Full disclosure— I’m a Nutritional Consultant who eats (and lives by) clean keto— and I have hemorrhoids. Embarasssssssing!
Even typing those words feels shameful. But why? Because girls aren’t supposed to poop? I mean, we’re certainly not supposed to talk about it.
But guess what? I’m not the only one with the roids— y’all have ’em too.
In fact, everyone is born with hemorrhoids. Hemorrhoids are simply cushions of tissue filled with blood vessels found at the end of the rectum.1 So when people say they “have hemorrhoids,” they mean their hemorrhoids have become inflamed. Inflamed hemorrhoids are little bastards. They’re often associated with symptoms such as itching, bleeding, and pain while pooing— yay!2
What Causes Inflammed Hemorrhoids?
Now that we got the embarrassment out of the way let’s talk prevention. To prevent these little beasts from cropping, we need to understand what causes them in the first place. Hemorrhoids can become inflamed for a variety of reasons, such as aging, pregnancy, or anal intercourse. But perhaps the most common reason is due to excessive straining while lifting, pooping, or pushing.3 Which is why hemorrhoids often become inflamed during labor or when constipated— and if you’re taking the time to read this lovely little article, you’re probably suffering from the latter.
If you’re brand new to keto and not sure where to begin, I encourage you to check out my FREE Keto Kickstart Masterclass! Inside this masterclass, you’ll learn exactly which foods to consume in order to avoid constipation on the ketogenic diet.
Why Does Keto Cause Constipation?
Constipation is enough to turn off the most die-hard keto enthusiast. Understandably so. Not only is constipation wickedly uncomfortable, but it’s also a clear indication that things are not right in the ol’ digestive department.
There are a number of reasons why ketogenic dieters are prone to constipation. First of all, beginning a new diet of any sort often triggers digestive upset. According to Dr. Tamara Freuman, “It’s not uncommon for people to experience a downgrade in their digestive regularity when they improve their diet.”4 The reason being, the body needs time to adapt to dietary changes. Therefore, constipation relief could be as simple as giving the microbiome time to adjust to its new and improved diet.
Beyond the microbiome, there are several other factors that may be contributing to constipation on keto. Factors such as fiber intake, dehydration, and processed “keto-friendly” foods. Let’s take a look at five of the most common reasons people experience constipation on a ketogenic diet.
5 Tips to Relieve Constipation on the Keto Diet
1. Adjust Fiber Intake
When seeking constipation relief, most often, we’re told to “eat more fiber.” The thing is, some people get constipated with too much fiber and others with too little. Unfortunately, determining whether you need more or less fiber in your diet may take some experimenting.
When to Increase Fiber Intake
If you’re suffering from constipation one of the first things to note is your fiber intake.
Prior to keto, most of us were accustomed to deriving our daily dose of fiber through bread, whole grains, cereals, and legumes— all of which are not so keto-friendly. The thing is, most of us are able to cut out these starchy foods in order to achieve ketogenic success, but few of us are able to meet our dietary fiber needs after doing so.
The current Dietary Guidelines for Americans recommend the following approximate daily intake:
- Adult men require about 34 grams of fiber (depending on their age)
- Adult women require about 28 grams of fiber (depending on their age)
If you want to continue having healthy bowel movements while in ketosis, you may need to up your daily dose of fiber. The following is a list of 10 high-fiber foods that won’t kick you out of ketosis.
10 High Fiber Keto-Friendly Foods
- Berries (strawberries, raspberries, blackberries, blueberries)
- Benefiber (supplement)
- Cruciferous veggies (broccoli, Brussels sprouts, cabbage, cauliflower)
- Nuts (macadamia, pecans, pine nuts, pistachios)
- Mushrooms (crimini, portabello, shitake, white)
- Seeds (chia, flax, hemp, pumpkin)
- Prebiotic veggies (asparagus, garlic, leeks, onions)
- Psyllium Husk (supplement)
When to Decrease Fiber Intake
On the other hand, eating too much fiber could be the very reason you’re constipated on keto.
Now I get it, when errbody is telling you that eating fiber helps you go number two, why would you think otherwise? I didn’t. Admittedly, for years I promoted a high-fiber diet to clients suffering from chronic constipation (mah bad)! It wasn’t until I began experimenting with carnivore that I realized this whole fiber thing may be complete bullshit!
For decades, we’ve been told by our doctors and health officials that fiber is an essential component of a healthy diet. The supposed benefits of a high-fiber diet have been linked to a lowered risk of diseases such as obesity, heart disease, and cancer, particularly colon cancer.5 Yet many of these health claims are not actually backed by research.6,7
In fact, quite the opposite. Many studies suggest that excessive fiber intake may actually be harmful, particularly for gut health.8
FIBER: IS IT NECESSARY FOR A HEALTHY GUT?
