Sorbitol is a type of carbohydrate that belongs to the sugar-alcohol family. It is naturally present in some foods but is also used as a sweetener in sugar-free products like sugar-free candies, sugar-free gum or sugar-free chocolate because it contains fewer calories and carbohydrates when compared to the same amount of regular sugar. However, sorbitol is one of the sugar alcohols that is poorly absorbed in many people and that may lead to gastrointestinal issues, including bloating, discomfort, cramping, flatulence, diarrhea and constipation.

The fruits with the highest sorbitol content include apples, apricots, gooseberries, grapes, peaches, pears, plums, raspberries and strawberries. Juices or dried fruits made of high-sorbitol fruits will also have a high sorbitol content. Cherries, lychees and avocado also contain sorbitol, but in smaller amounts. Sorbitol is also present in gums and mints sweetened with sorbitol. If you see the ingredients isomalt or maltitol on the food label, be aware that these ingredients may also produce some sorbitol.

Sorbitol malabsorption can be diagnosed with a hydrogen breath test, similar to the way lactose intolerance is diagnosed. You take a dose of sorbitol, and then the level of hydrogen in your breath is analyzed every 30 minutes in the following two to three hours. High levels of hydrogen indicate that you have not absorbed sorbitol properly and that it is fermented by the bacteria present in your gastrointestinal tract. Sorbitol malabsorption is associated with IBS-like symptoms, especially diarrhea, bloating and abdominal pain, that can be relieved by the elimination of sorbitol from your diet.

It is not uncommon for people suffering from sorbitol malabsorption to also have problems absorbing other short-chain fermentable carbohydrates, also called FODMAPs, properly. For example, fructose, fructans, galactans, lactose and mannitol are often problematic and may also be responsible for your gastrointestinal discomfort. You can ask for a hydrogen breath test to diagnose fructose malabsorption and lactose intolerance, but the only way to determine your tolerance to fructans, galactans and mannitol is by following an elimination diet. Intolerances to sorbitol, fructose and lactose can also be determined with an elimination diet if you prefer not doing the hydrogen breath test, which often is not covered by insurance.

An elimination diet can be complicated to do by yourself. Consult with a registered dietitian for help doing it right to save you both time and suffering. The purpose of an elimination diet is to eliminate all potentially offending foods that contain too much fructose, lactose, sorbitol, mannitol, galactan and fructan. Excess fructose is found in apples, pears, watermelon, asparagus and artichokes as well as in foods containing honey, agave syrup and high-fructose corn syrup. Lactose is found in fresh cheese, yogurt, milk and ice cream. Fructans are found in onions, garlic, broccoli, wheat and rye.