Sugar free or sugar substituted sweets have become increasingly popular in recent years as more people look to reduce their sugar intake for health reasons. However, some people report experiencing gastrointestinal side effects like diarrhea after consuming these products. In this article, we’ll explore whether there is any truth to the claim that sugar free sweets can cause diarrhea.
What are sugar free sweets?
Sugar free sweets are confectionary products that contain artificial sweeteners rather than sugar (sucrose). Some commonly used sweeteners in sugar free sweets include:
- Aspartame
- Acesulfame K
- Saccharin
- Sucralose
- Stevia
These artificial sweeteners provide the sweet taste without all the calories of sugar. Sugar free sweets often contain sugar alcohols like xylitol, sorbitol, and mannitol as bulking agents and sweeteners too.
Brand name examples of popular sugar free sweets include Werther’s Original Sugar Free Candy, Russell Stover Sugar Free Chocolates, and SmartSweets. These products are marketed to people looking to manage blood sugar, lose weight, or reduce calorie intake.
Do sugar free sweets cause diarrhea?
The digestive symptoms that some people report after eating sugar free products are often caused by the sugar alcohols used in them. Sugar alcohols are incompletely absorbed in the small intestine, so when consumed in large amounts they can have an osmotic effect and pull water into the intestines. This leads to diarrhea in some individuals.
The amount of sugar alcohols needed to cause this laxative effect varies between different sugar alcohols and also between different people. Some common sugar alcohols and the amounts that may cause diarrhea include:
- Xylitol: over 50 grams
- Maltitol: over 50 grams
- Mannitol: over 20 grams
- Sorbitol: over 20 grams
So in most cases, eating a few sugar free sweets that contain these ingredients is unlikely to cause problems. It’s when they are consumed in large amounts that digestive discomfort may occur. People who are particularly sensitive may experience effects from lower amounts.
Factors that influence risk of diarrhea
There are a few factors that can make someone more prone to developing diarrhea after eating sugar free sweets:
- Consuming large serving sizes in one sitting
- Eating excessive amounts of sugar free products regularly
- Individual sensitivity to sugar alcohols
- Pre-existing conditions like irritable bowel syndrome
If someone is sensitive to sugar alcohols, even small to moderate amounts may trigger diarrhea or abdominal cramping and gas. It’s possible to develop a tolerance over time if sugar free foods are consumed regularly.
Other potential side effects
In addition to diarrhea, sugar alcohols can cause some other gastrointestinal side effects in sensitive individuals including:
- Bloating
- Flatulence
- Abdominal pain
- Nausea
- Vomiting
These effects are temporary and dose-dependent. Other than causing discomfort, they are not generally dangerous.
Artificial sweeteners can also cause side effects in some people, though they are less likely to affect the digestive system. Headaches, migraines, and dizziness are sometimes reported after consuming aspartame. Acesulfame K may increase insulin secretion so could affect blood sugar regulation in diabetics.
Reasons people experience diarrhea from sugar free sweets
There are a few reasons why sugar free sweets, in particular the sugar alcohols they contain, can cause diarrhea in susceptible individuals.
Osmotic effect
Sugar alcohols like sorbitol, xylitol, and mannitol are poorly absorbed in the small intestine. This means they stay in the intestinal tract and cause an osmotic effect, drawing fluid into the bowels from surrounding tissues and blood. This extra fluid causes loose, watery stools.
Overconsumption
Eating a very large amount of sugar free sweets in one sitting increases the dose of sugar alcohols consumed. This means more enters the colon, causing osmotic diarrhea. People may overindulge in sugar free sweets because they believe them to be a healthy alternative.
Fermentation by gut bacteria
When sugar alcohols make their way to the colon, they can be fermented by the gut bacteria. This produces gases like carbon dioxide, methane, and hydrogen which can lead to gas, bloating, and diarrhea. People with conditions like small intestinal bacterial overgrowth (SIBO) may experience more fermentation.
Individual sensitivity
Some people are more prone to sugar alcohol diarrhea than others. Reasons for this higher sensitivity include:
- Insufficient levels of enzymes needed to digest sugar alcohols
- Pre-existing conditions like IBS and SIBO
- Impaired gut motility
- Abnormal gut microbiome
So in some cases, even a moderate amount of sugar alcohols can cause osmotic diarrhea or rapid transit through the gut before proper absorption occurs.
