One patient, a 21-year-old woman, had unexplained diarrhea and abdominal pain for eight months. She reported an unintended weight loss of 24 pounds, weighing in at about 90 pounds.
After she was asked about diet, she said she chewed sugar-free gum with sorbitol daily, taking in about 18 to 20 grams a day. One stick typically has 1.25 grams.
Once she eliminated sorbitol from her diet, the gastrointestinal problems stopped and she gained back more than 15 pounds.
The second patient, a 46-year-old man, had been hospitalized because of diarrhea and a weight loss of more than 48 pounds during the previous year. His blood work and other exams came back normal, but when asked about diet, he, too, reported excessive consumption of sorbitol. He chewed 20 sticks of sugar-free gum daily and also ate about 7 ounces of sweets daily, totaling about 30 grams of sorbitol.
When he cut out the sorbitol, he gained back 11 pounds within six months and his diarrhea problems disappeared.
The message for doctors, the authors conclude, is to inquire about dietary habits when a patient has unexplained weight loss.
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