Many individuals adopt a plant-based diet for health or ethical reasons. However, a sudden increase in plant-based foods can sometimes lead to digestive issues like gas, bloating, or diarrhea. This article explores the potential causes of diarrhea on a vegan diet and provides guidance on managing these symptoms for optimal gut health.
Why Diarrhea May Occur on a Vegan Diet
Vegetarian and vegan diets rely heavily on plants for protein, including foods like beans, legumes, broccoli, and asparagus. These foods, while nutritious, can contribute to digestive discomfort in some individuals.
FODMAPs: A Key Factor
FODMAPs, or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, are certain types of carbohydrates, starches, and sugars that can be fermented during digestion. They are found in many fruits, vegetables, wheat products, dairy products, and even artificial sweeteners like high-fructose corn syrup.
When FODMAPs are fermented, they can draw extra water into the colon and produce more gas, potentially leading to uncomfortable IBS symptoms that can last for hours or days.
Veganism and IBS: A Complex Relationship
Living with irritable bowel syndrome (IBS) often necessitates dietary changes. While a vegan diet may seem appealing to those seeking to improve their health or align with ethical values, it's not always a straightforward solution for IBS. Many plant-based foods can irritate the gastrointestinal (GI) system and either cause or worsen IBS symptoms.
Read also: Troubleshooting Carnivore Diet Diarrhea
A 2017 study indicated that two-thirds of people with IBS attribute their symptoms to specific foods. These symptoms can include bloating, diarrhea, gas, and constipation.
The Low-FODMAP Diet: An Alternative Approach
Adopting a diet that eliminates foods considered difficult to digest, such as the low-FODMAP diet, may be a better way to control IBS symptoms than following a strictly vegan diet. However, it is possible to combine both approaches under the guidance of a healthcare professional.
The low-FODMAP diet focuses on measuring foods by their ability to break down in the small intestine. Foods low in FODMAPs cause fewer GI reactions because the body breaks them down before they reach the colon.
Integrating Veganism with a Low-FODMAP Diet
Veganism for IBS may incorporate the low-FODMAP diet. While the low-FODMAP diet does not exclude meat and dairy products, it can be adapted to align with the principles of veganism.
Low-FODMAP Vegan Food Options
Fortunately, there are many plant-based foods that are low in FODMAPs and easier on the digestive system, such as rice, firm tofu, ginger, and spinach.
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High-FODMAP Vegan Foods to Limit
Conversely, certain vegan foods are high in FODMAPs and may trigger IBS symptoms. Examples include:
- Certain fruits: Apples, pears, mangoes
- Vegetables: Onions, garlic, broccoli
- Legumes: Beans, lentils
- Wheat-based products
Effectiveness of the Low-FODMAP Diet for IBS
A 2016 study found that up to 86 percent of participants with IBS experienced fewer GI symptoms when following the low-FODMAP diet. However, the study emphasized the importance of adhering to the diet closely and working with dietary professionals to ensure optimal nutrition.
Key Considerations for Managing IBS
Managing IBS effectively involves several factors:
- What and when you eat: Eating regular meals and snacks can help regulate digestion.
- How much you exercise: Regular physical activity can promote healthy bowel function.
- How much water you drink: Adequate hydration is essential for preventing constipation.
Practical Tips for Daily Life
Here are some ways to incorporate these considerations into your daily life if you have IBS:
- Eat breakfast, lunch, and dinner, as well as snacks as needed, according to a regular schedule.
- Plan nutritious meals and adhere to your diet.
- Watch your food portions and avoid large meals and long gaps between mealtimes.
- Eat slowly and chew your food carefully before swallowing.
- Exercise at least 150 minutes per week with moderate activity.
- Drink 6 to 12 cups of water per day.
- Avoid processed foods.
- Consume sugary or spicy foods in moderation.
- Keep a journal of your symptoms and note any suspected trigger foods or beverages.
Seeking Professional Guidance
If you live with IBS and experience uncomfortable symptoms, consider working with a registered dietitian nutritionist or a doctor. Changes to your diet, including veganism or a low-FODMAP diet, may be healthy options, and a professional’s expertise can help you plan a well-rounded diet that takes into account your nutritional needs.