Sugar alcohols and laxative effects
The key reason that sugar free sweets cause diarrhea in some people is due to their sugar alcohol content. Different sugar alcohols have different laxative effects.
Sorbitol
Sorbitol is one of the main culprits behind sugar free sweet diarrhea. It is poorly absorbed in the small intestine, with only around 33% being absorbed. Unabsorbed sorbitol makes its way to the large intestine where it can draw fluid into the bowels through osmosis, stimulating bowel movements. Studies show gastrointestinal effects occur with ingestion of over 20 grams of sorbitol.
Mannitol
Mannitol has a similar laxative effect to sorbitol, though a lower dose tends to cause symptoms. Doses of more than 10-20 grams may lead to diarrhea in sensitive people. Mannitol is also poorly absorbed, with only about 25% being absorbed in the small intestine.
Xylitol
Xylitol has less of a laxative effect than some other sugar alcohols, though diarrhea can still occur. Up to 45% of ingested xylitol is absorbed in the small intestine. Doses above 30-50 grams may overwhelm absorption capacity. Gas, bloating and osmotic diarrhea can result.
Maltitol
Maltitol has one of the lowest laxative effects. Around 85% is digestible so less enters the colon. Amounts over 50 grams may cause gastrointestinal issues like gas, cramps and diarrhea in susceptible people.
Isomalt
Isomalt is an exception – this sugar alcohol derived from beets is almost completely digested and absorbed so does not typically cause diarrhea. Only around 5% reaches the colon so it rarely has osmotic effects.
Tips to avoid diarrhea from sugar free sweets
Here are some tips to help avoid getting diarrhea after eating sugar free sweets:
Avoid overconsumption
Only eating moderate amounts avoids overloading your system with hard-to-absorb sugar alcohols. Don’t go overboard just because sweets are sugar free.
Reduce frequency of consumption
Minimizing how often you indulge in sugar free treats gives the body more time to digest and absorb sugar alcohols between exposures.
Drink plenty of water
Adequate hydration helps dilute sugar alcohols concentrations and improve absorption.
Look for isomalt sweetened products
Isomalt provokes little diarrhea so choosing products sweetened with it reduces risk.
Avoid if sensitive
People prone to sugar alcohol diarrhea should minimize intake of all types as even small amounts may trigger symptoms.
Take with food
Consuming sugar free sweets with or just after a meal slows intestinal transit allowing more time for absorption.
What to do if you get diarrhea from sugar free sweets
If you develop diarrhea after indulging in sugar free sweets, here is how to manage it:
Stop consuming trigger foods
Cease any products containing problematic sugar alcohols to give your digestive system a rest.
Rehydrate
Drink water, electrolyte drinks, or broths to replace lost fluids and prevent dehydration.
Eat binding foods
Bananas, rice, applesauce, and toast can help firm up loose stools.
Take anti-diarrheal medication
Over-the-counter drugs like loperamide (Imodium) slow gut motility to allow more time for water absorption.
Manage discomfort
Use heat pads or take OTC medication to ease abdominal cramps and pain until diarrhea resolves.
Seek medical help if severe
Consult a doctor if you have prolonged, severe diarrhea with symptoms like fever, blood in stool, dehydration or intense pain.
How to prevent sugar free sweetener diarrhea
You can take some proactive steps to help prevent sugar free sweets from causing diarrhea:
Find your tolerance level
Determine the threshold amount of sugar alcohols you can handle without ill effects. Then don’t exceed it.
Read labels carefully
Check ingredients lists so you know which sugar alcohols are present and can limit high risk ones.
Slowly increase intake
Gradually ramp up your consumption of sugar free products to allow your body time to adapt.
Avoid combining different sugar alcohols
Stick to products containing just one type rather than multiple kinds.
Take digestive enzymes
Supplements containing enzymes like lactase and lipase may improve digestion and absorption of sugar alcohols.
Try probiotics
Probiotic supplements support healthy gut flora and may reduce fermentation reactions.
The bottom line
Sugar free sweets can certainly cause diarrhea in some people due to their sugar alcohol content. However, by being aware of your personal tolerance levels, reading labels, moderating intake, and taking some supplemental aids, you can often enjoy these products without intestinal grief. If problems persist, consider steering clear of sugar alcohols completely. For most people though, sugar free sweets are fine in moderation.
