Keto Diet for Digestive Problems | What to Eat to help with IBS, SIBO, Bloating
How the Keto Diet can help with IBS, Bloating, Cramps and SIBO
When it comes to our our gut health, following a ketogenic diet can improve intestinal issues such as excess gas production, bloating, flatulence and other IBS (Irritable bowel syndrome) and SIBO (Small intestinal bacterial overgrowth) related issues.
The Keto diet can help cure the symptoms of IBS and SIBO like constipation and belly pain, because it's naturally low in sugar and FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols).
FODMAPs are carbs that cause digestive distress in people with IBS. However, this diet also helps by triggering neuroendocrine responses via serotonin that combat the symptoms of stress including: anxiety, depression, irritability and sleep disruption. - A Beginner’s Guide to the Low FODMAP Diet - https://www.healthline.com/nutrition/low-fodmap-diet (1)
If you suffer from either of these conditions -- or more generally, SIBO or IBS -- this guide can help you learn everything you need to know about how the keto diet can be used as a tool for your digestive health.
What are the Negative Effects from SIBO and IBS!
Both SIBO and IBS can cause a range of painful and negative effects such as bloating, cramping, distension, diarrhoea and constipation and share many of the same traits and symptoms.
Learn about SIBO
SIBO, short for small intestinal bacterial overgrowth, is a condition which is characterized by too much bacteria in the small intestine.
It can cause an array of unhealthy traits and pains linked to gas build up in the small intestine, this can result in bloating and stretching of the intestinal walls.
In some people this pain can be crippling, greatly affecting their ability to undertake ordinary daily tasks and normal life.
Learn about IBS
IBS or Irritable bowel syndrome is a condition that can make you feel feverish, bloated, and even put you at risk of a serious infection like bacterial overgrowth which and even lead to SIBO.
It can sometimes be difficult to determine whether your IBS symptoms are due to an issue with digestion or something else entirely!
The reason for this complication is because IBS (irritable bowel syndrome) can result from SIBO, which explains why IBS and SIBO symptoms can sometimes be similar or even identical.
Telling them apart, Do you have IBS or SIBO
It can be hard to tell them apart without proper testing, that being said IBS related issues tend to lead to constipation issues, where as SIBO tends to lead to Diarrhoea issues.
The only true way to tell however is to see a doctor or to undertake a test, such as the many home tests available, like breath testing kits.
FODMAPS role in digestion problems
FODMAPS is something we talk a lot about at the Carb Free Zone and the negative impact that FODMAPS have on your body.
FODMAPS can often help the initial cause of, or something which makes SIBO or IBS worse. This is because FODMAPS are essentially short chain carbohydrates that are poorly absorbed in the small intestine and are prone to ferment in the colon which can cause extra bacteria growth and pain from bloating.
"The low FODMAP diet is part of the therapy for those with IBS and SIBO. Research has found that it reduces symptoms in up to 86% of people" - Hazel Galon Veloso, M.D. https://www.hopkinsmedicine.org
A healthy and balanced diet tries to reduce FODMAPS to a level that the body can healthily manage without overloading the good bacteria in the gut and colon.
Since IBS and SIBO symptoms are similar and one often leads to the other, we will mainly be talking about SIBO in this article, but by following these steps it will help you to tackle both SIBO and IBS related problems.
What Symptoms can SIBO and IBS Cause?
- Abdominal pain
- Loss of appetite
- Unintentional weight loss
Another clinical feature of bacterial overgrowth is chronic nutritional deficiency, specifically that caused by nutrient malabsorption. Mal-absorbed nutrients include proteins, fats, fat-soluble vitamins, A, D ,E ,and K.
What can cause SIBO in the Human Body?
1. A Diet High in FODMAPs
A diet high in FODMAPs, can cause bad gut health, colon health and bad bacterial growth in the intestines.
"In the small and large intestine, the small FODMAP molecules exert an osmotic effect, which means more fluid is drawn into the bowel. FODMAPs are also rapidly fermented by colonic microflora producing gas. The increase in fluid and gas distends the bowel. This can cause the sensation of bloating and abdominal pain or discomfort and affects how the muscles in the wall of the bowel contract. It may cause increased forward movement (peristalsis) leading to diarrhea, but in some people, it can cause constipation" https://aboutibs.org (3)
FODMAPS are a highly fermentable type of carbohydrate. This means that whilst they do turn into food for the gut. Some people just happen to be sensitive or intolerant to this process - and that's where their gut issues might stem from.
Bacterial issues and inflammation in our bodies often comes from the imbalance of bacteria and whether FODMAPS are totally to blame they can be known for throwing of the good balance of bacteria in our bodies, which can cause bloating and digestive issues.