Read also: The Connection Between Diarrhea and Weight Loss
Adopting a low-FODMAP diet may require a period of time where you eliminate certain foods and slowly reintroduce potentially triggering items over time. A healthcare professional can ensure that you do this safely and effectively.
The Impact of Diet on Gut Health: A Vegan Perspective
Diet has a direct impact on the digestive tract-a fact that vegans can attest to firsthand. If you’ve recently transitioned to a plant-based diet or are simply looking to improve your bowel health, here are some things to keep in mind.
Increased Bowel Movements
Vegans tend to experience more frequent bowel movements. A University of Oxford study of 20,000 people found that vegans poop more than vegetarians, who in turn poop more than meat eaters. Eating a healthy vegan diet rich in fruits, vegetables, and whole grains makes it easy to exceed the recommended 25 to 30 grams of fiber a day, often resulting in daily bowel movements or even two or three.
Quality Over Quantity
More important than the frequency of bowel movements is experiencing a sense of complete relief afterward. Without this sense of satisfaction, constipation may be present, even with daily bowel movements or diarrhea (overflow). The ideal is to spend less than three minutes on the toilet and have a soft stool that passes without pushing or straining.
Plant-Based Diets and Constipation
While a plant-based diet provides a foundation for healthy bowel movements (especially when it includes flax and chia seeds), other factors, such as hormonal changes, also play a role. Regular exercise and adequate water intake help move food through the colon. Stress-reduction techniques such as yoga and meditation can also be beneficial.
Pelvic floor dysfunction, where muscles that are supposed to relax during bowel movements actually tighten up, can also contribute to constipation in plant-based individuals. Pelvic floor physical therapy can help address this issue.
Monitoring Stool Form
Consult the Bristol Stool Chart to understand the different types of stool. Type 4, which is poop formed like a long, bulky, soft sausage or snake, smooth without lumps, is considered ideal. Sixty percent of stool weight comes from the gut bacteria of the microbiome. When you feed gut bacteria the fiber-rich plant foods they prefer, they thrive and multiply, resulting in larger bowel movements.
Stool as a Vital Sign
Changes in stool can indicate that gut bacteria are not being properly nourished. Since gut health is integral to overall health, dysbiosis (an imbalance in the gut microbiome) may manifest into other disease states. Constipation can precede a diagnosis of Parkinson’s disease by as many as 20 years and is common in up to two-thirds of patients. It’s also linked to an increased risk for breast cancer and mood disorders.
Nourishing gut microbes with a diverse menu of 30 different kinds of plants per week is recommended. Pencil-thin stools, blood in the stool, or a feeling of incomplete bowel emptying warrant a consultation with a doctor.
Understanding Your Poo: A Guide to Gut Health
Our poo matters! More than 4 in 10 people suffer from poor digestion, and 1 in 4 suffer from IBS. Our poo says a lot about our gut health. There are 7 types of poo, each indicating an area of health that is either in or out of balance in our gut.
Over 70% of your immune system originates in your gut. Research shows you're nearly twice as likely to suffer from poor skin, weaker hair, and a lack of energy if you suffer from even mild IBS. You're also more likely to experience higher levels of stress, struggle to concentrate and focus, and suffer from poor sleep and insomnia if you have digestion issues or IBS.
The Importance of Elimination
Eliminating toxins, organisms, bad bacteria, fungi, and parasites from your body through your poo is vital for your overall health.
The Significance of Color
Properly digested food will exit the body as a medium brown color.
- Pale or yellow poo: Indicates that you are not digesting or absorbing fat effectively, potentially due to undiagnosed gut issues such as coeliac disease or a lack of lipase (fat-digesting enzymes).
- Very dark poo: Generally a sign to see your doctor, as it can indicate an issue such as an ulcer in the gut. However, it's normal if you are taking medication containing iron.
Ideal Poo Characteristics
- Smooth, without cracks: Indicates sufficient fiber intake and probiotics in your gut to metabolize food effectively, as well as enough water for hydration. Cracks suggest dehydration or insufficient fiber.
