SUGAR-FREE, BUT NOT SYMPTOM-FREE: THE IMPACT OF ARTIFICIAL AND POLYOL-BASED SWEETENERS ON IBS AND GASTROINTESTINAL HEALTH
Abstract
Introduction and Objective: Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder significantly influenced by diet. In recent years, sugar-free products containing artificial sweeteners and polyols have become increasingly popular, especially among people with IBS. This article reviews the impact of these sweeteners on IBS symptoms and gut microbiota.
Methods: This is a literature review based on articles from the PubMed database published between 2020 and 2025. Studies focusing on artificial sweeteners, polyols, and their effects on IBS and gut health were included.
Results: The reviewed studies show that some artificial sweeteners and polyols can worsen IBS symptoms such as bloating, gas, and diarrhea. Additionally, they may negatively affect the gut microbiota, contributing to dysbiosis.
Conclusion: Although promoted as healthier sugar substitutes, many sweeteners may be problematic for IBS patients. Their consumption should be individualized and approached with caution.
References
Bellini, M., Gambaccini, D., Stasi, C., Urbano, M. T., Marchi, S., & Usai-Satta, P. (2014). Irritable bowel syndrome: A disease still searching for pathogenesis, diagnosis and therapy. World Journal of Gastroenterology, 20(27), 8807–8820. https://doi.org/10.3748/wjg.v20.i27.8807
Lovell, R. M., & Ford, A. C. (2012). Global prevalence of and risk factors for irritable bowel syndrome: A meta-analysis. Clinical Gastroenterology and Hepatology, 10(7), 712–721. https://doi.org/10.1016/j.cgh.2012.02.029
Soldán, M., Argalášová, Ľ., Hadvinová, L., Galileo, B., & Babjaková, J. (2024). The effect of dietary types on gut microbiota composition and development of non-communicable diseases: A narrative review. Nutrients, 16(18), 3134. https://doi.org/10.3390/nu16183134
Olivier-Van Stichelen, S., Rother, K. I., & Hanover, J. A. (2019). Maternal exposure to non-nutritive sweeteners impacts progeny’s metabolism and microbiome. Frontiers in Microbiology, 10, 1360. https://doi.org/10.3389/fmicb.2019.01360
Huang, K. Y., Wang, F. Y., Lv, M., Ma, X. X., Tang, X. D., & Lv, L. (2023). Irritable bowel syndrome: Epidemiology, overlap disorders, pathophysiology and treatment. World Journal of Gastroenterology, 29(26), 4120–4135. https://doi.org/10.3748/wjg.v29.i26.4120
Ciriza de Los Ríos, C., Aparicio Cabezudo, M., Zatarain Vallés, A., & Rey, E. (2022). Practical approach to irritable bowel syndrome-diarrhea beyond low-FODMAP diet. Revista Española de Enfermedades Digestivas, 114(8), 481–488. https://doi.org/10.17235/reed.2022.8749/2022
Malik, V. S., & Hu, F. B. (2022). The role of sugar-sweetened beverages in the global epidemics of obesity and chronic diseases. Nature Reviews Endocrinology, 18, 205–218. https://doi.org/10.1038/s41574-021-00539-2
Arshad, S., Rehman, T., Saif, S., et al. (2022). Replacement of refined sugar by natural sweeteners: Focus on potential health benefits. SSRN Journal. https://doi.org/10.2139/ssrn.4050519
Feng, J., Peng, J., Hsiao, Y. C., et al. (2024). Non/low-caloric artificial sweeteners and gut microbiome: From perturbed species to mechanisms. Metabolites, 14(10), 544. https://doi.org/10.3390/metabo14100544
Hosseini, A., Barlow, G. M., Leite, G., et al. (2023). Consuming artificial sweeteners may alter the structure and function of duodenal microbial communities. iScience, 26(1), 108530. https://doi.org/10.1016/j.isci.2022.108530
Zinöcker, M. K., & Lindseth, I. A. (2018). The Western diet–microbiome–host interaction and its role in metabolic disease. Nutrients, 10(3), 365. https://doi.org/10.3390/nu10030365
Otten, B. M. J., Sthijns, M. M. J. P. E., & Troost, F. J. (2023). A combination of acetate, propionate, and butyrate increases glucose uptake in C2C12 myotubes. Nutrients, 15(4), 946. https://doi.org/10.3390/nu15040946
Azad, M. A. K., Sarker, M., Li, T., & Yin, J. (2018). Probiotic species in the modulation of gut microbiota: An overview. BioMed Research International, 2018, 9478630. https://doi.org/10.1155/2018/9478630
Bien, J., Palagani, V., & Bozko, P. (2013). The intestinal microbiota dysbiosis and Clostridium difficile infection: Is there a relationship with inflammatory bowel disease? Therapeutic Advances in Gastroenterology, 6(1), 53–68. https://doi.org/10.1177/1756283X12454590
Mirsepasi-Lauridsen, H. C., Vallance, B. A., Krogfelt, K. A., & Petersen, A. M. (2019). Escherichia coli pathobionts associated with inflammatory bowel disease. Clinical Microbiology Reviews, 32(1), e00060-18. https://doi.org/10.1128/CMR.00060-18
Conz, A., Salmona, M., & Diomede, L. (2023). Effect of non-nutritive sweeteners on the gut microbiota. Nutrients, 15(8), 1869. https://doi.org/10.3390/nu15081869
Basson, A. R., Katz, J., Singh, S., et al. (2023). Sweets and inflammatory bowel disease: Patients favor artificial sweeteners and diet foods/drinks over table sugar and consume less fruits/vegetables. Inflammatory Bowel Diseases, 29(11), 1751–1759. https://doi.org/10.1093/ibd/izac272
Chumpitazi, B. P., Cope, J. L., Hollister, E. B., et al. (2015). Randomised clinical trial: Gut microbiome biomarkers are associated with clinical response to a low FODMAP diet in children with the irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 42(4), 418–427. https://doi.org/10.1111/apt.13286
Yao, C. K., Tan, H. L., van Langenberg, D. R., et al. (2014). Dietary sorbitol and mannitol: Food content and distinct absorption patterns between healthy individuals and patients with irritable bowel syndrome. Journal of Human Nutrition and Dietetics, 27(Suppl. 2), 263–275. https://doi.org/10.1111/jhn.12144
Staudacher, H. M., & Whelan, K. (2017). The low FODMAP diet: Recent advances in understanding its mechanisms and efficacy in IBS. Gut, 66(8), 1517–1527. https://doi.org/10.1136/gutjnl-2017-313750
Varney, J., Barrett, J., Scarlata, K., et al. (2017). FODMAPs: Food composition, defining cutoff values and international application. Journal of Gastroenterology and Hepatology, 32(Suppl. 1), 53–61. https://doi.org/10.1111/jgh.13698
Ruiz-Ojeda, F. J., Plaza-Díaz, J., Sáez-Lara, M. J., & Gil, A. (2019). Effects of sweeteners on the gut microbiota: A review of experimental studies and clinical trials. Advances in Nutrition, 10(Suppl. 1), S31–S48. https://doi.org/10.1093/advances/nmy037
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Copyright (c) 2025 Weronika Stachera, Maciej Sobczyk, Julia Stępień, Barbara Wołoszyn, Julia Guzowska, Małgorzata Zach, Patrycja Rzeźnik, Aleksandra Borowy, Wiktoria Suchcicka, Aleksandra Chajnowska

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