If the sugar substitute is also a sugar alcohol such as sorbitol, they are unfortunately also not well tolerated. dietitian) if they are required to avoid particular foods. Specifically, the study had 25 patients undergo hydrogen breath testing after drinking a variety of solutions. For people with Fructose Malabsorption or Lactose Intolerance, sorbitol is taboo: it would worsen the symptoms. Once identified, parents of infants who carry mutant aldolase B alleles leading to HFI, or older individuals who have clinical histories compatible with HFI can be identified and counselled with regard to preventive therapy: dietary exclusion of foods containing fructose, sucrose, or sorbitol.  |  This detailed guide includes … Annals of Clinical & Laboratory Science, 47(4), pp.447-451. A symptom and food diary can also provide information about which foods you cannot tolerate. Once you know a proper fructose malabsorption food list, you can improve your well-being significantly. Maybe you are already familiar with the term ingredient intolerance. NIH 2016 Aug 15;7(3):256-65. doi: 10.4291/wjgp.v7.i3.256. If you have a sorbitol intolerance, care should be taken to ensure that your diet is low in sorbitol and low in fructose. What is irritable bowel syndrome (IBS)? It's true that beer can cause problems for a lot of different food intolerances, but this doesn't have anything to do with its sorbitol content, which is much too low to matter. Processed foods aren't usually nutritious, so … No one can digest sorbitol like a sugar. Unlike a food allergy, food intolerance is not caused by the immune system reacting to the food. Dried fruits (In dried fruits, the sorbitol content per 100 grams of fruit is … In addition, the body converts sorbitol to fructose. Sorbitol chemical compounds have their own numbers. The therapy is to avoid sorbitol-containing foods ; If you are sensitive to sorbitol, it is likely that you also have an intolerance to other polyols, or sugar-alcohols, like mannitol. Never share sorbitol with another person, especially someone with a history of eating disorder. In order for you to get over these symptoms, it is very important that you stay away from foods that use Sorbitol as a sugar substitute. You can find more information on the Sweetener page. Foods to avoid in IBS – Low-FODMAP Diet; Hereditary Fructose Intolerance (HFI) Food Poisoning; Intestinal Parasites; Food Allergies; Celiac Disease; Lactose Intolerance; Small Intestinal Bacterial Overgrowth (SIBO) References: Foods with high fructose, sorbitol, or F:G ratio (fructose.at) Foods… Food Group Serving Size and Suggestions Intestine Friendly Foods to Limit Foods to Avoid Fruits Note: Avoid eating large amounts of any fruit. It is the rule, not the exception. Molasses. In our article on sorbitol, you will find a list of the relevant E numbers. First, you should know that Sorbitol is found in quite a number of chewing gums and sweets due to the fact that it has less calories and is less likely to cause dental issues; therefore, it is very easy for you to intake too much of this product and the consumption of too much Sorbitol can lead to a number a food intolerance and allergic reactions. World J Gastroenterol. Since sorbitol is not broken down into glucose, it has no negative impact on blood sugar levels. It can cause similar symptoms to fructose … A food intolerance is not the same as a food allergy. World J Gastrointest Pathophysiol. Ice cream. No treatment can cure hereditary fructose intolerance. When the indigestible source is a manufactured, highly refined and processed food like erythritol, sorbitol, mannitol or xylitol that the body would not naturally encounter in that state or quantity simply consuming whole foods… Rabast, U. Because of sorbitol’s moistening properties, it is often added to soap and cosmetics. Avoid all foods on the lactose containing food lists. Sorbitol is used in many diet foods as an artificial sweetener. “Sugar-free” diet products CARA CARE … To learn more about which foods are high in sorbitol or polyols download the FODMAP Friendly App. Food Intolerances can, for example, be used for histamine intolerance, mastocytosis, a diet low in FODMAP for IBS, fructose malabsorption, sorbitol intolerance, lactose intolerance, salicylate intolerance or gluten sensitivity. Can be downloaded under this Link. Menu. Login. As little as** five grams of sorbitol **can cause digestive problems in some people? 