The sweetener sorbitol has been linked to serious bowel problems when taken in high amounts, according to a warning released by German doctors today. Sorbitol is a sweetener used in chewing gum, diet drinks, candies, mints, ice cream, cake mixes, and some medications. The warning came after two patients suffered chronic diarrhea, abdominal pain, and severe weight loss after ingesting large amounts of the sweetener. Writing in The British Medical Journal, the doctors from Berlin said the patients—one man and a woman—had consumed around 15 to 20 sticks of chewing gum daily. Once they stopped chewing sorbitol-sweetened gum, their bowel function returned to normal.
Sorbitol is also known as E420 or glucitol and is a sugar alcohol that metabolizes in the body slowly, is poorly absorbed by the small intestine, and is known to have laxative properties. Because sorbitol is so poorly absorbed, it is able to provide fewer calories than traditional sugars. Dr. Juergen Bauditz and colleagues of the University of Berlin said consumers might fail to connect sorbitol use with gastrointestinal problems. “Our cases demonstrate that sorbitol consumption can cause not only chronic diarrhea and functional bowel complaints but also considerable unintended weight loss—about 20 percent of usual body weight,” they wrote. Ingesting 20 grams daily in sugar-free gum has led to severe diarrhea leading to unintended weight loss. In 1999 a 114-pound woman lost 24 pounds and another patient required hospitalization after habitually consuming 30 grams per day. Sorbitol is known to worsen some digestive disorders such as irritable bowl syndrome and fructose malabsorption/dietary fructose intolerance.
In 1999, The Center for Science in the Public Interest petitioned the Food and Drug Administration (FDA) to improve warning labels on processed foods containing sorbitol. Studies in the prior fifteen years proved sorbitol can cause gastrointestinal symptoms, ranging from mild discomfort to severe diarrhea, when adults consume between 10 and 50 grams of the additive; children may be affected by smaller amounts. The FDA requires a laxative notice on products that may lead to the consumption of 50 grams or more of sorbitol daily, though some companies voluntarily label additional products. When added to cough syrups and lozenges, sorbitol is generally listed under those product’s inactive ingredients.
Sorbitol is naturally occurring in many stone fruits and berries from trees of the genus Sorbus, thus its name. Because sorbitol provides dietary energy it is referred to as a nutritive sweetener and is categorized as a sweetener, an emulsifier, and a humectant and can be dispensed as a non-stimulant laxative because of its ability to draw water into the large intestine, stimulating bowel activity.
As a humectant—a substance able to derive moisture from the air—sorbitol is also often used in cosmetics. Sorbitol is also used as a thickener in cosmetics and there are some transparent gels that can only be made with sorbitol because of its light reflecting properties. Sorbitol can also be found in some cigarettes for its humectant properties and is added to surimi, an uncooked fish paste. Oddly enough, sorbitol is also a component in amateur solid rocket fuel.
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