Does the Keto Diet Treat IBS?

If you deal with irritable bowel syndrome (IBS), you’re not alone. This common condition causes bloating, gas, stomach pain, constipation, and diarrhea.

To manage IBS, your healthcare provider may recommend that you change your diet, improve your lifestyle quality, and limit your intake of certain fermentable carbs called FODMAPs.

You may have also heard that the high fat, very low carb ketogenic helps treat IBS symptoms.

Yet, you may wonder whether this claim is backed by scientific evidence — and whether you should try out keto if you have IBS.

This article examines how the keto diet affects IBS symptoms.

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What is IBS, and how is it treated?

Irritable bowel syndrome (IBS) affects 14% percent of the world’s population. Its symptoms include stomach pain, bloating, cramping, constipation, and diarrhea (1, 2).

There’s no one identifiable cause of IBS. Instead, it likely involves a number of processes that may be unique to each individual (1).

Possible causes include increased digestive sensitivity, chemical signals from your gut to your nervous system, psychological and social stress, immune system activity, changes in your gut bacteria, genetics, diet, infections, certain drugs, and antibiotic use (1, 3).

Treatment

IBS treatment focuses on managing symptoms via medications, diet, and lifestyle adjustments (1, 4).

Many individuals find that food is a trigger for specific symptoms, so 70–90% of people with IBS limit certain foods to try to decrease negative effects (1, 5).

Experts often recommend a diet that includes regular meals, as well as adequate fiber and fluids. You should limit alcohol, caffeine, and spicy or fatty foods if they trigger symptoms (5).

Currently, a common treatment for IBS is a low FODMAP diet, which limits short-chain, fermentable carbs that are poorly absorbed by your body. FODMAPs are found in wheat, onions, some dairy, and some fruits and vegetables (1, 6).

These carbs cause increased water secretion and fermentation in your gut, which produces gas. Although this doesn’t negatively affect healthy people, it may trigger symptoms in people with IBS (1).

Diets low in FODMAPs have been shown to reduce the severity of IBS symptoms, particularly pain and bloating (2, 5, 7).

Very low carb, gluten-free, paleo, and immune-modulating diets are likewise used to treat IBS, though evidence on their effectiveness is mixed (2).

summary

IBS is a chronic condition characterized by stomach pain, bloating, cramping, constipation, and diarrhea. It’s commonly treated by restricting certain foods, eating a low FODMAP diet, and adopting other dietary and lifestyle changes.

What is the keto diet?

The ketogenic diet is a high fat, low carb eating pattern that’s similar to the Atkins diet. Originally developed in the 1920s to treat children with severe epilepsy, it’s commonly used for weight loss and other health conditions like blood sugar control (6, 8, 9, 10, 11, 12).

Its exact macronutrient ratio may differ based on individual needs, but it’s usually 75% fat, 20% protein, and 5% carbs (6, 13).

Keto limits bread, pasta, grains, beans, legumes, alcohol, sugar, and starchy fruits and vegetables while increasing your intake of high fat foods like nuts, seeds, oils, cream, cheese, meat, fatty fish, eggs, and avocados (6).

By restricting carbs to 50 grams or fewer per day, you enter a metabolic state in which your body burns fat for energy instead of carbs. This is known as ketosis (13, 14).

summary

The keto diet is a low carb, high fat eating pattern that shifts your body’s metabolism away from carbs. It’s long been used to treat epilepsy and other ailments.

Food Fix: Keto Basics

How does the keto diet affect IBS?

Despite keto’s popularity, very few studies investigate its effectiveness for treating IBS.

A 4-week study in 13 people with diarrhea-predominant IBS found that the keto diet helped reduce pain and improve the frequency and consistency of stools (15).

This may be due to the diet’s influences on your gut microbiome, or the collection of bacteria in your gut. Interestingly, people with IBS often have an imbalance in their types and numbers of gut bacteria, which may contribute to symptoms (16, 17).

Furthermore, animal and human studies reveal that very low carb diets deplete the bacteria in your gut that produce energy from carbs while boosting the number of beneficial bacteria (16, 18).

However, some research also suggests that low carb diets like keto decrease the overall diversity of gut bacteria and increase the number of inflammatory bacteria, which may have negative effects (18).

Currently, there’s not enough information to conclude whether the keto diet can benefit people with IBS. Further studies are necessary.

summary

Some research indicates that the keto diet may reduce symptoms of diarrhea-predominant IBS and improve aspects of your gut microbiome. Still, results are mixed and more research is needed.

Should people with IBS try the keto diet?

Despite some promising results, evidence for using keto to treat IBS remains limited.

It’s unclear whether positive effects can be attributed to the diet itself or rather the incidental elimination of trigger foods, such as FODMAPs or gluten (19).

Therefore, people with IBS shouldn’t use the keto diet as a primary treatment for IBS.

Many people may find keto too restrictive in nature, as it eliminates food groups like grains, beans, and legumes.

That said, if this diet can fit into your lifestyle, and you are interested in how it could change your symptoms, please talk to a medical professional to learn more.

summary

The keto diet isn’t currently recommended as a standard treatment for IBS due to a lack of scientific evidence. Yet, if it fits your lifestyle, it may reduce some symptoms and provide other benefits. Speak to a medical professional if you want to learn more.

Potential downsides

It’s important to remember that the keto diet may have a few downsides.

For example, fatty foods trigger symptoms in some people with IBS. Because the keto diet is very high in fat, it may worsen symptoms instead of improving them (5).

Furthermore, the keto diet can be low in soluble fiber, a nutrient that may alleviate some IBS symptoms (20).

Thus, it’s important to eat plenty of leafy green vegetables and seeds to boost your intake of soluble fiber if you have IBS and decide to try keto. Alternatively, you can take a fiber supplement (5).

Finally, people with diabetes should consult a health professional before starting keto, as the low carb intake could cause dangerously low blood sugar levels (13).

summary

The keto diet’s high fat levels may trigger IBS symptoms in some people. Furthermore, this eating pattern can be low in soluble fiber, a nutrient that may ease IBS-related complaints.

The bottom line

Studies on the ketogenic diet and IBS are limited and provide mixed results.

On the one hand, research demonstrates an improvement in diarrhea symptoms in people with IBS, as well as some positive changes to the gut microbiome.

On the other hand, keto may have several negative effects on your gut microbiome and is more restrictive than other dietary treatments.

Although the keto diet isn’t currently recommended to treat IBS, some people may find it advantageous for symptom management or other benefits, such as weight loss and improved blood sugar control.

If you’re curious about trying keto to help treat your IBS symptoms, it’s best to discuss your plans with your healthcare provider first.