Adapting to the keto diet is never easy, but there are things that can make the experience a little smoother. One issue that people experience when they are first adapting to the keto diet is diarrhea.
Keto diarrhea is "the runs" - a digestive problem that happens when your digestive tract is starting to adapt to a new set of foods and new eating habits. Typically, when you start taking in a lot more fat and a lot fewer carbohydrates, you will experience a period where your bowels are loose, and you experience diarrhea.
There are a few theories for why this happens. Some people suspect that the issue is caused by candida in your digestive tract dying off. This could make sense, but it is not a theory that has been substantiated by peer-reviewed studies as of yet.
Whatever the cause, the good news is that most people find that the period of diarrhea is brief and that they get over it within a couple of days. In rare cases it lasts for longer, but it should still pass of its own accord.
To some extent, the best way of 'treating' diarrhea is to ride it out and make sure that you stay healthy in the mean time. Your body is flushing out something that it does not like.
The primary concern for anyone who is suffering from diarrhea is dehydration. So, the first thing that you should do is try to drink more water. This is doubly important when you are on keto, because in a low carb diet, your body will already be flushing out more water than it usually does. Make sure that you are drinking enough water to keep yourself fully hydrated. After a week of doing this, your body will adapt to the increased water intake and you should find that you don't have to go to the bathroom as frequently as you did when you first upped your water intake.
Because you're going through so much water, it's important that you take in more electrolytes. Salty bone broth, condiments such as lite salt, and avocados all contain valuable electrolytes. When you have diarrhea, and are losing water rapidly it is important to be mindful of your electrolyte levels - because if you replace the lost water with plain water then you will cut the risk of dehydration, but you could become seriously ill because you aren't replacing electrolytes as quickly as you are losing them.
You can help to soothe diarrhea with fermented foods and probiotics. These boost your immune system and help to bulk up your stools. Sauerkraut and pickled carrots are both good options. Foods that are high in fiber are also useful. A lot of people make the mistake of cutting out bread, but then not adding vegetables. Broccoli and cauliflower are both good additions to a keto diet.
When you are suffering from diarrhea, the last thing you probably want to do is eat. Instead of taking in solid foods you may want to try supplements. There are some good supplements that contain probiotics, which may help to both ease the diarrhea and also stop it from coming back.
Digestive enzymes are useful for people who are struggling to get into the swing of the keto diet. Some people have difficulty digesting fats and the proteins that are found in the kinds of foods that you get in the keto diet. If this is the case, then instead of having comparatively normal diarrhea (usually a sign that your stomach is just adjusting to a new diet, and perhaps you're not quite getting enough fiber), they end up wiht yellow, very runny diarhhea. Left untreated, this unpleasant condition can drag on for weeks. People who try the keto diet after having their gallbladder removed are particularly vulnerable to this issue.
To treat keto diarrhea, consider using a pro-biotic supplement combined with an HCL supplement. This will help to support the stomach acids that you need to break down fats and foods, and ensure proper digestion.
The best way to avoid diarrhea on a keto diet is to eat a balanced diet in general. A lot of people are attracted to keto because they think that it is an excuse to eat junk - "hey, it's a steak and egg diet!". This is not really the case. Keto is low carb, but that means swapping your sandwiches for salad, not just eating nothing but burgers.
If eating a diet rich in vegetables and meats does not appear to work for you for preventing diarrhea while you are following the keto diet, then it could be that you suffer from an allergy that is making you more susceptible to digestive problems. There are a few tests that you can have done, privately, that will help you to dial in on the right foods for you - they are tests for allergies, FODMAPS, SIBO, and parasites.
Allergies are the easiest test - indeed if you are generally healthy and have a suspiscion about your allergies you may find that you can figure out what is giving you trouble simply by keeping a food diary and studiously eliminating foods one at a time.
Be careful with this, though, and do not eliminate entire food groups from your diet without first consulting a doctor. If you're unsure about your allergies, then there are tests that you can use.
Common elimination diets start with wheat, egg, fish, peanuts, soy, shellfish, dairy and nuts. They work by having the user cut out those things for between two and four weeks, then, if you start feeling better, re-add those things one at a time - slowly, while keeping a diary of how you feel. If you notice that re-introducing something makes you feel worse, then there's likely an allergy problem.
SIBO stands for Small Intestinal Bacterial Overgrowth - and this is something that you need a blood test for. It's normally only worthwhile if you have had allergy tests and didn't find anything. The same applies for parasites - if all else fails, then they are worth investigating.
FODMAPS are a form of short-chain carbohydrate. They are not well absorbed by the small intestine. Some people struggle to digest them to the point that yes, they end up suffering from diarrhea. Foods that can cause issues with FODMAPS include garlic, onions and nuts - which are all things that people who are following a keto diet often start eating more of. Sugar alcohols can also cause issues.
If you think that you have a FODMAPS issue, then look at the diets followed by people with IBS for inspiration. You might find that there is something there that will appeal to you.
Don't give up on keto if you experience diarrhea. Don't worry too much if you find yourself struggling with the 'low carb flu' either. It's normal to have an adjustment period of a few days or weeks. Spend that time paying attention to how you feel, and thinking about what works for you.
As your body adjusts you should find that you have more energy, you feel more clear-headed, and that you end up looking leaner and feeling stronger too. It is worth pushing through an initial adjustment period until your digestive tract adapts, and you learn which foods you can enjoy and which aggravate your stomach and intestines.