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Sorbitol in Chewing Gum Linked to Chronic Diarrhea

Severe weight loss in two patients traced to substantial consumption of sugar-free gum

FRIDAY, Jan. 11 (HealthDay News) -- Chewing large amounts of sugar-free gum can lead to chronic diarrhea and severe weight loss, according to a "Lesson of the Week" published in the Jan. 12 issue of BMJ.

Juergen Bauditz, M.D., of the Charite Universitatsmedizin in Berlin, Germany, and colleagues report two case studies in which consumption of chewing gum sweetened with sorbitol led to chronic diarrhea, functional bowel problems and significant weight loss.

A 21-year-old woman and a 46-year-old man both complained of chronic diarrhea (up to 12 bowel movements a day) and unintended weight loss. Other symptoms included abdominal pain and gas. Laboratory analyses in the woman's case indicated hypoalbuminaemia, but in both cases other examinations, including colonoscopy, abdominal ultrasound and computed tomography, were normal. Stool analyses for both patients revealed large osmotic gaps (80 mmol/L in the woman and 116 mmol/L in the man), which the authors attributed to unabsorbed solute. Inquiries into diet revealed that the woman consumed a daily dose of 18-20 g sorbitol from sugar-free gum (one stick contains about 1.25 g) while the man consumed approximately 30 g sorbitol daily from a combination of gum and sweets. In both cases, symptoms subsided and weight was regained when sorbitol ingestion was discontinued.

The authors conclude by recommending that "investigation of unexplained weight loss should include detailed dietary history with regard to foods containing sorbitol."

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