How do I fix constipation on a ketogenic diet?

By Dr. Stephen Phinney and the Virta Team

Many people assume that constipation while following a well-formulated ketogenic diet is due to inadequate fiber. However, it is often caused by the combination of too little sodium and inadequate fluid intake (dehydration).  In this case, a simple fix is to add 2 cups of broth or bouillon daily along with adequate fluids rather than a fiber supplement. With sustained nutritional ketosis, many people even report improvement in symptoms like gas, and bloating, and improvement with symptoms of irritable bowel syndrome.

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  1. Avatar

    Hello, I’m an Australian dietitian who is trialling a ketogenic diet currently for health benefits. Could you please provide some insight if there is any research on ketogenic diet and changes in gut microbiome. I am trying to find ways of incorporating resistant starches into the diet and maintaining total carbohydrates under 20g/day. I have read your comments on total vs net carbohydrates. I’d appreciate knowing if this is an area you are interested in researching as I’m not finding much about it currently. Thank you


    1. Virta Health

      Great question! Keep following along with us as we will be addressing a similar topic on the blog in the near future!


    2. Virta Health

      Hi Joy! Please see Dr. Phinney’s response to your question as well as our latest post on fiber on a WFKD. The topic of dietary fiber and the the gut microbiome is in considerable flux due to the rapidly expanding range of microorganisms that can be characterized, plus our increasing appreciation of the overlapping roles that butyrate and beta-hydroxybutyrate (BOHB) play in maintaining gut health. Butyrate is a product of the fermentation of dietary fiber by a healthy microbiome, whereas BOHB is produced in substantial quantities from dietary either dietary fat or stored body fat. From this perspective, there are two parallel paths to maintaining colon health, in which the nutritional ketosis path reduces the importance of a high fiber intake.


  2. Avatar

    Hi there, I’ve been following a strict Keto diet for the past 6 weeks and have not had any issues that have not resolved themselves until recently (about a week ago).

    Recently, I started to get bloating/over fullness in my stomach after each meal that will last hours or even into the next morning in the case of dinner.

    I’ve tried different animal protein sources and not having vegetables for a meal to test if it was due to fibre but that doesn’t seem to be the case.

    I have not introduced anything new into my diet recently as well.

    Would anyone be able to point me in the right direction to get myself fixed?


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