Additional Information on Sorbitol for Health Professionals

What is Sorbitol

Sorbitol is a low calorie sugar known as a sugar alcohol or polyol. It is found naturally in foods including prunes and apricots; is made commercially, where its uses include ‘bulk sweeteners’, humectants (which help products retain moisture), as an ingredient in chewing gum and sugar free sweets and as an ingredient in some medicines

What does Sorbitol do in the body?

Sorbitol is very similar to glucose, but unlike glucose, it acts as a laxative by being absorbed very slowly into the blood. As a consequence of this slow absorption as it passes through the gut, the sorbitol tends to hold onto some water. This then increases the moisture content of the stools which leads to easier passage from the body.

Potential benefits and risks

Sorbitol rarely causes negative side effects (see below), however, due to the effect on the gut, this can cause abdominal discomfort, flatulence, diarrhoea, a need ‘to go’ and nausea. Sorbitol containing drugs can also cause diarrhoea.

If sorbitol is consumed in a large enough dose, excess water may not be absorbed, so can cause diarrhoea; flatulence; and loose stools.

Table 1 below outlines the potential risks and benefits of sorbitol.

 

Potential Benefits
  • Low Glycaemic Index
  • Involved in dental caries prevention
  • Low in energy
  • Laxative properties to help relieve constipation
  • Acts as a prebiotic, which promotes the production of good bacteria in the gut
  • Produces stools of a ‘good’ consistency to help leave the body easily, which can help prevent against colon cancer and irritable bowel disease
Potential Risks
  • Diarrhoea
  • Abdominal discomfort

References

1) Garrow JS, James WPT, Ralph A (2000) Human nutrition and dietetics. Churchill Livingstone, London.2) Livesey G (2001) Tolerance of low-digestible carbohydrates: a general view. British journal of nutrition. 85; S7-S16.

3) Stacewicz-Sapuntzakis M, Bowen P, Hussain E, Damayanti-Wood B, Farnsworth N (2001) Chemical composition and potential health effects of prunes: a functional food? Critical review in food science and nutrition. 41; 251-286.

4) Chassany O, Michaux A, Bergmann J (2000) Drug-induced diarrhoea. Drug safety. 22; 53-72.

5) Ratnaike R, Jones T (1998) Mechanisms of drug-induced diarrhoea in the elderly. Drugs and aging. 13; 245-53.

6) Geissler C, Powers H (2005) Human Nutrition. Churchill Livingstone, London.

7) Piirainen L, Peuhkuri K, Bäckström K, Korpela R, Salminen S (2007) Prune juice has a mild laxative effect in adults with certain gastrointestinal symptoms. Nutrition research. 27; 511-513.

8) Bowman WC, Rand MJ. 1980. Textbook of Pharmacology. Blackwell Scientific Publications 2nd Edn.

9) Gattuso J, Kamm M (1994) Adverse effects of drugs used in the management of constipation and diarrhoea. Drug safety. 10; 47-65.

10) McRorie J, Zorich N, Riccardi K, Bishop L, Filloon T, Wason S, Giannella R (2000) Effects of olestra and sorbitol consumption on objective measure of diarrhoea: impact of stool viscosity on common gastrointestinal symptoms. Regulatory toxicology and pharmacology. 31; 59-67.

11) Wang Y, van Eys J (1981) Nutritional significance of fructose and sugar alcohols. Annual review of nutrition. 1; 437-75.

12) Reele S, Chodos D (1985) Sorbitol induced diarrheal illness model. International journal of clinical pharmacology, therapy and toxicology. 23; 403-405.

13) Skoog S, Bharucha A, Camilleri M, Burton D, Zinsmeister A (2006) Effects of an osmotically active agent on colonic transit. Neurogastroenterology and motility.

18; 300-6.

14) Madsen J, Linnet J, Rumessen J (2006) Effect of nonabsorbed amounts of a fructose-sorbitol mixture on small intestinal transit in healthy volunteers. Digestive diseases and sciences. 51; 147-153.

15) James L, Nichols M, King W (1995) A comparison of cathartics in pediatric ingestions. Pediatrics. 96; 235-238.

16) NHS Clinical Knowledge Summaries. Constipation in adults. http://cks.library.nhs.uk/constipation/management/detailed_answers/constipation_in_adults {accessed 08/12/08}

17)  Lucas E, Hammond L, Mocanu V, Arguitt A, Trolinger A, Khalil D, Smith B, Soung D, Daggy B, Arjmandi B (2004) Daily consumption of dried plum by postmenopausal women does not cause undesirable changes in bowel function. The journal of applied research. 41; 37-43.

Learn more about recommended doses and sources of Sorbitol