2007 Nov 21;13(43):5687-91. doi: 10.3748/wjg.v13.i43.5687. Sugar alcohols are not fully absorbed by the body and can cause significant gastrointestinal distress in some individuals. Ask a doctor or pharmacist before taking this medication if you have an allergy… medicine-and-health. On this website, failsafe refers to foods that are F ree of A dditives and L ow in S alicylates, A mines and F lavour E nhancers. Gum and Candy Foods that have a 1:1 ratio of glucose to fructose may be tolerated better on the low-FODMAP diet than those foods that contain more fructose than … The only time to try these foods is if you take lactase enzyme medicine with them. AAPS J. Do not use honey or sweeteners like sorbitol to sweeten your food as they will worsen your symptoms.  |  But what is bad for people with fructose intolerance is great for diabetics. Other foods like ice cream, candy, and processed foods are also very rich in this ingredient. Ernährungsumschau, 9, 540-546. I will show you what is favorable to eat and what you should avoid for eliminating symptoms and restoring normal digestion. Because it is lower in calories than sugar, sorbitol is often used in sugar-free products and products with no added sugar. Prevention for food intolerances is much the same as for allergies: Read labels and be careful when eating out to avoid the food or ingredient as much as possible. Such a fermentation gives rise to symptoms such as bloating and diarrhea. My Food Sensitivities: Sugar Alcohols from Sorbitol to Xylitol Bits of Nutrition Carlene January 05, 2013 how do I know if i have a food intolerance , i feel sick when i eat sugar free candy , i feel sick when i have xylitol , sorbitol sensitivity , sugar alcohol allergy When cutting particular foods out of your diet you are at risk of nutritional deficiency. This can be distinguished from food intolerances that cause non-immunological reactions to food. Baked goods, desserts, cake, pastries. You can find out more in our specialist article on food allergies. Online: http://www.annclinlabsci.org/content/47/4/447.short. Many people avoid gluten, a group of proteins found in grains like wheat, barley, and rye, due to personal preference or a medical condition ().Celiac disease, wheat allergy, and non-celiac … In the case of fructose, sorbitol and fructose compete for the same transport and metabolic pathway. Research shows that consumption of 5g of sorbitol, equating to 100g of dried apricots, resulted in more than 50% of people experiencing uncomfortable … In case of proven sorbitol intolerance the following food and products may cause symptoms: Diet / ‘light’ and diabetic drinks, sugar-free chewing gum and sweets / candies. Causes Sorbitol is a sugar alcohol (polyol) commonly used as a sweetener in so-called sugar-free sweets and chewing gum, diet and diabetic foods. 2018 Aug;67(8):1380-1399. doi: 10.1136/gutjnl-2017-315909. Georg Thieme Verlag. The best way to avoid symptoms of a food intolerance is to avoid certain foods or eat them less often and in … Search. It is therefore important to take a look at the additives list and the E numbers when shopping. Please enable it to take advantage of the complete set of features! Hence, avoiding these food items will show immediate relief from the symptoms… COVID-19 is an emerging, rapidly evolving situation. Many people suffering from irritable bowel syndrome, or IBS, or with gastrointestinal issues, including bloating, constipation, diarrhea, flatulence and abdominal pain, believe that some foods may trigger … Irritable bowel syndrome, or IBS, is by far the most diagnosed gastrointestinal condition, affecting as many as 20 percent of Americans, according to the National Digestive Disorders Information Clearinghouse. Many processed food products contain the additive. Since an increased intake of sorbitol already has a laxative effect on people without intolerance, you should avoid too many foods with sorbitol additives. ½ cup of cut fruit or a medium (baseball size) whole fruit. There was a good correlation between the severity of symptoms and the amount of hydrogen exhaled. What it means is that the stomach is unable to make use of certain ingredients that are contained in some foods. To prevent the symptoms of sorbitol intolerance, avoid foods including chewing gum, low-calorie diet and diabetic foods, and stone and dried fruits. The typical symptoms of food intolerance are: If typical gastrointestinal symptoms often occur after eating, a food intolerance test should be carried out by a gastroenterologist. Irritable bowel syndrome, or IBS, is by far the most diagnosed gastrointestinal condition, affecting as many as 20 percent of Americans, according to the … Home; Application; Game; Search. Keep the medication in a place where others cannot get to it. Look for low-sugar dairy products, fruits, vegetables, and snacks. Sorbitol is a sugar alcohol that occurs naturally in such foods as apples and prunes. These included lactose, fructose, sorbitol, sucrose, and a combination of fructose and sorbitol. 