2. Antibiotic Use and Food Poisoning
Anything that disrupts the bacterial balance in your body is generally a bad thing and although antibiotics can be used to clear up a excessive amounts of large bacteria in the body, its also wipes out the good bacteria we have.
This disruption of the bacterial balance makes it critical that we start of again with good gut bacteria by eating foods which cater to creating those good bacteria. If we fail to do this, bad bacterial forms such as pathobionts can build up in excessive amount and make us sick again.
"antibiotics have an impact on the abundances of the bacteria in the gut community, causing rapid and diminished levels of bacterial diversity and taxonomic richness, increases and decreases in the relative abundances of certain taxa, leading to dysbiosis, as well as antibiotic and individual host-specific effects" https://bmjopen.bmj.com
The same goes for Food Poisoning where your body tries to flush out your system via diarrhoea and your body’s ion, water and bacterial balance in the gastrointestinal tract is compromised.
Good things to eat after this, are items containing healthy bacteria, probiotics are often a good choice as they are filled with health bacteria such as Bacteroides, Lactobacillus, and Bifidobacterium.
3. Lack of good Stomach Acid
Gastric acid is one of the main components that work together to help break down one's food. One would have to have enough gastric acid before eating since their body can't properly digest food without it. Gastric acid also serves as a protective element by destroying pathogens, which are smaller organisms that could harm the body through the use of bacteria or viruses.
A balance of "pro" and "anti" nutrients is crucial for gastric acid levels. A higher-than-average pH of 4.0 can mess with your health by increasing the risk of bacterial overgrowth in cases where there's not enough HCL (hydrochloric acid) on hand to neutralize the ingested foods you are eating.
"Low stomach acid is the cause of small intestinal bacterial overgrowth (SIBO)/IBS' Stomach acid is crucial for the effective digestion of food, and when the level of gastric acid is reduced some food particles will not be fully digested allowing the bacteria in the digestive tract to feed on them" - https://thefunctionalgutclinic.com
Symptoms include bloating and burping, which is caused by a build-up of gas in the intestines. This acidic imbalance can also cause abdominal cramping and pain, indicating SIBO. A possible source of low stomach acid could for example be H. pylori (associated with a condition called peptic ulcer), but there are many other stress factors that lead to the production of low stomach acid too, such as advancing age and increased stress from work or family related matters.
Stomach acid problems are better solved by consulting your doctor for advice on that to do next, they often require further medical analysis or changes to diet.
4. Constipation related SIBO
The occurrence of constipation can also cause small intestinal bacterial overgrowth. These symptoms include abdominal pain, bloating and foul smelling burps. If you're experiencing any of these symptoms in addition to having less frequent bowel movements, you have a reason to suspect SIBO or even IBS.
A recent study nevertheless explained that methane gas, generally associated with the digestion of food and resultant waste by-products in the healthy gut flora, could be significant as a symptom of excessive methane production in patients with constipation.
Diarrhoea is another common bowel dysfunction tied to methane production and data suggests that it is characteristic of slow gut transit time. Note: Gut flora is microorganisms present in the body which aid in absorption and digestion of foods.
Slow intestinal transit time means your colon is less effective at removing an enzyme that causes the fermentations of carbohydrates. Hence having a Keto Style / Low Carb diet whilst including dietary fiber may be enough to deal with constipation related symptoms.
The Keto Diet to improve symptoms of SIBO!
Can you use the Keto Diet to help with SIBO related issues?
When considering a diet that aims to improve issues relation to SIBO and IBS, you essentially need to look at diets which reduce the effects of bloating caused by symptoms of SIBO (small intestine bacterial overgrowth).
People that suffer from SIBO often find relief from following a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet.
The FODMAPs are a collection of short chain carbohydrates known as dietary fiber which are poorly absorbed in the small bowel and therefore fermented by bacteria in the large bowel. This can cause bloating, abdominal pain and distension - all symptoms that are commonly associated with SIBO!
The FODMAP diet and KETO share a lot of the same qualities and by undertaking a low-carb diet you will automatically reduce you intake of FODMAP's. This should helps to reduce these symptoms you're experiencing.
Common high FODMAP foods that cause fermentation and related SIBO symptoms, include apples, pears, grains (such as bread and cereal), soya beans, dairy products, and sugar alcohols. Note: The sugars and carbs in these foods are the reason for their high FODMAP content.
So, the keto diet is no doubt an effective diet plan when it comes to reducing inflammation and improving gut health, which in turn can help improve weight loss as well since good gut health is crucial for losing weight.
