Chewing too much gum containing sorbitol, a sugar substitute that is also a laxative, may cause chronic diarrhea leading to potentially dangerous weight loss, German doctors warn.
In an unusual case study reported by Saturday's issue of the British Medical Journal, German gastro-entorologists describe how they investigated two patients who had persistent diarrhea.
One was a 21-year-old woman who had been experiencing diarrhea 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 diarrhea so bad that he had lost 22 kilos (48 pounds), or a fifth of his body weight, over the past year.
Their cases remain mysteries until the doctors asked about their chewing habits. Both were found to be consuming a lot of sorbitol, primarily from chewing gum, said Dr. Herbert Lochs, professor of internal medicine at Humboldt University in Berlin, and one author of the report.
After both patients started a sorbitol-free diet normal bowel movements resumed and weight gain was achieved.
Sorbitol consumption in large amounts can cause functional bowel complaints and considerable unintended weight loss, so the investigation of unexplained weight loss should include detailed dietary history with regard to foods containing sorbitol, the authors say in a statement.