2013 Oct;15(4):1043-50. doi: 10.1208/s12248-013-9509-z. Medication. Marmalade. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Most of these contain high fructose corn • Avoid sorbitol (a sugar alcohol). Epub 2013 Jul 19. Today, sorbitol (E 420) is not just absorbed through its natural sources but it’s contained in all baked goods, low-calorie soft drinks, chewing gum, and many other industrially manufactured products. Symptoms of food intolerance are often delayed and may occur several hours after consuming the trigger food. Foods With Sorbitol. food back to your diet at a time and wait 3-4 days in between to see how you feel. With a daily dose of between 20-50 grams of sorbitol, diarrhea occurs. Sorbitol malabsorption occurs when sorbitol can be partially absorbed or not absorbed at all into the blood in the small intestine. Food allergy and food intolerance are commonly confused as some of the symptoms and trigger foods can be similar. What is important is to watch out for how much sorbitol you eat. All processed food products that don’t contain sorbitol as an ingredient are also suitable. The foods listed in the table generally contain a higher proportion of sorbitol. Many people suffering from irritable bowel syndrome, or IBS, or with gastrointestinal issues, including bloating, constipation, diarrhea, flatulence and abdominal pain, believe that some foods … beverages. Foods to Avoid With Fructose Malabsorption. Originally marketed only to the Diabetic population, products containing sweeteners like aspartame, saccharin, sorbitol, xylitol, maltitol, mannitol, acesulphame-K, cyclamates and sucralose are now included routinely in Sugar-free jubes, mints, breath fresheners, chewing gum, soft drinks, diet yoghurt, low-joule ice cream and sugar-substitute baking ingredients. Since sorbitol in the intestine inhibits fructose uptake, the symptoms of sorbitol consumption can worsen if there is a fructose intolerance. Foods that have a 1:1 ratio of glucose to fructose may be tolerated better on the low-FODMAP diet than those foods that contain more fructose than glucose. After ingestion of 10 g of sorbitol solution, end expiratory breath samples were collected at 15-min intervals for 4 h and analyzed for H2 concentration. Also stay away from “diet” foods, which are often high in sugar alcohols, such as sorbitol, mannitol and xylitol. Sorbitol doesn't cause the blood glucose spike associated with table sugar, so it is a common ingredient in cakes, cookies and other goodies made for diabetics 3. Sugar Intolerance Combinations . ‘Food intolerance’ is a term used widely to describe a variety of reactions that some people have after eating or drinking certain foods. You don’t need to follow a strict low FODMAP diet, as you don’t need to avoid … Avocado contains sorbitol, a fruit sugar, which undergoes fermentation in individuals with avocado intolerance. This indigestibility is the reason that sorbitol contains fewer calories - just like other sugar alcohols. Tracking can be done easily on your mobile phone using the Cara Care app. Check out the table and the figure there for a … Sorbitol is a commonly used sugar substitute in "sugar-free" food products. Since the total sorbitol content depends on maturation and production methods, the sorbitol content of various foods cannot be clearly stated. So the tolerance limit is often exceeded. In other words, they should avoid eating foods that contain fructose or sucrose. Once diagnosed with sorbitol malabsorption it is recommended that you reduce your consumption of high sorbitol foods. Arasaradnam RP, Brown S, Forbes A, Fox MR, Hungin P, Kelman L, Major G, O'Connor M, Sanders DS, Sinha R, Smith SC, Thomas P, Walters JRF. Most of these contain high fructose corn • Avoid sorbitol (a sugar alcohol). Therefore always read the list of ingredients carefully. **Try our free online tests for lactose intolerance, gluten intolerance, fructose intolerance, or histamine intolerance.  |  Sorbitol-containing foods include: Stone fruits, such as cherries, plums, apricots and peaches. However, sorbitol’s versatile properties mean it and its chemical compounds (e.g. Be sure to check the label carefully for such ingredients in food products such as pre-prepared smoothies, trail mixes, cereals, and sauces as well. This is despite surveys suggesting around 80 percent of people do not tolerate the sugar substitute well in large quantities. Due to high demands in the working world, there is less time to provide yourself with healthy and fresh food. If you enjoy sweet fruits, but must avoid sorbitol … Sorbitol intolerance symptoms are the same as those of other intolerances (lactose and fructose intolerance, wheat sensitivity). CARA CARE supports you with your digestive problems, https://www.ernaehrungs-umschau.de/fileadmin/Ernaehrungs-Umschau/pdfs/pdf, http://www.annclinlabsci.org/content/47/4/447.short, Berries: Raspberries, blueberries, blackberries, gooseberries, sea buckthorn, currants, Citrus fruits: Lemon, lime, orange, grapefruit, Vegetables such as eggplant, bell pepper, leafy salads, spinach, parsnips, radishes, broccoli, peas, fennel, kale, kohlrabi, Swiss chard, okra, asparagus, onions, E 967: Xylitol (may be tolerated in moderation), E 968: Erythritol (may be tolerated in moderation). Start by checking labels—avoid foods that include fructose, crystalline fructose, honey and sorbitol. Irritable bowel syndrome or IBS is a medical condition affecting the large bowel. Food intolerance Early childhood services Food intolerances are reactions to certain foods which are not caused by an immune system reaction. I’m André, a medical doctor from Berlin. Wegweiser Nahrungsmittel-Intoleranzen: wie Sie Ihre Unverträglichkeiten erkennen und gut damit leben. Since an increased intake of sorbitol already has a laxative effect on people without intolerance, you should avoid too many foods with sorbitol … Honey. With the help of a food diary, you can find out your individual tolerance limit. Unfortunately, sorbitol is not only hidden in the foods listed. The intolerances include celiac disease (gluten sensitivity), intolerance to lactose, fructose, sorbitol, and histamine as well as IgG4-caused intolerance. However, even in people without this deficit, a healthy person can only absorb a limited amount of this sugar, approximately 20-25 grams, so if it exceeds this range, it can also produce symptoms. Forty-two healthy adults (23 whites, 19 nonwhites) participated in this study. Mannitol is found in watermelon, mushrooms, cauliflower, celery and sweet potatoes. Ledochowski, M. (2009). Search for: Search. The app Food Intolerances is a tool to help everyone who has to stick to a restricted diet because of food intolerances or allergies. Avoid ready-made products and food with added sugar. Foods to Avoid With Fructose Malabsorption. One stick of sugar-free chewing … Read product labels carefully and avoid foods containing: Fructose. **Bread **that is still moist after days contains sorbitol with a high degree of certainty. If you are avocado intolerant, avoid intake of foods … Chocolate. The following table gives you an overview. Sorbitol is a FODMAP! The food industry achieves longer shelf life and optimizes the texture and taste by adding additives. These symptoms could lead to an extensive diagnostic work-up and lifelong diagnosis of irritable bowel syndrome. NLM If you have rashes and gastrointestinal symptoms combined, this may be due to a food allergy. Start by checking labels—avoid foods that include fructose, crystalline fructose, honey and sorbitol. Clipboard, Search History, and several other advanced features are temporarily unavailable. Sugar intolerance, also known as dietary fructose intolerance or sugar malabsorption, is a digestive disorder that affects nearly one-third of all adults, according to the website Food Intolerance … Maple-flavored syrup. It. You should therefore enjoy them carefully. It is better to buy fresh bread from the bakery and do without industrial bulk goods. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. application. As with testing for fructose or lactose intolerance, the H2 breath test is also carried out if sorbitol intolerance is suspected. … High-fructose corn syrup. And it's a misunderstanding that you have to completely avoid sorbitol when you have a sorbitol intolerance. Therefore, you need to stay away from foods that their ingredients list honey, fructose, Sorbitol, and crystalline fructose on the labelling. Sorghum. Be sure to check the label carefully for such ingredients in food products such as pre-prepared smoothies, trail mixes, cereals, and sauces as well. No, sorbitol intolerance does not manifest with skin symptoms. Sorbitol is also found in excessive amounts in fruit (especially apricots, nectarines, plums, blackberries, apples and pears) and sugar free gums and lollies. The following food list is specific for fructose malabsorption. Impact of osmotically active excipients on bioavailability and bioequivalence of BCS class III drugs. Foods to eat instead. Our eating habits have changed a lot in recent decades. Dietetic foods, many of them containing