Artificial Sweetener Linked to GI Problems
Bauditz J, Norman K, Biering H, et al. Severe weight loss caused by chewing gum. BMJ. 2008;336:96-97.
Sorbitol, an artificial sweetener frequently used in sugar-free chewing gum and candy, is now associated with chronic diarrhea and functional bowel problems which can lead to severe weight loss. Two recent German case studies were the focus of this, and were published in the January 12 issue of BMJ.
Very few people who chew sugar-free gum or eat sugar-free candy will experience severe gastrointestinal problems or weight loss, since one would have to consume 20 to 50 grams of sorbitol for it to have this effect. That amounts to about 16 to 20 pieces of gum daily. However, even in small amounts, sorbitol can cause symptoms such as gas, bloating, and abdominal cramping to occur.
Both patients in the case report had been suffering from unexplained persistent diarrhea and weight loss. Once detailed dietary histories were taken, it was uncovered that both patients consumed very large amounts of sorbitol. In both cases, once the sorbitol was eliminated from their diets, the diarrhea went away and they began to regain weight.
Primary care providers should take a detailed dietary history of food containing sorbitol for all patients who present with unexplained persistent gastrointestinal symptoms and/or weight loss. This could solve the problem quickly and eliminate the need for unnecessary and expensive diagnostic tests and lab work.