Your body “cannot fully digest or absorb them in the small intestine,” Bobrick explains, so instead, they head on to the next stage of the digestive journey more or less intact. “Once they reach the large intestine,” she says, “they draw in water and are fermented by gut bacteria, leading to gas, bloating, and diarrhea.”
The GI impact can be so pronounced that products containing the sugar alcohols sorbitol and mannitol are federally mandated to feature a warning on the nutrition label: “Excess consumption may have a laxative effect.” Mannitol in particular has a tendency to linger in your intestines, often triggering bloating and diarrhea as a result, according to Yale New Haven Health.
Who is most at risk for uncomfortable side effects?
While sugar alcohols can trigger digestive irritation in anyone, some demographics are more sensitive, especially people with preexisting digestive health conditions, according to Dada. “Certainly anybody who has IBS would potentially be at a bigger risk,” for example, she says. Same for IBS’s sister condition, SIBO, as well as celiac disease and IBD, according to Bobrick. (Yep—contrary to what you might think, IBD is a totally distinct condition from IBS!)
For similar reasons, people who have had GI surgery (like bariatric surgery) should also steer clear of sugar alcohols in large amounts, according to Bobrick. Ditto those following a low-FODMAP diet, which restricts or eliminates common problem carbs and then slowly reintroduces them in a bid to identify digestive triggers, Dada says. Sometimes, in fact, “people will figure out that they’re susceptible to these GI disturbances” through that process, she says.
Finally, folks prone to cardiovascular issues may want to avoid one sugar alcohol in particular, according to Dada: erythritol. Some research has linked erythritol to an increased risk of blood clots, itself a risk factor for heart disease and stroke—something “to be paying attention to” if you might be more susceptible, she says.
What can you do to prevent this?
Checking the nutrition label for sugar alcohols is an excellent place to start. Just keep in mind that not all labels will be completely transparent: Per the FDA, manufacturers are only required to list sugar alcohols if a statement is made on the packaging about the health effects of sugar or sugar alcohols (e.g., a claim like “sugar-free”), though some may choose to provide this information anyway.
