Sorbitol is a sugar substitute used as a sweetener and humectant in the food industry, but can also occur in nature (in dried fruit). Sorbitol is very common in chewing gum, sugar-free products, diabetic products, etc. Sorbitol is poorly absorbed in the small intestine and can continue to block the transporter for fructose (fruit sugar). Therefore, a distinction needs to be made between a genuine sorbitol intolerance and the condition of sorbitol-dependent fructose malabsorption. This is of importance because sorbitol and fructose are often found in together in food (fruits). It is possible that a person can tolerate sorbitol and fructose alone, but in combination (such as after chewing gum [sorbitol] followed by fruit consumption [fructose]) these compounds can then cause discomfort. In this case, fructose intolerance should always be tested.
Why does sorbitol intolerance occur?
The mechanism of sorbitol intolerance has not been well explored. It seems that sorbitol cannot be transported sufficiently through the small intestinal wall. Consequently, it passes into the large intestine and undergoes fermentation leading to the formation of gas. Diarrhoea and abdominal pain are common symptoms. Sorbitol is a FODMAP component (see FODMAP section).
When can sorbitol intolerance exist?
If one experiences clear discomfort after eating chewing gum, sweets, light drinks, honey, diabetic products or fruit, sorbitol intolerance may exist. We can test this with the hydrogen breath test in our practice. This test must always be combined with the fructose (fruit sugar) intolerance test.
Where do you find sorbitol?
Sorbitol is hidden in the ingredients behind the number E420. There are other E-numbers which also contain sorbitol including: E432, E433, E434, E435 and E436. Even in natural products, sorbitol can be found especially in dried fruits, pears, plums, apples, apricots, peaches and raisins.
Sorbitol content of selected foods (g/100g food)
Weiss beer 0.0020, blueberry 0.0040, raspberry 0.0090, blackcurrant nectar 0.0200, strawberry 0.0300, grapes 0.2000, apple 0.5100, apple juice 0.5600, apricot 0.8200, raisins 0.8500, peach 0.8900, sour cherry 0.9000, dried date 1.3500, plum 1.4000, cherry, sweet cherry 1.6000, pear 2.1700, dried apple 2.4900, dried apricots 4.6000, dried apricots 4.6000, dried peach 5.3300, dried plum 6.5700
How can sorbitol intolerance be treated?
It is advisable to carry out a strict exclusion diet omitting all sorbitol-containing foods. Thereafter, your individual tolerance is tested. We recommend carrying out this test procedure with a competent nutritionist.