Letzte Aktualisierung am 7. December 2023 von Dr. Michael Zechmann-Khreis
Sorbitol is a sugar substitute and is used as a sweetener and humectant in the food industry. As a food additive with the E number “E420”, sorbitol can be added to foods in any quantity. However, it can also occur in nature. Pears, apples and plums, for example, contain relatively high levels of sorbitol. If these fruits are dried, the sorbitol becomes more concentrated, i.e. dried fruit has very high sorbitol values. If there is an intolerance to sorbitol, this is referred to as sorbitol intolerance.
Frequency of sorbitol intolerance
Nothing is known about the frequency of sorbitol intolerance. However, it is thought to occur relatively rarely. However, sorbitol intolerance is often associated with fructose intolerance coupled. This should therefore be tested in any case. If fructose intolerance is present, sorbitol consumption should also be restricted.
Sorbitol intolerance: symptoms
The exact mechanism of sorbitol intolerance has not yet been researched. It appears that sorbitol cannot be sufficiently transported out of the small intestine in the case of intolerance. The whole thing seems to work in a similar way to fructose malabsorption. Bacteria in the large intestine then metabolize the unabsorbed sorbitol, producing gases and short-chain fatty acids. This causes symptoms such as abdominal pain, flatulence, diarrhea and abdominal cramps.
Treatment of sorbitol intolerance
After one to two weeks of a strict diet, during which absolutely all sorbitol should be avoided, a slow approach to an individual diet can then be made. You should definitely go down this path together with a nutrition expert! It is important to normalize eating habits and increase the amount of sorbitol. It is not necessary to avoid sorbitol completely.
A food and symptom diary can help in the first few months. Also apps and lists with sorbitol contents of foods (e.g. app“Ask Ingrid!“).
It is often advised to avoid oral hygiene products that contain sorbitol, as the sorbitol is said to be absorbed through the oral mucosa and then cause problems. However, this is in contrast to the theory mentioned above, because sorbitol that is absorbed through the mucous membrane does not reach the small intestine and therefore cannot cause any symptoms. Whether sorbitol is absorbed through the oral mucosa at all is not found in the literature. However, this is rather unlikely.
If you suffer from sorbitol intolerance, you should also avoid products that contain other sugar substitutes. These are, for example, isomalt, maltitol, xylitol and lactitol. Although these are generally tolerated, they can also cause flatulence and diarrhea.
Sources and others
1) Souci-Fachmann-Kraut, Food Table for Practical Use, 3rd edition
2) Ledochowski, M; “Patient information sheet on sorbitol intolerance”, 2001
3) “Ernährung. Physiological basics, prevention, therapy”, WVG, 2016