Constipation is a common issue for those following a ketogenic or low-carb diet. This is because keto diets are very low in fiber, which helps promote regular bowel movements. The good news is there are many things you can do to relieve constipation while staying in ketosis. This article will discuss several natural remedies, over-the-counter medications, and lifestyle changes to get things moving again when you’re constipated on keto.
Why Does Keto Cause Constipation?
There are a few reasons why the keto diet can lead to constipation:
- Low Fiber Intake – Keto limits fruits, vegetables, grains, and legumes, which are all high fiber foods. This means your total daily fiber intake may be much lower on keto.
- Dehydration – In the initial stages of keto, the loss of excess water weight can lead to dehydration. Being dehydrated makes your stool harder and more difficult to pass.
- Electrolyte Imbalance – Keto flu causes low electrolyte levels, especially sodium, magnesium, and potassium. Electrolytes help food and waste move through your GI tract.
The combination of very low carbs, low fiber, dehydration, and electrolyte imbalance is why constipation is so common when transitioning to a ketogenic diet. The good news is that making a few diet and lifestyle changes can help get your digestive system back on track.
Natural Remedies for Constipation on Keto
If you’re suffering from constipation while following a keto or low carb diet, there are several natural remedies you can try before turning to laxatives or other medications:
Increase Healthy Fat Intake
Boosting your intake of healthy fats can help lubricate your digestive tract and make stools easier to pass. Try adding more olive oil, avocados, nut butters, coconut oil, and full-fat dairy like butter and heavy cream to your daily diet.
Stay Hydrated
Dehydration makes constipation worse, so focus on drinking plenty of fluids. Aim for at least eight 8-ounce glasses of water per day. You can also try sipping on bone broth, herbal tea, or adding some lemon to your water. Electrolyte drinks like keto-approved sports drinks can help replenish lost minerals too.
Eat More Fiber
Try to incorporate as much fiber into your keto diet from low carb sources like vegetables, nuts, seeds, and some fruits. Leafy greens, broccoli, asparagus, artichokes, avocado, chia seeds, flaxseeds, and berries are great options. Over time, aim for 25-35 grams of fiber daily.
Take Magnesium Supplements
Magnesium helps draw water into the intestines to soften and add bulk to stool. Take 300-400 mg daily in supplement form to aid regularity. Make sure to spread doses out, as too much magnesium at once can cause diarrhea.
Use Probiotics
Probiotic supplements support healthy gut flora, which is key for proper digestion and bowel regularity. Look for broad spectrum probiotic capsules and take according to label instructions. You can also get probiotics from fermented foods like sauerkraut, kimchi and kefir.
Exercise More
Being physically active every day helps increase motility in your digestive tract to get things moving. Aim for at least 30 minutes of moderate exercise like walking, jogging, cycling, or yoga on most days.
Drink Coffee
Coffee can stimulate the urge to have a bowel movement in many people. Sipping on a cup of black coffee when constipated can provide quick relief. Just be mindful that too much caffeine can become dehydrating.
Over-the-Counter Constipation Remedies
If natural remedies aren’t providing enough relief, there are some over-the-counter medications and supplements that can help get you regular again while following the keto diet:
Stool Softener
A stool softener like Colace or other docusate sodium brands draw water into the colon to soften and loosen stool. This makes bowel movements easier to pass. Start with 100mg 1-2 times per day as needed.
Osmotic Laxative
Osmotic laxatives like Milk of Magnesia or magnesium citrate pull water into the colon from surrounding tissue via osmosis. This increases motility and hydrates stool for easier passage. Follow dosage on the label and use sparingly to avoid dehydration.
Stimulant Laxative
Stimulant laxatives induce bowel contractions to essentially push out stool. They include options like Dulcolax, Correctol, or senna/sennosides derived from plants. Use stimulant laxatives only occasionally when very constipated. They can cause dependency with frequent use.
MCT Oil
MCT oil often has a laxative effect, especially when taking higher doses. Start with 1 tsp of MCT oil daily and increase slowly up to 2-3 tablespoons with meals if needed for a bowel stimulating effect.
Psyllium Husk
Psyllium is a soluble fiber supplement that soaks up water and adds bulk to stool. Mix 1-2 teaspoons into 8 oz of water and drink once a day. Be sure to drink extra fluids with psyllium to avoid worsening constipation.
Magnesium Citrate
Magnesium citrate provides a concentrated dose of magnesium to help relax the muscles in your colon. Take 100-300mg as needed, but avoid daily use as it can cause loose stools.
Lifestyle Changes to Improve Constipation on Keto
Making a few simple lifestyle tweaks can also help you find long-term relief from constipation while following a keto or low carb diet:
Eat Less Dairy
High fat dairy like cheese, butter, cream and sour cream are common on keto, but too much dairy can be constipating for some. Try reducing your dairy intake if you suspect it may be a factor.
Drink Bone Broth
Sipping bone broth provides electrolytes plus collagen, glutamine and other gut-healing compounds. Try drinking 1-2 cups per day.
Take a Magnesium Bath
Soaking in a warm bath with some magnesium flakes or Epsom salts can help magnesium absorb through your skin to relax muscles and support bowel motility.
