Severe weight loss caused by chewing gum

doi:10.1136/bmj.39280.657350.BE

BMJ 2008;336:96-97 (12 January), doi:10.1136/bmj.39280.657350.BE

Practice

Lesson of the Week

Severe weight loss caused by chewing gum

Juergen Bauditz, consultant¹, Kristina Norman, nutrition scientist¹, Henrik Biering, junior doctor¹, Herbert Lochs, head of department¹, Matthias Pirlich, consultant¹

¹ Department of Gastroenterology, Hepatology, and Endocrinology, Charité Universitätsmedizin, 10117 Berlin, Germany

Correspondence to: J Bauditz juergen.bauditz@charite.de

Sorbitol intake should be considered in patients with bowelproblems, chronic diarrhoea, and weight loss

The first 150 words of the full text of this article appear below.

About 10-20% of adults and adolescents are estimated to havesymptoms related to functional bowel disorders, resulting inhigh healthcare costs.¹ We report two cases of chronic diarrhoeaand substantial weight loss in which extensive investigationshad been performed previously. However, final diagnosis wasonly established after precise evaluation of eating habits,which showed habitual ingestion of sorbitol, a widely used sweetenerin food products which has laxative properties.

Case reports

Case 1
A 21 year old woman had experienced diarrhoea and diffuse abdominalpain for eight months. She had four to 12 bowel movements withwatery stools daily. She was initially suspected to have infectiouscolitis. However, as clinical investigation suggested no cleardiagnosis and diarrhoea persisted, she was transferred to ourdepartment for further evaluation. At that time she had lost11 kg and weighed 40.8 kg (body mass index 16.6). Laboratoryanalysis showed hypoalbuminaemia (albumin 30.7, normal range33-50 g/l; total . . . [Full text of this article]