Individuals who chew lots of gum with sorbitol, a sugar substitute that is also a laxative, may suffer from diarrhoea so chronic that it could cause a severe loss of weight, German doctors warn.
In an unusual case study reported by next Saturday's British Medical
Journal (BMJ), gastro-entorologists at Berlin's Charite hospital
describe how they investigated two patients who had persistent
One was a 21-year-old woman who had been experiencing diarrhoea and
diffuse abdominal pain for eight months and had lost 11 kilos (24.2
pounds) of her 51.8-kilo (114-pound) body weight.
The other was a 46-year-old man with flatulence, abdominal bloating
and diarrhoea so bad that he had lost 22 kilos (48 pounds), or a fifth
of his body weight, over the past year.
But the doctors were flummoxed when blood tests, colonoscopies,
ultrasound and computed tomography scanners all showed the patients
were otherwise healthy.
Their next step was to examine electrolytes in the patients' stools,
and these showed extremely high levels of potassium and sodium.
Questioned about their dietary habits, the young woman said she
chewed on more than a dozen sticks of sugar-free gum each day, and the
man used up 20 sticks and also ate up to 200 grams (6.5 ounces) of
sweets each day.
According to the doctors' calculations, the female patient was
ingesting 20 grams (0.7 ounces) of sorbitol each day, while the man's
intake was around 30 grammes (1.05 ounces).
The patients modified their chewing habits and within a year had
returned to normal intestinal health, the letter adds. The woman gained
seven kilos (15.4 pounds) and the man five kilos (11 pounds).
"Our cases show that sorbital consumption can cause not only chronic
diarrhoea and functional bowel problems, but also considerable
unintended weight loss," say the doctors.
"Thus, the investigation of unexplained weight loss should include
dietary history with regard to foods containing sorbitol." – (Sapa-AFP)