiber inulin will help with keto constipation
Prebiotic Fiber Inulin

Most green leafy vegetables have some combination of Inulin and Oligofructose (prebiotics) in them.

Here is a list of some Keto approved foods and their percent of inulin* and oligofructose** content:

  1. Chicory root: 41.6* and 22.9**
  2. Jerusalem artichoke: 18* and 13.5**
  3. Garlic (raw): 12.5* and 5*
  4. Asparagus (cooked):2.5* and 2.5**
  5. Dandelion greens (cooked): 9.1* and 7.3**
  6. Onions (raw): 4.3 and 4.3**
  7. Leeks (raw): 6.5 and 5.2**

*Source: Presence of Inulin and Oligofructose in the Diets of Americans.

Taking citrus pectin will also help prevent keto constipation

Apple and orange pectin (oligosaccharides) are derived from the peels of apples and oranges. Their fiber cannot be absorbed by the body, therefore, are calorie-free.  Also, pectin seems to protect probiotics from gastric acids and pancreatic juices.

The best part of citrus fruit is the pith.

The pith is the white, spongy tissue lining around outside of citrus fruits, sometimes called the rind.

Additionally, prebiotic pectins protect and feed your intestinal microbiota and have antioxidant and anticancer abilities. How ironic, the most healthy part of the fruit is in the skin.

Add probiotics to your diet to heal the gut and improve Keto Digestion

kimchi is a keto-constipation solution
Fermented Kimchi

The best source for probiotics is Natto, kefir (milk, coconut, water), greek yogurt, cheese (blue, gouda and brie) and sour cream. Fermented foods are also a great source of probiotics.

You can ferment almost anything. Kimchi, sauerkraut, beans (Natto), cucumbers (pickles), garlic, onions, are the most popular, but Beet Kvass is my favorite

If you have never tried beet Kvass you are really missing out. It’s easy to make yourself at home. Here are instructions on how to make beet Kvass.

If you let the beets ferment long enough the culture eats most of the sugar, similar to milk Kefir and the lactose consumption. Kombucha also has probiotics, but it’s usually too high in sugar to be a Keto approved food.

How to make Beet Kvass (video)

How to ferment beet kvass

And then there is fiber:

Bring on the bulk. You will get most of your bulk-forming fiber by simply eating vegetables, but I have found a few tricks that work to increase the fiber and help with bowel regularity.

Try chia seed pudding

I mix about a tablespoon of chia seeds, inulin and a tablespoon of ground flax-seed in a cup of unsweetened, plain, flax or macadamia nut milk. The more chia seeds and the longer you let it sit, the thicker it gets. Just stir (shake) it early and often or the chia seeds will stick together and clump up.

Chia seeds are a remedy or constipation on keto
Chia Seeds will help you have more frequent bowel movements

Stir it up, let it sit, stir it up again, wait for it. You get the idea, the chia seeds will eventually absorb the liquid and thicken up into a gel. You can even mix a bunch up with coconut milk and coconut oil and let it sit and it will almost turn into a pudding that you have to eat with a spoon.

Another supplement you can take is psyllium husk powder capsules. It’s the same thing as Metamucil, but Metamucil has to much sugar in it, so look for the plain capsules. Walmart has a generic brand that’s very inexpensive.

Magnesium Citrate helps with Constipation on keto

Magnesium citrate will help with keto constipation..
Magnesium Citrate will help you poop

Another helpful tool is the electrolyte magnesium citrate. The recommended minimum daily intake of magnesium is only 327 mg a day. The latest government study shows that 68% of Americans are not getting enough magnesium. Magnesium is involved in over 300 biochemical reactions, it plays a role in proper nerve and muscle function and blood sugar regulation. 

A recent study shows that adults that don’t consume the recommended amount of magnesium are 1.48 and 1.75 times more likely to have elevated inflammation markers as defined by the C-reactive protein test.

Inflammation in the arteries is far more responsible for cardiovascular disease than elevated cholesterol. Magnesium citrate works to ease constipation by pulling water into the intestines. 

This water combines with the dry feces and makes it smoother to pass. Nutrients and medications that work in that way are called osmotic laxatives. Osmotic laxatives are a temporary way to improve keto digestion.

Magnesium citrate is very effective against constipation because it’s the most bioavailable form of magnesium. This study found on PubMed, compared the bioavailability of three common magnesium preparations (amino-acid chelate, citrate, and oxide). After 60 days the citrate group showed the greatest (P = 0.027) mean salivary magnesium concentration.

Salt and avocados are also a good keto constipation remedy

Not to give all the publicity to magnesium citrate, but electrolytes in general help with regularity. Sodium (salt), potassium and chloride also play a role. So don’t be afraid of adding extra salt to your food and eat vegetables for your electrolytes. Supplementing your diet with magnesium citrate might be helpful.

So there you have it, be patient and eventually, you’ll get used to your new bowel movement routine, but feeding your gut properly with fiber, prebiotics and probiotics will give you multiple benefits even more important than bowel regularity.

Constipation on keto can be prevented by consistently adding prebiotic fiber and probiotic bacteria to your diet by eating fermented foods, vegetables, and keto superfoods.

Here are 5 ways to prevent the Keto Flu.

Robert Bryant
Robert Bryant

Honestly, out of all the supposed “downsides to keto.” Keto constipation is the only issue I have had difficulty with. I think more than anything it’s just hard adapting to the frequency. Everyone is different, but I went from pooping everyday, to pooping approximately every three or four days. That’s a big change.

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