Insoluble fiber is the stuff we’re told to eat in order to “keep stuff movin’.” Interestingly enough, insoluble fiber passes through our digestive tract virtually untouched. Not even the bacteria in our gut flora can easily digest it. It’s said to be good for us because it can “bulk up our stool,” but there’s mounting evidence to support that it can actually be detrimental to digestive health.9 Rather than aiding our bowels, it can elongate and irritate them. What’s more, studies have shown that reducing fiber intake actually reduces constipation.10
ARE WE DESIGNED TO EAT FIBER?
When it comes to optimal health, natural design is an important consideration. Eating in alignment with our anatomy promotes health and longevity. As Maria Emmerich claims, “The digestive tract can be a good indicator of what an animal is designed to eat.”11
As compared to other omnivores such as primates, humans have a much smaller colon. The colon is responsible for breaking down fibrous fruits, leaves, stems, and stalks. This means, the larger the colon, the greater its ability to digest fiber.12 What’s more, humans also have a much smaller cecum. The cecum is responsible for fermenting plant matter (cellulose or fiber) and turning it into energy (fatty acids). The human cecum is too small to perform this— which is why fiber goes right through us.13
If our digestive tract has anything to say, it’s telling us there’s no need for fiber.
2. Drink Less Alcohol
Now don’t freak out— I didn’t say no alcohol— just less. Dehydration is one of the main reasons for constipation. And consuming alcohol can dehydrate the body in a variety of ways. First off, alcohol decreases the body’s production of antidiuretic hormone, which is used by the body to reabsorb water. With less antidiuretic hormone available, your body loses more fluid than normal through increased urination. What’s more, oftentimes when you’re busy drinking alcohol, you’re not busy drinking water. Therefore, reduced water intake paired with increased urination sets the stage for seriously backed-up bowels (and a killer hangover). Beyond that, excessive alcohol consumption can lead to vomiting, which depletes the body further, thereby exacerbating dehydration.
3. Replace Conventional Dairy with Raw Dairy
To be on the safe side, it would be wise to avoid these conventional dairy products when constipated.
Conventional Dairy to Avoid When Constipated
- Pasteurized cheese
- Ice cream (keto or not)
- Cow’s milk
- Sour cream
- Processed dairy products (cheese crisps, string cheese, whipped cream, etc.)
If you’ve been told that consuming raw dairy products is dangerous, you’ll be surprised to know that you’ve been rather misled. In fact, an extensive look into research and claims made by the FDA and CDC related to the dangers of raw dairy has been found to be completely unwarranted.17 The reason being, the FDA and CDC make no distinction between pre-pasteurized milk and raw milk intended for direct human consumption.18
When selecting raw dairy products the health and welfare of the farm is vitally important. Due to poor care and conditions of cattle, dairy derived from conventional farms (CAFOs) is subject to a substantial pathogen exposure.19 This means, conventional dairy MUST be pasturized for safe consumption. On the other hand, raw dairy derived from healthy cows actually benefits your body in many ways.20,21
In fact, raw and organic probiotic yogurt, cheeses, and kefir have been consumed by some of the healthiest populations around the world for thousands of years (such as those residing within the infamous Blue Zones). Dr. Axe (amongst others) recommends consuming raw dairy products when treating the following ailments.22
Raw Dairy May Aid in the Treatment of
- Colon cancer
- Inflammatory bowel disease
- Intestinal infections
- Irritable bowel syndrome
- Skin infections
- Weakened immune system
- Urinary tract infections
- Vaginal yeast infections
4. Limit Processed Foods
This one may seem obvious because keto stresses the importance of cutting out processed food products. The thing is, most processed food products on the market contain excessive amounts of sugar and carbohydrates— making them an obvious no-go on the ketogenic diet. The problem is, food companies are catching on to this “keto-craze,” and with that comes a slew of “keto-friendly” processed food products.
Now don’t get me wrong, I’m certainly not dogging them all— I’m thankful to have the occasional bag of chicken chips or erythritol ice cream without feeling like a heroin addict in serious relapse. The problem is— keto or not, these processed food products aren’t exactly healthy— and when consumed in excess, will most certainly lead to backed-up bowels.
There are a few reasons why processed keto food products can cause constipation. For one, many of them contain significant amounts of fiber. A lot of companies bank on the fact that keto enthusiasts count net carbs, which means fiber will be subtracted from total carb counts.23 And as we mentioned above, for some, too much fiber in the diet means constipation. The other reason processed food products may cause constipation is because they’re filled with chemically manufactured additives and preservatives. Here are a few constipation-causing ingredients to be on the lookout for.
- Keto sweeteners (erythritol, stevia, xylitol)
- Synthetic sweeteners (sucralose, aspartame, saccharin)
- Xanthan gum
- Chicory root
5. Work on Stress Relief
One of the first body systems to be affected by stress is the gastrointestinal system. Chronic stress can lead to ulcers, indigestion, constipation, diarrhea, and IBS (irritable bowel syndrome).24 This means, if you want to avoid giving birth out the ol’ glory hole, you better work on your stress relief.
If you’re anything like me, you often find yourself reaching for the bottle in order to silence stress. But you know, as well as I do, this is a rather ineffective method of stress relief (especially considering that alcohol dehydrates). Therefore, your best bet would be to combat stress in more productive ways.
