Sorbitol intolerance – colloquially called sorbitol intolerance (SU) – (synonyms: sorbitol malabsorption; food intolerance; food intolerance; ICD-10-GM T78.1: Other food intolerance, not elsewhere classified) is a disorder of absorption (uptake) of the sugar alcohol sorbitol in the small intestine. Sorbitol intolerance is one of the non-allergic food intolerances.
Sorbitol is formed by so-called “catalytic hydrogenation” from glucose. It is converted into fructose in the body.
Naturally, sorbitol is found in many types of fruit, especially in pome fruit. However, sorbitol is also produced industrially. The glucose contained in corn and wheat starch is used for this purpose. In the food industry, sorbitol is declared as additive E420 and is used as a humectant (protects food from drying out due to its hygroscopic properties (binds moisture from the environment)), a carrier substance for vitamins and flavors, and as a sugar substitute. The latter is found primarily in chewing gum, sugar-free candies or desserts. Cosmetics, medicines and toothpastes can also contain sorbitol. Sorbitol is half as sweet as sucrose (household sugar). It is metabolized independently of insulin and is therefore used as a sugar substitute in diabetic products. Furthermore, sorbitol provides less energy than sucrose – sucrose provides 4 kcal/g and sorbitol 2.4 kcal/g. Therefore, sorbitol is found in energy-reduced foods.
The prevalence (disease incidence) is about 8-12% (in Germany).
Course and prognosis: Sorbitol tolerance is not curable. The individual tolerance limit must be determined by testing. Often the intake of small amounts remains asymptomatic. Symptoms usually occur with quantities of 5 grams of sorbitol or more per day. For comparison: In healthy people, quantities of 20 g of sorbitol per portion or 50 g per day can trigger symptoms. People with a sorbitol intolerance need to look very carefully at the list of ingredients in food. If those affected eat a diet low in sorbitol, they can live almost symptom-free. Avoiding sorbitol and foods containing sorbitol usually leads to an improvement in symptoms after just 2 to 3 days. An easily digestible, non-flatulent diet is also useful in the context of this diet.
Comorbidities (concomitant diseases): People suffering from sorbitol intolerance are also affected by fructose intolerance or an intolerance to another carbohydrate in approx. 80-90% of cases. However, sorbitol intolerance also occurs in isolation.
