Sorbitunverträglichkeit

Sorbitol intolerance: Description

In the case of a sorbitol intolerance (sorbitol tolerance, sorbitol malabsorption), the uptake (absorption) of the sugar alcohol sorbitol in the small intestine is impaired, so that it is bacterially metabolised in the large intestine. This can cause unpleasant digestive problems.

Where is sorbitol included?

Sorbitol is a so-called sugar alcohol – a sweet-tasting carbohydrate that occurs naturally mainly in fruits (apricots, plums, apples, pears, etc.) and concentrated in dried fruit / dried fruits.

Sorbitol is also produced industrially and may be added as a food additive E420 in any amount of certain foods. It can be found, for example, as a sugar substitute or humectant in products such as mustard, mayonnaise, ketchup, salad dressing, toasted bread, biscuits, cakes, cereals, muffins, candies, chewing gum, chocolate and praline fillings.

Especially so-called “sugar-free” light products often contain sorbitol. Because compared to normal sugar sorbitol has a lower sweetness and a lower calorie content.

Another product group that very often contains sorbitol is diabetic foods. The reason for this is that the body can use sorbitol (unlike normal sugar) without insulin. That is, the cells can absorb sorbitol from the blood without the help of insulin.

In addition, because sorbitol causes no tooth decay and on the tongue develops a slightly cooling effect, it is also found in many toothpastes and Zahnpflegekaugummis.

In addition, sorbitol is used as a carrier in the pharmaceutical industry (eg for effervescent tablets) and the cosmetics industry.

Sorbitol intolerance: frequency

So far, there are no reliable figures on how many people in the population have a sorbitol intolerance. However, it is known that the sorbitol intolerance often occurs in combination with a fructose intolerance (fructose intolerance) and / or lactose intolerance (lactose intolerance).

In addition, people with a pure fructose intolerance also indirectly tolerate no sorbitol: On the one hand sorbitol inhibits the addition of fructose in the body additionally; On the other hand, sorbitol is converted into fructose in the body.

Sorbitol intolerance: symptoms

From a certain amount (20 to 50 grams per day), sorbitol is incompatible with every human being, because the absorption capacity of the sugar alcohol in the small intestine is limited. This amount of consumption causes diarrhea. Especially people with a sorbitol intolerance but have at lower doses, complaints such as bloating, abdominal pain, belching and nausea.

From which amount of consumption such symptoms of sorbitol intolerance occur in individual cases, is different. For example, some people react from 15 grams of sorbitol per day with symptoms of intolerance, while others react as early as five grams per day.

Sorbitol intolerance: causes and risk factors

In sorbitol intolerance, the ingested sorbitol in the small intestine can not or only partially be utilized. It then passes with the food remains in the large intestine, where it is metabolized by the bacteria located here. This creates gases and waste products that lead to digestive problems.

How it comes to the recovery error exactly is unclear. In any case, it is not an allergic reaction – the colloquially used term sorbitol allergy is therefore wrong. In case of an allergy, the immune system becomes active against the supposed enemy, which is not the case with sorbitol intolerance.

Sorbitol intolerance: examinations and diagnosis

Sorbitol intolerance can be demonstrated by means of an H2 breath test:

The patient must appear sober for the test. Now the first thing to do is to determine the hydrogen content of the exhaled breath by blowing the patient into a breath tester. Then he has to drink a sorbitol solution (for example, five grams of sorbitol dissolved in 200 milliliters of water). Subsequently, the hydrogen concentration in the exhaled air is measured several times at certain time intervals.

In the case of a sorbitol intolerance, this concentration increases significantly (in comparison to the fasting value): If the bacteria metabolize the undigested sorbitol in the large intestine, a lot of hydrogen is produced which is released into the body via the exhaled air.

Sorbitol intolerance: treatment

The symptoms of sorbitol intolerance can only be avoided by not taking any or only as much sorbitol as you personally tolerate. It may be helpful if, after the diagnosis has been made, it is possible to dispense with sorbitol-containing products for as long as possible until the symptoms have subsided completely. Then it’s time to slowly test the personal tolerance of sorbitol by first consuming small and then increasing amounts of sorbitol-containing foods (see list below). This tolerance limit often varies quite strongly with sorbitol intolerance.

Food list: sorbitol content of selected foods

Those who can not tolerate the foods mentioned in the list, even in small quantities, can resort to varieties that contain only little or no sorbitol. These include, for example, banana, orange, tangerine, lemon, pineapple, kiwi, watermelon and sugar melon. For finished products, you should always read the ingredient list first.

Incidentally, anyone who suffers from sorbitol intolerance should also avoid products containing other sugar substitutes such as mannitol, isomaltitol, maltitol and lactitol. They can also cause bloating and diarrhea.

Sorbitol intolerance: disease course and prognosis

A Sorbitunverträglichkeit is not curable. However, avoiding or limiting the consumption of sorbitol-rich foods can prevent discomfort.