Healthy Ways of Relieving Stress
- Bath bombs
- Massage therapy
- Sex therapy
- Working out
- Getting some fresh air
Beyond these 5 tips to relieve constipation on the ketogenic diet, there are also a few supplements to consider on keto. These recommendations will help aid your digestive system and work to keep you regular.
3 Best Products to Prevent Constipation
1. Electrolyte Supplement
Electrolytes are minerals that serve to regulate adequate hydration throughout the body. They aid in cellular and organ function and are essential for a number of bodily functions. By drastically reducing carbohydrate intake, the body begins to process electrolytes differently. On keto, less insulin is released, causing the kidneys to excrete more sodium. As your body begins to lose sodium, this may also impact the balance of other key electrolytes in your body. Potentially causing issues such as frequent urination, constipation, diarrhea, and muscle cramps.25
Electrolyte supplements are especially important for keto-newbies.26 However, I’m 6 years keto-strong and still take an electrolyte supplement. I’m a BIG fan of Superieur electrolytes. Their products contain Himalayan sea salt, zero grams of sugar, and they taste delicious!
2. Bile Salts
Bile is an important component aiding in the breakdown and digestion of fats within our body. Because the ketogenic diet calls for such an extreme amount of fat, taking bile salt supplements can help in the absorption of fat-suluble vitamins like A,D, E and K. Essentially, bile salts serve as natural laxatives, promoting bowel movements by softening the stool.27,28
I’d recommend taking Dr. Berg’s extra-strength gallbladder formula.
Dr. Axe claims probiotics are the #1 deficiency in the United States. Probiotics are positive bacteria that line your digestive tract and support your body’s ability to absorb nutrients and fight off infection. They also line and repair the gut, while serving to breakdown gluten and casein. When we don’t have enough positive bacteria in our system, the side effects may lead to: digestive disorders, skin issues, candida, autoimmune disease, and frequent colds and flus.29
Foods containing probiotics
- Yogurt (goat’s milk best, otherwise select a raw or organic, grass-fed varietal)
- Kefir (again, goat’s milk is ideal)
- Fermented foods such as: sauerkraut, miso, tempeh and kimchi
- Kombucha (fermented tea)
What to consider when purchasing a probiotic
- Brand quality — Seek reputable brands such as: Garden of Life, MegaFood and Axe Naturals
- High CFU count — CFU counts range from 15 billion to 100 billion. Purchase a probiotic brand that has a CFU count of 50 billion or higher.
- Strain diversity — Search for a probiotic supplement that has 10–30 different strains.
- Survivability — Look for robust strains like bacillus coagulans, saccharomyces boulardii, bacillus subtilis, lactobacillus rhamnosus, ensuring the probiotics make it to the gut and are able to colonize.
- Research — Do your homework and purchase a brand that supports your specific needs.
But just in case you’re a little too late for preventative measures.
3 Best Products to Relieve Constipation
1. Smooth Move Herbal Tea
Smooth Move is an organic blend of herbs designed to provide gentle overnight relief from constipation. The main ingredient, senna works by stimulating the intestines in order to aid the body’s natural elimination process. Smooth Move is best taken at night, as it takes about 6-12 hours to kick in. Smooth Move is by far my top choice to get things moving along.
MiraLAX is an over-the-counter stool softener recommended by my GI doctor. The active ingredient Polyethylene Glycol, is designed to produce a bowel movement within 1-3 days. MiraLAX proves to be a bit more effective at breaking up some serious backup, but it also comes with some uncomfortable cramping. However, the backlash I’ve experienced with MiraLAX is far less than with other brands on the market.
3. MCT Oil
MCT oil is basically your granny’s way of relieving constipation. The fats in olive oil can help smooth the bowels, making it easier for stool to pass. It may also help the stool hold in more water, keeping it softer. One tablespoon of MCT oil, taken on an empty stomach in the morning, may relieve constipation for many healthy adults. Just be aware that taking more than one tablespoon (per day) may lead to diarrhea and cramps.30
Interested in high-protein keto but have no idea how to begin?
I’ve got you! Check out my free Beginner’s Guide to High-Protein Keto
If you’re looking for:
- A clear understanding of macros and how to effectively calculate yours
- A simple breakdown of “healthy” vs. “unhealthy fats”
- A complete list of best choice proteins (and why high-protein keto is the way to go)
Then you better download this guide— cause it was made just for you!
Whether you’re well-versed or brand spankin’ new to keto life and looking for some help, you should check out Katie’s coaching program. Coach Katie lives keto all day, errryday. She keeps up to date on the latest science, so you don’t have to. But more importantly, she addresses your specific goals to help you achieve ultimate success on your keto journey. And it’s always better to have someone in your corner, guiding you along. So if you’re ready for total life transformation and ultimate keto success, schedule your FREE keto strategy sesh today!
This content is for informational and educational purposes only. It is not intended to provide medical advice or take the place of treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Katie Rodriguez nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.