"Systemic inflammation is regulated by the production of pro- and anti-inflammatory cytokines. Alterations in the balance of these mediators results in reduction or increase in systemic inflammation (20). The effects of KD on systemic inflammation are related to three main drivers: (1) insulin reduction, (2) BHB synthesis, (3) glucagon increase (21). Additionally, since insulin reduction leads to weight loss, all the anti-inflammatory effects of weight loss should be taken into account as well" - www.frontiersin.org (5)
The Keto Diet can help with a range of the SIBO and IBS symptoms, by improving gut health, reducing inflammation, improving bacterial balance in the intestine and in a study recent study, it was found that participants with diarrhoea related IBS improved stool frequency while stool consistency went from diarrhoea to normal after they started using a low carb diet.
How can I Cure and Improve SIBO and IBS?
The good news is, SIBO can be treated with holistic treatments such as reducing excess sugars and other types of carbohydrates, balancing your pH levels either through diet or supplementation and restoring balance to your gut flora either through probiotic sources or herbal remedies.
The following will give you ideas on steps to follow to naturally treat your SIBO related symptoms
1. Probiotics and Herbal Drinks
Probiotics are good for your gut health and using them in your diet can aid with SIBO related issues by improving the quality and balance of good bacteria such as Bacteroides, Lactobacillus, and Bifidobacterium in your body.
Preliminary evidence suggests that fermented food products containing live bacteria can help alleviate chronic diarrhoea caused by bacterial overgrowth and excess expansion in the small intestine.
Take for instance one study, which showed subjects who took probiotics experienced great reductions in pain, bloating, belching and diarrhoea compared to subjects who only took antibiotics.
Herbal tea's can be used for a range of ailments in the human body, due to their diverse range of herbal benefits. Ginger Tea for instance is great for people who suffer from constipation. Try taking ginger tea to relieve symptoms of IBS and SIBO.
Ginger has many health benefits like assisting with IBS symptoms and helping to maintain a healthy gut which is often why people eat Ginger related items when feeling unwell or suffering from pregnancy related abdominal pains.
Studies suggest that ginger extract can speed up the digestive system Ginger speeds up gastric emptying, boosting efficiency and reducing the chances of indigestion or gas.
2. Consume Healthy Fats
A keto diet goes hand in hand with increased fat intake and significantly lowers carb intake compared to a typical diet. When one undergoes a diet like this, the body converts into burning fats instead of carbohydrates and releases ketones as a result.
When the body is more efficient at burning fats and utilizing ketones, weight loss results from a sudden change in metabolic processes, and when experiencing constipation from underlying SIBO specifically, there is an increased tendency for bowel movements.
Essentially the Keto Diet whilst eating healthy fats encourages bowl movements and the bodies ability to flush its own system helping to speed up gut to bowl transit times, reducing the time for food to ferment and cause gas related pains.
We are what we eat, and so is your body. Be sure to choose healthy sources of fat in your diet, like MCT oil (medium-chain triglyceride), eggs, olive oil, fatty cuts of meat, and avocados as these will help you feel energized and alert during the day whilst speeding up your foot transit times.
3. Undertake a Low FODMAPS Diet
This one goes hand in hand with the Keto and Low carb diets as they share many of the same restrictions and benefits.
Both diets essentially limit your carbohydrate intake the key difference it that FODMAPS are a specific type of carbohydrates so be sure to reduce these whilst undertaking your low carb diet.
The foods to reduce when following a FODMAP diet are
Lactose - Found in Dairy products such as milk, and butter
People without sufficient lactase cannot fully digest the sugar molecules called lactose. Therefore, they experience diarrhea, gas and bloating after consuming dairy products. The condition is usually harmless, but luckily most people can decrease their symptoms by having smaller servings of dairy foods or by eating with other foods that contain fat at each meal.
Polyols - Such as maltitol ,xylitol ,sorbitol and mannitol
Polyols are indigestible carbohydrates that are also commonly known as sugar alcohols. Normally not absorbed by the small intestine, these get passed directly to the large intestine, where they are often fermented by gut bacteria, producing considerable amounts of gas in the process. This can cause a lot of bloating for people with irritable bowel syndrome (IBS).
Fructose - Found in Fruits such as Pears, Mangoes, Apples and Berries
Fructose is normally metabolized in the small intestine, but for those who have fructose intolerance, the carbohydrates travel to the colon where it is fermented and released as hydrogen and methane gases. This causes pain, bloating, flatulence and diarrhea
Fructans - Pulses, Nuts, Certain Fruits (on the Fructose list) Garlic, Onions, Asparagus, Brussels Sprouts and cabbage
Fructans and GOS (galacto-oligosaccharides) are carbohydrates that occur naturally in plants and foods, like wheat, asparagus and artichokes. People who have trouble digesting fructans may experience gas, bloating, belching or constipation.
