People who chew sugarless gum and eat sugarless sweets are at risk for chronic diarrhea and severe weight loss, according to a new study published this week in the British Medical Association journal, BMJ.
Researchers say sorbitol, one of the ingredients in sugarless candy, sweets and gum, has laxative properties and is poorly absorbed by the small intestine.
The study follows the cases of two patients with chronic diarrhea, abdominal pain and severe weight loss. Although extensive investigations were carried out, final diagnosis was only established after a detailed analysis of eating habits.
On questioning, both patients said they consumed substantial amounts of sugar-free gum and sweets.
The first patient, a 21 year old woman, chewed large amounts of sugar-free gum, accounting for a total daily dose of 18-20 grams of sorbitol (one stick of chewing gum contains about 1.25 grams of sorbitol). The second patient, a 46 year old man, reported chewing 20 sticks of sugar-free gum and eating up to 200 grams of sweets each day, which together contained around 30 grams of sorbitol.
After both patients started a sorbitol-free diet, the diarrhea subsided and normal bowel movements resumed and weight gain was achieved.
Many sugar-free sweets containing sorbitol warn consumers of a laxative effect, but fail to recognize a link with their gastrointestinal problems, the authors wrote.
"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)," the authors wrote.