All five substances are polyhydric alcohols (polyols) related to naturally occurring carbohydrates. These substances are less cariogenic than sucrose or glucose1 and are non-toxic, but they are only partially absorbed from the gut, so that significant quantities reach the large bowel. If enough is taken, fermentation by the colonic flora can cause distension, downward flatulence and diarrhoea. Other constituents of the diet, such as fibre, the unabsorbed trisaccharides in haricot beans, and even fructose,2 can also cause downwind and diarrhoea, and their effects are additive with those of the bulk sweeteners. Fermentation of these substances can produce symptoms resembling irritable bowel syndrome.2,3
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