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 diarrhoea.

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 grammes (6.5 ounces) of sweets each day.

According to the doctors' calculations, the female patient was ingesting 20 grammes (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."

PARIS, Jan 11, 2008 (AFP) -


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