Starting a keto diet is a major lifestyle change. Turning your eating habits upside down can fuel a positive transformation, which we see in the many positive benefits of ketosis, but it can also throw your stomach for a loop.
After all, carbohydrates used to take up about half of your diet (based on how most Americans eat), and now they account for just 5-10%. You’ve cut out many of the foods that your body is used to digesting, and have likely introduced new ones.
It’s not surprising that your stomach may need some time to catch up.
Everyone’s body reacts differently to ketogenic eating. Many people experience constipation, others diarrhea, and some don’t notice any significant changes in their bathroom experience.
So yes, the keto diet can give you the runs.
There are a few different reasons why your body might be reacting this way. We’ll explore the most common ones so you can identify why you’re getting diarrhea on keto and find solutions.
The first thing to know is that it’s normal to have diarrhea during keto, especially when you are starting a low-carb diet for the first time.
It can vary in severity. You may have loose or watery stools (liquid poops), frequent bowel movements, or both. If watery poop is making you take 3 or more trips to the bathroom a day, congratulations, you officially have diarrhea.
Although this is a relatively common side effect, it should not be ignored. Diarrhea can dehydrate you and prevent your body from getting the nutrients it needs.
No, not necessarily. Having liquid bowel movements doesn’t mean that you are in ketosis.
It is possible to have diarrhea and be in ketosis at the same time. But you can also be in ketosis without stomach trouble. Or you can have the runs without being in ketosis.
To find out if you’re in ketosis, you have to measure the amount of ketones in your breath, urine, or blood.
If you’ve done some reading about the keto diet on blogs and social media, perhaps you’ve come across something called the whoosh effect.
As you may have guessed, “whoosh” is not a technical medical term. This so-called phenomenon is not backed up by scientific data.
What is the whoosh effect?
Basically, the theory is that soft and squishy areas of your body can magically become firmer and leaner by suddenly releasing fat and water.
Some people say that watery diarrhea on keto is a positive sign of the “whoosh” effect.
According to them, you wake up one morning and voilá you have “wooshed” your way to weight loss and look visibly thinner.
Again, there is no data to back up this theory. Diarrhea is not something to aspire to, as it can be harmful to your body.
What is really happening?
What you may experience at the start of the keto diet is dramatic weight loss in the form of water loss.
(This may be what the “wooshers” are referring to, because you can see the numbers on the scale drop, but they are wrong about it being related to fat loss.)
You lose water weight because having a low carb intake lowers the amount of glycogen stores. Glycogen retains water, so less glycogen means less water stored in your body1.
So while you may lose weight quickly at first, it’s due to water loss, not fat loss.
This is why you urinate more frequently on keto. It also points to why it’s so important to drink lots of water to stay hydrated, since your body won’t be storing as much water.
There are several different reasons you may be pooping water on a ketogenic diet.
Can eating too much protein cause diarrhea?
Indirectly, yes. It’s not the protein itself that would cause a problem, but if you’re eating too much of it, that won’t leave enough room for vegetables and other sources of soluble fiber, probiotics, and prebiotics.
Also, protein powders and bars may contain artificial sweeteners or sugar alcohols that can give you stomach problems.
The amount of time it takes for keto diarrhea to go away depends on what caused it in the first place. If it’s just a matter of your body adjusting to the new diet, it should go away within a week in most cases, although it may take a few weeks.
The good news is that there are proactive steps you can take to help stop this digestive issue or prevent it from happening in the first place. Keep reading to learn more!
If you are having constant diarrhea on keto for more than 2 days, especially multiple times a day, it’s best to see a doctor to rule out other possible causes and to prevent severe dehydration.
Here are concrete steps you can take to stop diarrhea during a keto diet:
1. Get more soluble fiber.
To treat keto diarrhea, eat more foods with soluble fiber:
*Watch your portion size of these foods in order to keep your carb count low.
It is important to get fiber from whole foods, but you can also consider taking a fiber supplement.
2. Reduce your intake of caffeine, alcohol, sugar alcohols, and sweeteners.
Eliminate or cut down on:
Check labels of packaged food or drinks, especially those that are marketed as sugar-free or low-carb, for the following ingredients:
Any of these can cause stomach issues, especially when consumed in large amounts.
3. Eat small meals and snacks throughout the day instead of a few large meals4.
4. If you suspect you may be lactose intolerant, stop eating dairy and see if your symptoms improve. In addition to loose stools, gas, bloating, pain, and nausea are also signs of lactose intolerance5.
Make sure to drink plenty of fluids when you have diarrhea to help prevent dehydration. In addition to sipping room temperature water, you may want to have some soup or broth to help replenish electrolytes.
Ketogenic dieters may also experience these symptoms, especially when first transitioning to a low-carb lifestyle:
Make an appointment to see a doctor if you have diarrhea for more than 2 days without signs of improvement, or if you also have:
Experiencing loose, watery stools 3 or more times a day for 4 weeks or more is known as chronic diarrhea. This could be a sign of a serious underlying condition and should be thoroughly assessed by a doctor8.
Diarrhea is not uncommon on keto, but it should not be ignored. There are proactive steps you can take to prevent or treat stomach issues related to a low-carb diet, such as transitioning into the diet gradually, eating foods high in soluble fiber and probiotics, and avoiding caffeine, alcohol, and sugar substitutes. If symptoms persist or increase in severity, it’s best to see a doctor.
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