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Irritable Bowel Syndrome (IBS) and Keto

Irritable Bowel Syndrome (IBS) can cause a lot of unpleasant symptoms. You may experience issues like constipation, diarrhea, cramps and pain, flatulence, heartburn, and acid reflux. This can significantly affect your daily life. Often, following the FODMAP diet is advised for IBS. This diet involves avoiding many foods that often lead to a negative reaction. People often experience positive results with this diet because they stop eating things that their intestines react to. However, it is often challenging because you have to give up and avoid many things. Many people find this diet to be monotonous and miss the ability to eat a variety of foods. But fortunately, I have good news for everyone suffering from IBS! Eating keto really works wonders for your intestines.

No FODMAP diet

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Many of the products on the FODMAP list are already excluded when you follow a ketogenic diet. However, you will find that there are quite a few products on the list that are suitable for a ketogenic lifestyle. The great thing is that you can generally eat these products even if you have IBS and are following a keto diet. So say goodbye to the well-known FODMAP diet.

How to Get Started
As indicated above, you can basically set aside the FODMAP list and fully enjoy all the things you can eat on a ketogenic lifestyle. In this article, you can see what falls under that category. With a ketogenic lifestyle, you eat as many pure and unprocessed products as possible, real food for your body, not fillers that your body struggles to process.
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In the Beginning

If you have IBS and you’ve just started a keto diet, you may experience an increase in your digestive symptoms (diarrhea or constipation) during the first 1-2 weeks. However, for most people, these symptoms quickly subside, and they become completely free of their IBS symptoms. If your symptoms persist for more than 10 days, you can still take a look at the FODMAP list to see if you are consuming many of the products recommended to avoid on a FODMAP diet (such as lactose in the form of cheese, cream, yogurt, nuts, and certain vegetables). You can temporarily exclude these products to see if your symptoms improve. Once you have been symptom-free for a while, you can gradually reintroduce these products (bit by bit) to test how your body responds. There is a good chance that you will tolerate them better later on. It can also be helpful to cook or bake certain vegetables instead of consuming them raw.
Fiber: Normally, it is recommended to consume 20-30 grams of fiber per day. In a ketogenic lifestyle, most of these fibers come from vegetables, nuts, seeds, and grains. Fiber is important for proper bowel function; however, it may be that your intestines respond less favorably to fiber when you have IBS. To test how your intestines react to fiber, try consuming less fiber for at least 2 weeks. Initially, avoid nuts, seeds, and grains and consume fewer vegetables. If your intestines become calmer during this period, it may indicate that your intestines respond less favorably to fiber. In that case, try consuming significantly less fiber for a period and then reintroduce it to see how it goes.

High-Risk Products

As mentioned earlier, it may be advisable to avoid certain foods at the beginning. The foods most likely to trigger reactions in most IBS patients following a ketogenic diet are mainly vegetables, such as cauliflower, broccoli, Brussels sprouts, green cabbage, and red cabbage (cruciferous vegetables). You can easily replace these vegetables with others that do not cause symptoms. Here you can see which vegetables you can choose from. After about a month, you can slowly reintroduce the vegetables that caused reactions into your menu. Do this with small quantities and experiment with different cooking methods. Sweeteners, alcohol, caffeine, and carbonated drinks can also cause unpleasant reactions in your intestines/stomach, so it’s best to avoid them as much as possible.

Rest and Recovery

IBS, as the name (irritable bowel syndrome) suggests, is an overstimulation of the intestines. To calm your intestines and return them to a peaceful state, fasting (in part) can yield excellent results. When you fast, you consume nothing, so your intestines receive no stimuli and can truly rest. You can find everything you need to know about fasting in this article.

Negative Effects on the Intestines

Both stress and a lack of exercise can have negative effects on our intestines. Try to engage in at least an hour of physical activity each day, which can be as simple as taking a leisurely walk or bike ride. Also, try to minimize stress as much as possible (something that’s always a good idea for everyone 😉). Ensure you get a good night’s sleep as well because a lack of sleep can create stress for your body. You can read about the most common causes of stress and what you can do to prevent them (as much as possible) here.

Experiencing Constipation?

A ketogenic diet is excellent for your intestines, and you will likely experience this firsthand. However, in the beginning, your body may need some time to adjust to this new way of eating, which can lead to constipation (or even diarrhea). In such cases, it’s good to know what you can do to alleviate the discomfort of constipation.
Fats: Fats are the best way to soften stool and expedite a trip to the toilet. Taking a tablespoon of flaxseed oil (or another type of fat) on an empty stomach every morning can work wonders. Make sure to wait at least 15 minutes before consuming anything else so that the fats are absorbed effectively and quickly. The effect can be swift, so ensure you have access to a restroom.