sorbitol, are very popular with diabetics and "weight watchers." Fructose is a sugar found naturally in fruits, fruit juices, some vegetables and honey. On one page ; All food additives, problems highlighted ... oats) Soy: Sugar free sweeteners: Sugar free sweeteners: polyols, sorbitol, mannitol. Blackberries and raspberries have a high sorbitol content, as do apples, apricots, pears, nectarines and plums. in application, medicine-and-health. It is produced by the human body, occurs in fruit, beer and … These include: However, artificial sweeteners such as aspartame and saccharin are well tolerated if you have a sorbitol intolerance. When this causes digestive problems, it’s referred to as sorbitol intolerance. 2006 Sep;2(9):654-662. Together with a team of medical doctors, nutritionists and data scientists we empower people to understand digestive issues with our app Cara Care. Although the blood sugar level is not affected in this case, people with sorbitol intolerance cannot tolerate diabetic products. Sorbitol occurs naturally in pome fruit (apples and pears) and stone fruit. Palm or coconut sugar. Why you should care about sorbitol intolerance. It is important to understand that there are two types of fructose intolerance. Sorbitol is a commonly used sugar substitute in "sugar-free" food products. (2008). • Avoid packaged baked goods. Although sorbitol intolerance manifested by abdominal pain, bloating, and diarrhea has been observed in children, it has not been … sorbitan monostearate) are added to numerous industrially manufactured products. On the other hand, people with partial malabsorption, which is the most common pathology, can consume foods low in sugar. Gastroenterol Hepatol (N Y). Gibt es noch sinnvolle diätetische Maßnahmen in der Gastroenterologie?. That corresponds to four to five “sugar-free” candies! Related Searches: Fiber Foods. Sorbitol is a sugar alcohol. Additives to avoid . If you enjoy sweet fruits, but must avoid sorbitol for gut health reasons, there are plenty of low FODMAP friendly fruits to eat instead. Carbohydrate malabsorption in patients with non-specific abdominal complaints. Sugar alcohol intolerance frequently co-occurs with irritable bowel syndrome. Sugar-free chewing gum and candies. **Do you have an intolerance? In particular, diabetic products or foods advertised as sugar-free contain large amounts of sorbitol. This is the most common cause for IBS symptoms. COVID-19: What you need to know There are certain foods to avoid with IBS and, in doing so, you’ll find your food-related and digestive-related lives are going to get a whole lot easier. Sorbitol Intolerance. Our app was tested by the medical jury of MeinAllergiePortal and was awarded the Digital Health Heroes Award 2018 at the 13th German Allergy Congress*. However, severe clinical sorbitol intolerance was significantly more prevalent in nonwhites (32%) as compared to whites (4%). fructose intolerance you should avoid foods that contain fructose and sucrose. There is still a lot of food to enjoy without experiencing any symptoms of fructose malabsorption. Login. Avoid products with high-fructose corn syrup, honey, agave nectar, inverted sugar, maple syrup, molasses, palm or coconut sugar, sorghum, or sorbitol. Sorbitol. Lychees, cherries and avocado ... Sweeteners and Processed Foods… Also stay away from “diet” foods, which are often high in sugar alcohols, such as sorbitol, … sorbitol from the diet ... registered dietitian can work with the parents and child to identify and avoid fructose and sucrose foods and . Update on diagnostic value of breath test in gastrointestinal and liver diseases. Sorbitol and fructose are often found in large quantities in the same foods (dried fruit, stone fruit, pome fruit). Products for diabetics. What foods or food groups do I need to avoid? HHS FODMAPs are a group of food ingredients that people with a sensitive gastrointestinal tract often cannot tolerate. Agave syrup. You are here: Home. Industrially manufactured foods are not only cheap, quick, and easy to prepare – they are also tasty thanks to their high salt and fat content. Sorbitol, a sugar-alcohol, is converted to frutose during digestion, should be avoided as well. Typical application cases are: histamine intolerance, mastocytosis, fructose malabsorption, sorbitol intolerance, aspirin intolerance, gluten sensitivity, lactose intolerance or a diet low in FODMAPs. Invert sugar. Transporters in the intestine are too busy and can no longer absorb sorbitol into the blood, and typical digestive problems are the result. Online: