Sorbitol malabsorption in normal volunteers and in patients with coeliac disease.
Sorbitol is a hexahydroxy alcohol used as a sugar substitute in many dietetic foods and as a drug vehicle. Previous studies have suggested that sorbitol ingestion may be an additional cause of non-specific gastrointestinal distress. We evaluated sorbitol malabsorption in 30 healthy volunteers, seven patients with untreated coeliac disease and nine patients with coeliac disease on a gluten free diet, using a four hour H2 breath test. After ingestion of test solutions containing sorbitol 10 and 20 g and of four sweets (6.8 g sorbitol), 90%, 100%, and 62% of healthy volunteers, respectively had significantly raised H2 excretion, indicating malabsorption of sorbitol. Of all healthy subjects tested, 45% after 10 g, 100% after 20 g, and 50% after four sweets complained of symptoms of carbohydrate intolerance during the eight hours after sorbitol. After a 5 g dose given at concentrations of 2%, 4%, 8%, 16%, malabsorption was shown in 10%, 12%, 22%, and 43% of the healthy volunteers. Symptoms of intolerance at 5 g were experienced only at concentrations of 8% and 16%. Unlike healthy volunteers and coeliac patients on a gluten free diet, 100% of untreated coeliacs malabsorbed a 2% solution of 5 g sorbitol. These results show that malabsorption and intolerance of sorbitol may result from ingestion of doses and/or concentrations usually found in many foods and drugs; they underline the need to consider this as a possible and hitherto underestimated cause of gastrointestinal symptoms.
Corazza
G R
GR
I Department of Medical Pathology, University of Bologna, Italy.
Strocchi
A
A
Rossi
R
R
Sirola
D
D
Gasbarrini
G
G
D000328:Adult; D001944:Breath Tests; D002446:Celiac Disease / Q000378:metabolism*; D005260:Female; D006801:Humans; D007408:Intestinal Absorption; D008286:Malabsorption Syndromes / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D013012:Sorbitol / Q000008:administration & dosage / Q000493:pharmacokinetics*
D013012:Sorbitol