What happens if SIBO and IBS are not treated?
Untreated SIBO can lead to complications and other health related issue in the future. Problems can range from mild to severe such as nutrient deficiencies, malnutrition, weight loss, and in extreme cases heart disease, bone disorders and other health related issues.
An alarming finding from the Journal of the American Heart Association's study determined a high prevalence SIBO among heart failure patients. Furthermore, patients with SIBO are at a greater risk to re-hospitalize. That being said, this should motivate proactive heart failure patients and their caretakers to look into some preventative tactics in order to keep them out of the hospital as it were.
"Small intestinal bacterial overgrowth (SIBO) was highly prevalent and independently associated with poor outcomes in patients with heart failure" https://www.ahajournals.org/doi/10.1161/JAHA.119.015292 (2)
If your in any doubt about your SIBO or IBS symptoms please seek sound medical advise and speak to your doctor or qualified medical practitioner
So can the Keto Diet help people suffering from SIBO and IBS related symptoms and help to cure the illness?
SIBO has a lot of different symptoms. Some of these include abdominal pain, diarrhea and constipation, nausea, bloating and more. However, it can be easily treated with the help of a professional medical doctor and even by following some different strategies such as going on a keto diet for SIBO. Partaking in restricted low-FODMAP diets or helping flush out your gut with some probiotics usually works to ease other symptoms associated with this infection too.
It can be seen that Yes the Keto Diet can help with SIBO and IBS related issues, by cutting out bad FODMAPS and eating a higher fat content diet which aids in digestive track transit time.
A Note on Carbs and your Gut Bacteria
Although all of the information in this article is based on current given information in relation to the best way of reducing the sympoms of SIBO and IBS, it has to be noted that most gut bacteria, good and bad use carbohydrates for their source of fuel.
Undertaking a Keto Diet, will help to reduce bad bacteria to a level that helps to improve many of the related symptoms with IBS and SIBO, but it can also make it harder for the good bacteria to grow in the body, for this reason when recommending a diet for SIBO and IBS, we would recommend a short term Keto Diet whilst transitioning on to a low carb diet utilising pro-biotics and non FODMAP's to ensure a healthy gut bacteria start.
The health information that The Carb Free Zone provides across all of it sources, including this website is for educational purposes only and should not be used as a substitute for medical advice.
Be sure to consult with a qualified health professional or your doctor for your individual needs
(1) Ariane Lang, BSc, MBA and Megan Rossi, PhD, RD — Medically reviewed by Adrienne Seitz, MS, RD, LDN, Nutrition — Updated on January 12, 2022 - A Beginner’s Guide to the Low FODMAP Diet - https://www.healthline.com
(2) Yu Song, Yuan Liu, Baozhen Qi, Xiaotong Cui, Xinyue Dong, Yanyan Wang, Xueting Han, Fuhai Li, Dongli Shen, Xian Zhang, Kai Hu, Shiyao Chen, Jingmin Zhou and Junbo Ge - Originally published17 Mar 2021 https://doi.org/10.1161/JAHA.119.015292Journal of the American Heart Association. 2021;10:e015292 - https://www.ahajournals.org
(3) Effects of FODMAPs on the Gut - Adapted from IFFGD Publication #251 by CK Yao, Jessica Biesiekierski, Sue Shepherd, Peter Gibson, Eastern Health Clinical School, Monash University, Box Hill Hospital, Melbourne, Australia and Adapted from IFFGD Publication #273 “Functional GI Disorders, Microbes, and Brain-Gut Interactions” by Cole W. Norton and Aki S. Norton, IFFGD, in collaboration with Emeran Mayer Adapted by Abigale Miller. https://aboutibs.org
(4) Antibiotic-induced changes in the human gut microbiota for the most commonly prescribed antibiotics in primary care in the UK: a systematic review - Karen T Elvers1, Victoria J Wilson2, http://orcid.org/0000-0002-6657-1514Ashley Hammond2, Lorna Duncan2, http://orcid.org/0000-0001-9409-7891Alyson L Huntley2, Alastair D Hay2, http://orcid.org/0000-0002-5330-5735Esther T van der Werf2,3 https://bmjopen.bmj.com
(5) The Effect of Ketogenic Diet on Inflammatory Arthritis and Cardiovascular Health in Rheumatic Conditions: A Mini Review - Jacopo Ciaffi1*, Dmitri Mitselman2, Luana Mancarella1, Veronica Brusi1, Lucia Lisi1, Piero Ruscitti3, Paola Cipriani3, Riccardo Meliconi1,4, Roberto Giacomelli5, Claudio Borghi2 and Francesco Ursini1,4 - https://www.frontiersin.org