- Sausage shape: Indicates enough fiber and water to sweep the bowel clean.
- Soft blobs: Also healthy, as long as they are mid-brown and do not float.
- Floaters: A warning sign of poor absorption of fat. If the poo is also yellow, it indicates a bigger problem.
- Quickly sinking poo (diarrhea): Can indicate mineral malabsorption.
Offensive Odor
While it's natural for poo to smell, a really offensive odor can indicate that your food is not being digested or absorbed properly, or a possible gut infection (bacterial, viral, or parasitic).
The Bristol Stool Chart
The Bristol Stool Chart makes it easier to discuss your poo with your practitioner by providing a visual guide.
- Types 1 & 2: Constipation Small, hard balls of poo that are hard to pass are a sign of constipation. Increase hydration, eat more water-soluble fiber from fruits and vegetables, and try taking gut-friendly bacteria through your diet or a probiotic supplement. Exercise also helps relieve constipation as it gets the gut moving. If these tips don’t help, ask your doctor to investigate further.
- Types 5, 6 & 7: Diarrhoea This is a sign of irritation in the gut and often accompanies infections or auto-immune diseases of the gut.
- Incontinence: The inability to control your bladder or your bowel. Consult your doctor on first signs. Bowel incontinence may be due to a number of factors including an anal prolapse, weak pelvic floor muscles, inflammatory bowel diseases, problems with the spine, severe haemorrhoids, or after childbirth.
Seeking Medical Advice
If you have a sudden change in bowel movements, it is important to discuss this with your doctor. Sometimes the first sign of irritable bowel diseases (IBS) or bowel cancer can be a sudden change in bowel habits.
Plant-Based Diets and Bowel Health: A Study
The beneficial effects of a plant-based diet on gut microbiota diversity are well documented, however, its impact on clinical bowel health and defecation patterns are less well understood. Vegetarian diets have been associated with a higher bowel movement (BM) frequency as well as softer stools in cross-sectional studies.
A study examined bowel health and defecation patterns in relation to diet and nutrient intake in a young and healthy sample of n = 65 physically-active German university students who were randomly assigned to either a vegan or a meat-rich diet for eight weeks. Bowel health assessment included the Bristol Stool Form Scale (BSFS), the Gastrointestinal Quality of Life Index (GIQLI) and the Cleveland Clinic Fecal Incontinence Score (CCFIS). Nutrient intake was assessed using weighed food diaries.
Weekly BM frequency slightly increased in vegans, whereas it remained unaltered in participants assigned to a meat-rich diet. Fiber intake increased significantly in vegans (34.89 (18.46) g/d) whereas it decreased in those assigned to the meat-rich group (22.79 (12.5) g/d). No significant intergroup differences in BSFS and CCFIS patterns were observed.
Study Design and Methodology
The study was a monocentric, randomized-controlled trial performed at the Centre for Complementary Medicine at Freiburg University Medical Center, Germany. Participants were recruited by placing advertisements on notice boards at local universities, in student residences and in public places in Freiburg, Germany. In addition, advertisements were posted on social media platforms.
Healthy individuals aged 18-60 years and with a BMI between 21 and 30 kg/m2 were considered. Criteria of exclusion included: chronic health conditions, a regular intake of medication, pregnancy or lactation, clinically-relevant allergies, eating disorders as well as alcohol (>20 g/d) and daily nicotine intake.
Participants were assigned to a balanced mixed diet for one week (run-in phase), following the recommendations of the German Nutrition Association (DGE). After the first week, participants were invited for a second appointment where randomization and biosampling took place. An independent person created a block-wise randomization list using Stata software.
Participants were instructed on how to implement their assigned diet in individual coaching sessions, receiving a study- and diet-specific booklet. The coaching ended with a brief capstone session, and participants were invited to a mandatory group seminar for their diet at the end of the first study week.
Bowel health and defecation pattern assessment included the Bristol Stool Form Scale (BSFS), the Gastrointestinal Quality of Life Index (GIQLI), and the Cleveland Clinic Fecal Incontinence Score/Jorge-Wexner Score (CCFIS/JW Score). Dietary intake was estimated based on a 3-day weighed food diary.