Use with Caution

When bowel problems strike, you usually take great care choosing foods that are good for you, because irritating your gut can have painful consequences. However, something you might not even think about – chewing gum – could be the source of tummy troubles.

Doctors in Germany recently issued a warning in the British Medical Journal 1that consuming too much sorbitol, a sweetener widely used in sugar-free chewing gum and other low-calorie sweets, can cause intestinal problems.

Although the journal report only involved two patient case studies, a 21-year-old woman and a 46-year-old man, authors attribute both patients’ severe weight loss to excessive sorbitol consumption. In the case of the woman, she ingested 18-20 grams/day, and the man, around 30 grams/day. A typical piece of gum contains about 1.25 grams of sorbitol, so their consumption was clearly higher than normal. Side effects noted by the authors included chronic diarrhea, abdominal pain, and severe weight loss of up to 20% of usual body weight. After starting a sorbitol-free diet, both patients resumed normal bowel habits and weight.

Sorbitol, like mannitol and xylitol, are from a family of polyalcohol sugars. According to the Calorie Control Council2, sorbitol is about 60% as sweet as sucrose, with one-third fewer calories. A French chemist first discovered sorbitol in the berries of the mountain ash in 1872 and it has been safely used in processed foods, pharmaceuticals, and cosmetics for almost fifty years.

The gum-producing Wrigley Company indicates that sorbitol occurs naturally in a wide variety of fruits and berries including pears, plums, cherries, dates, apricots, peaches, and apples.3

Chewing sugar-free gum is beneficial because this stimulates salivary production and helps remove food particles from around the teeth. However, it is important to be cautious when providing gum and candies containing alcohol-sugars to children, who might unwittingly over-consume these products and might not be expressing their tummy upsets clearly.

Products containing sorbitol do carry a warning that excessive ingestion may cause minor digestive side effects, but the authors of the BMJ article state that excessive use could cause chronic diarrhea and malabsorption, leading to unintended weight loss, so they recommend consumers take care with quantities. Problems from sorbitol could begin at around 5 grams/day, a quantity which could accumulate quickly when consuming a variety of sugar-free products.

First published in the Inside Tract® newsletter issue 166 – March/April 2008
1. Bauditz J, et al. Severe weight loss caused by chewing gum. British Medical Journal. 2008;336(7635):96-97.