Magnesium Oxide: This product is readily available at drugstores. There are many different types of magnesium supplements, so be sure to choose magnesium oxide specifically. Start with 2 tablets before bedtime and observe how your body responds. Everyone reacts differently to magnesium, so some may find this sufficient, while others may need more, possibly taking extra the next day.

Vitamin C: When used excessively, vitamin C can also have a laxative effect. However, you cannot overdose on vitamin C (your body excretes the excess), so it can be a helpful way to make your bowel movements smoother. Most people who take extra vitamin C for this reason find relief with 3000 mg per day. Take note that it’s best to consume this during the day (not after 6:00 PM) because it can interfere with sleep, causing stress for your body.

Laxatives: There are two types of laxatives: those that stimulate your intestines to work harder and those that increase moisture in the intestines, leading to softer stools. Both types are not generally recommended for use. The first type can potentially make your intestines lazy, causing them to no longer function properly on their own. The second type can cause your body to become dependent, making it challenging to stop using them without the symptoms returning immediately.

Experiencing Diarrhea?

Diarrhea is something you naturally want to get rid of as quickly as possible. Aside from being uncomfortable, detrimental to your body, and inconvenient to be constantly near a restroom, it can also feel embarrassing. Diarrhea often has a well-identifiable cause, so check if you recognize anything in the following causes and adjust them if necessary.
Insufficient Salt: When you start a ketogenic diet, it’s crucial to ensure you’re getting enough salt. You can read about the importance of this (and the reason for it) in this article. Too little salt can lead to diarrhea (in some cases, it can also cause constipation). Moreover, when you have diarrhea, it’s even more important to replenish your minerals because diarrhea causes you to lose them rapidly.

Wrong Timing: If you take the recommended extra salts or supplements on an empty stomach, it can lead to diarrhea. This also applies to “sole” (water saturated with salt) or broth. Ideally, take the extra salt (and other supplements) combined with a meal (this can be just before/after the meal).

Magnesium: Are you taking magnesium as a supplement? Magnesium is a commonly taken supplement, especially among those who follow a ketogenic (or low-carb) diet. However, there are different forms of magnesium, and not all of them are suitable as a basic supplement. Magnesium oxide is a form of magnesium that does nothing for your body except making the stool softer. So, if you take this while your stool has a good consistency, it can lead to diarrhea.

Random Diarrhea Episodes: Sometimes you suddenly experience diarrhea out of nowhere shortly after eating, without any other issues for the rest of the day. In such cases, look at what you ate before the diarrhea occurred, as you might have started eating different foods with your new ketogenic lifestyle. This is often seen with avocado, seeds and nuts, sauerkraut, and other fermented products, but it could be something entirely different. If this happens, identify what you ate and cautiously test it in the future to see if it triggers a reaction. If you consistently experience this after eating something specific, there’s a good chance your body currently doesn’t tolerate it well. So, refrain from these products for a while. Maybe you can reintroduce them a few weeks later when your body has become more accustomed to this way of eating. It might still not work, so keep them out of your diet for now. You can always try them again later because our bodies are constantly changing.

Quick Solutions

If you have an appointment or need to go out for something, you naturally want to get rid of diarrhea as quickly as possible. Fortunately, there are options for this. As a quick temporary solution, you can use an antidiarrheal medication. Using it occasionally is not a problem, but don’t use it every day. It’s not a healthy long-term solution.
You could also take some extra fiber in the form of seeds, nuts, and psyllium husk. However, be cautious with this, as it can exacerbate diarrhea or even cause constipation (something you also want to avoid).


Barbara Bolen, PhD, Can a Ketogenic Diet Help Your IBS?, Updated on August 17, 2022

IBS and the keto diet, By Anne Mullens, medical review by Dr. Bret Scher, MD, Updated June 17, 2022

Donnellan CF, Yann LH, Lal S. Nutritional management of Crohn’s disease. Therap Adv Gastroenterol. 2013 May;6(3):231-42. doi: 10.1177/1756283X13477715. PMID: 23634187; PMCID: PMC3625021.

Crohn’s disease successfully treated with the paleolithic ketogenic diet, August 8 2016 by Dr. Andreas Eenfeldt, MD

Why Keto is a Game Changer- for Crohn’s Disease and Ulcerative Colitis, BY THE GUT NINJA April 17, 2018

Crohn’s disease successfully treated with the paleolithic ketogenic diet, by Csaba Tóth, Andrea Dabóczi, Mark Howard, Nicholas J. Miller, Zsófia Clemens

de Punder K, Pruimboom L. The dietary intake of wheat and other cereal grains and their role in inflammation. Nutrients. 2013 Mar 12;5(3):771-87. doi: 10.3390/nu5030771. PMID: 23482055; PMCID: PMC3705319.


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