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July 18, 1980

Dietetic Food Diarrhea

Author Affiliations

From the Internal Medicine Group Atlanta.

JAMA. 1980;244(3):270. doi:10.1001/jama.1980.03310030046027

THE HEXITOLS, a group of sugar alcohols that are acted on slowly by bacteria in the oral cavity and are slowly absorbed from the gastrointestinal tract, are capable of inducing osmotic diarrhea.1-4 Sorbitol and mannitol, the best known of the hexitols, are key ingredients in many "sugarfree" foodstuffs used as weight reduction aids and to help prevent dental caries. Although Gryboski2 described the occurrence of diarrhea in children consuming dietetic candy in 1966, it was not until 1978 that the subject was revived by the report of "chewing gum diarrhea" in an adult.3 The following case is presented to create awareness of the phenomenon and to demonstrate that it may be induced not only by chewing gum but also by other dietetic foodstuffs.

Report of a Case  A 29-year-old healthy man had diarrhea of two weeks' duration. Attempting to reduce weight by dieting, he found it difficult