People who eat large quantities of a type of sweetener could be putting themselves at risk of an upset stomach, experts said today.
Sorbitol, which is widely used in ‘sugar-free’ products like chewing gum, sweets and some cereals, could cause severe weight loss, abdominal pain and diarrhoea, they warned.
Writing in the British Medical Journal (BMJ), doctors from Berlin said patients eating the equivalent of 14 or more sticks of gum a day suffered severe symptoms.
They said medics should ask patients about their intake of the sweetener if there was unexplained weight loss and other such problems.
Sorbitol (also called E420) is a bulk sweetener that has about the same sweetness as sugar.
It can be added to foods in similar quantities to sugar but contains around a third fewer calories.
Sorbitol is known to have a laxative effective and is poorly absorbed by the small intestine.
Juergen Bauditz and colleagues, from the Charite Universitatsmedizin Berlin medical school, reported on two patients with chronic diarrhoea and substantial weight loss.
They had already undergone extensive investigations to find what was wrong to no avail.
On questioning, both patients said they ate large 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 18-20g sorbitol (one stick of chewing gum contains about 1.25g sorbitol).
At the time of her appointment, she had lost 24lb (11kg) and weighed 6st 6lb (40.8kg).
After both patients started a sorbitol-free diet, their diarrhoea stopped and they gained weight again.
The authors said people should be warned of the dangers of too much sorbitol, including diabetics who rely on low-sugar or sugar-free foods.
They said: ‘As possible side-effects are usually found only within the small print on foods containing sorbitol, consumers may be unaware of its laxative effects and fail to recognise a link with their gastrointestinal problems.’
A statement from Wrigley, which uses sorbitol in some of its gums, said: ‘It is well documented in medical literature, with studies going back more than 20 years, that excessive consumption of polyols, such as sorbitol, can have a laxative effect in some individuals.
‘Those studies generally indicate that people can consume up to 40g of sorbitol without experiencing a laxative effect, subject to the individual and other components of his or her diet – a level not even approached by normal consumption of sugar-free chewing gum.
‘In the interest of informed consumer choice, the Wrigley Company clearly labels ingredient information on all of its packaging.
‘Per EU regulations, packages of our sugar-free chewing gum containing sorbitol and other polyols carry the required statement: Excessive consumption may produce laxative effects.’
©The Press Association, All Rights Reserved