https://www.ernaehrungs-umschau.de/fileadmin/Ernaehrungs-Umschau/pdfs/pdf2008/0908/EU09540546.qxd.pdf, Perets, T.T., Hamouda, D., Layfer, O., Ashorov, O., Boltin, D., Levy, S., Niv, Y. and Dickman, R., 2017. Food Intolerances can, for example, be used for histamine intolerance, mastocytosis, a diet low in FODMAP for IBS, fructose malabsorption, sorbitol intolerance, lactose intolerance, salicylate intolerance or gluten sensitivity. Sorbitol intolerance is caused by a lack of a specific intestinal transporter. Soap and Cosmetics. To avoid these hidden sources, check the ingredients list on packaged foods. The app Food Intolerances helps you if you have to stick to a restricted diet after being diagnosed with food intolerances, sensitivities or allergies. Sorbitol is listed as E 420. Sugar intolerance, also known as dietary fructose intolerance or sugar malabsorption, is a digestive disorder that affects nearly one-third of all adults, according to the website Food Intolerance Diagnostics. Because of its water-binding properties, sorbitol has a laxative effect on everyone after a certain amount. A small study looked at the link between sugar intolerances and functional bowel disease. Epub 2018 Apr 13. There is currently no cure for food intolerances. Instead, you’ll create an individualized FODMAP food list that brings on symptoms, and then avoid them. This site needs JavaScript to work properly. Certain food intolerances or sensitivities such as sensitivity to processed or junk foods, carbonated drinks, caffeine and alcohol. Clinical sorbitol intolerance was detected in 43% of the whites and 55% of the nonwhites, the difference not being statistically significant. Symptoms of a sorbitol intolerance include bloating, discomfort, gas, diarrhea and abdominal pain. They can even consume a moderate amount of foods high in fructose. To do this, they will need to avoid the following foods: any foods and beverages containing high fructose corn syrup, which include many processed items, such as soda and prepackaged baked … Digestive Disorders > Intolerances > Sorbitol Intolerance. Fructose … Here are some foods high in fructose: Dried apricots, persimmons, and cherries. Our app was tested by the medical jury of MeinAllergiePortal and was awarded the Digital Health Heroes Award 2018 at the 13th German Allergy Congress*. Guidelines for the investigation of chronic diarrhoea in adults: British Society of Gastroenterology, 3rd edition. Gut. Small Intestinal Bacterial Overgrowth May Increase the Likelihood of Lactose and Sorbitol but not Fructose Intolerance False Positive Diagnosis. Sorbitol Intolerance is not a disease, but completely normal. Sorbitol is not well absorbed in the intestine. Side Effects of Sorbitol – Sorbitol is a sugar alcohol. Fruit juices. However, sorbitol intolerance rarely occurs alone: A combined fructose-sorbitol intolerance is often the cause. Food Intolerances 2.6 Apk for Android . Although sorbitol intolerance manifested by abdominal pain, bloating, and diarrhea has been observed in children, it has not been well documented in adults. Ask your doctor or care giver about lactase pills or liquids. In general, for treating dietary fructose intolerance it’s best to restrict the intake of foods with high fructose and a fructose:glucose ratio > 1, fructans, and sugar alcohols like sorbitol. Since the body metabolizes sorbitol to fructose, patients with a Hereditary Fructose Intolerance must also strictly avoid sorbitol. To avoid fructose, read food labels very carefully. Search for: Search. Instead, a person should avoid consuming fructose. Learn which foods to avoid if you have fructose intolerance. • Avoid foods and drinks with high fructose corn syrup (candy, sodas, sweetened juice). This medicine may break down enough of the lactose for you to digest some foods … USA.gov. • Avoid foods and drinks with high fructose corn syrup (candy, sodas, sweetened juice). Foods to eat instead. Unlike with an allergy, certain amounts of the trigger can be handled with an intolerance: It’s the amount that does the harm. • Avoid packaged baked goods. Fruits. Almost everyone has heard of digestive problems due to lactose or gluten intolerance, yet sorbitol intolerance is far less known. Based on our observations, we believe that a large number of adults could be suffering from sorbitol-induced nonspecific abdominal symptoms and diarrhea. Avoid sorbitol-containing foods and carefully check the product label if you have sorbitol intolerance (look for E420), IBS, diarrhea, or if you are on a keto diet. This, in effect, leads to abdominal pain, bloating, constipation, diarrhea, and/or flatulence. This makes diagnosis purely by recording the symptoms impossible. Oher fruits such as pears and apples.