Eat More Coconut Oil
Coconut oil contains unique medium-chain triglycerides that act as a mild laxative for many people. Add 1-2 tablespoons daily into recipes, drinks, or with meals.
Try Intermittent Fasting
Fasting gives your digestive system a rest and can stimulate motility. Try fasting for 16-20 hours 1-2 days per week. Just be sure to stay hydrated.
De-stress with Meditation
High stress levels can manifest in digestive issues like constipation. Try relaxing practices like meditation, yoga, deep breathing, or taking a warm bath.
Get Plenty of Sleep
Not getting your 7-9 hours of quality sleep per night can disrupt hormones that control your digestive rhythm. Focus on good sleep hygiene to optimize your sleep.
Foods to Eat on Keto for Constipation Relief
Certain foods are especially helpful for relieving constipation on a ketogenic diet. Try incorporating more of these options:
Leafy Greens
Leafy greens like spinach, kale, swiss chard, arugula, lettuce and microgreens are low carb, full of fiber, and contain magnesium. They support regularity without kicking you out of ketosis.
Avocado
Creamy, fatty avocados are a keto-approved source of fiber to help maintain bowel regularity. One medium avocado has about 10 grams of fiber.
Chia and Flax Seeds
Just 1-2 tablespoons of chia or flax seeds provide 5-8 grams of fiber to bulk up stool. They can be soaked in liquid to form a gel.
Coconut
Coconut meat, coconut flour, and coconut oil provide a good dose of fiber and MCTs for a natural laxative effect.
Nuts and Seeds
Almonds, walnuts, pecans, pumpkin seeds and sunflower seeds offer fiber, healthy fats and magnesium to support regularity.
Bone Broth
Sipping bone broth supplies electrolytes to improve hydration and provides glutamine to heal the gut lining.
Fatty Fish
Salmon, mackerel, sardines and other fatty fish provide anti-inflammatory omega-3s to reduce gut inflammation that can contribute to constipation.
Berries
Berries like raspberries and blackberries contain seeds that add fiber and polyphenols that feed good gut bacteria. Limit to 1⁄2 cup portions.
Herbs and Spices
Anti-inflammatory herbs and spices to flavor keto foods include turmeric, garlic, ginger, oregano, thyme, cumin, coriander and cinnamon.
Olives
Green and black olives provide a dose of monounsaturated fatty acids that can help lubricate your digestive tract.
Foods to Avoid for Constipation Relief on Keto
There are also certain foods it’s best to limit or avoid altogether when constipated while following a keto diet:
Low-Carb Baked Goods
While low in carbs, items made with almond or coconut flour tend to be low fiber and can be dehydrating. Limit portions.
Processed Meat
Deli meats, bacon, sausage and heavily processed proteins are hard to digest. Opt for fattier cuts of fresh meat.
Cheese
Cheese, especially low-moisture varieties, can be binding for some people. Reduce portions if constipated.
Eggs
Eggs are very low in fiber and high in fat, which can slow digestion. Limit to 2-3 whole eggs daily.
Nuts and Nut Butters
While healthy fats, nuts are high in fat and low in water content. Portion nuts to 1⁄4 cup servings and nut butters to 2 tablespoons.
Sugar-Free Sweeteners
Artificial sweeteners like sucralose, saccharin, and aspartame are hard on your gut microbiome. Stevia and monk fruit are better alternatives.
Deli Meat and Bacon
Foods that are high in sodium like cured and processed meats can contribute to dehydration.
Refined Oils
Vegetable, soybean and canola oils promote inflammation. Opt for olive oil, avocado oil, and coconut oil instead.
Sample Keto Meal Plan for Constipation
Here is a 3-day sample keto meal plan focused on foods that relieve constipation:
Day 1
Breakfast: Keto yogurt with raspberries, chia seeds, and almonds
Lunch: Tuna salad over arugula with olive oil and avocado
Dinner: Baked salmon with roasted Brussels sprouts and kale
Day 2
Breakfast: Veggie and egg scramble with avocado
Lunch: Leftover salmon salad wrapped in lettuce
Dinner: Grass-fed burger on portobello bun with spinach and goat cheese
Day 3
Breakfast: Coconut milk chia seed pudding
Lunch: Zucchini noodle salad with chicken, peppers, and basil pesto
Dinner: Roasted chicken thighs with steamed broccoli and cauliflower mash
Focus on getting plenty of leafy greens, avocado, oils, nuts, seeds and natural fat sources at each meal. Stay hydrated, supplement magnesium, add coconut oil or MCT oil, and sip bone broth when constipated.
Conclusion
Constipation while following a keto or low-carb diet can be frustrating, but there are many effective remedies. Be sure to increase healthy fats, fiber, magnesium, probiotics and fluids. Over-the-counter options like stool softeners and osmotic laxatives can provide relief when used occasionally. And make lifestyle tweaks like exercising more, de-stressing, and getting enough sleep. Incorporating proactive foods like leafy greens, avocados, chia seeds, nuts and coconut can help maintain regular bowel movements on keto as well. With the right combination approach, you can successfully manage and overcome constipation while sticking to a ketogenic diet.