A Systematic Review of the Effects of Polyols on Gastrointestinal Health and Irritable Bowel Syndrome
Open accessAbstract
Polyols are sugar alcohols found in certain fruits, vegetables, and sugar-free sweeteners. They make up a component of the diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which is gaining popularity in the treatment of patients with irritable bowel syndrome (IBS). We conducted a systematic review to evaluate the effects of polyols on the gastrointestinal tract in healthy men and women and in patients with IBS. Utilizing PubMed, Ovid, and Embase databases, we conducted a search on individual polyols and each of these terms: fermentation, absorption, motility, permeability, and gastrointestinal symptoms. Standard protocols for a systematic review were followed. We found a total of 1823 eligible articles, 79 of which were included in the review. Overall, available work has shown that polyol malabsorption generally occurs in a dose-dependent fashion in healthy individuals, and malabsorption increases when polyols are ingested in combination. However, studies in patients with IBS have shown conflicting results pertaining to polyol malabsorption. Polyol ingestion can lead to intestinal dysmotility in patients with IBS. Regarding the microbiome, moderate doses of polyols have been shown to shift the microbiome toward an increase in bifidobacteria in healthy individuals and may therefore be beneficial as prebiotics. However, data are limited regarding polyols and the microbiome in patients with IBS. Polyols can induce dose-dependent symptoms of flatulence, abdominal discomfort, and laxative effects when consumed by both healthy volunteers and patients with IBS. Further research is needed to better understand the effects of specific polyols on gastrointestinal function, sensation, and the microbiome in health and gastrointestinal disorders such as IBS.
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Non-caloric sweeteners may cause gastrointestinal distress for some patients.
“and may cause gastrointestinal distress for others [148].”
From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [148]
The Introduction says polyols are used as sugar-free sweeteners and can trigger gastrointestinal symptoms; the “Gastrointestinal symptoms in patients with IBS” section reports abdominal symptoms in patients with IBS. But the paper describes polyols as having fewer calories than sucrose, not as non-caloric sweeteners, so it does not support that specific characterization. (LLM, conf=0.85)
Experimental — accuracy not yet measuredDiets high in added sugars, artificial sweeteners, and sugar alcohols have been associated with gastrointestinal discomfort-including gas, bloating, and diarrhea-and in some studies, increased hunger and a potential link to obesity.
“Diets high in added sugars, artificial sweeteners, and sugar alcohols, often found in ultra-processed products, have been associated with gastrointestinal discomfort—including gas, bloating, and diarrhea—and in some studies, increased hunger and a potential link to obesity [148,169,171,173,175].”
From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [148]
The Introduction and Conclusion report that polyols (sugar alcohols) can cause dose-dependent gastrointestinal symptoms, including flatulence, bloating, and laxative effects. The paper does not support extending that finding to added sugars or artificial sweeteners generally, and it does not address increased hunger or a link to obesity. (LLM, conf=0.88)
Experimental — accuracy not yet measured
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- Authors
- Lenhart, A., & Chey, W. D.
- Affiliations
- Henry Ford Health (US)
- Michigan Medicine (US)
- Corresponding author
- Chey, William D
- Venue
- Advances in Nutrition
- Publisher
- Elsevier BV
- Published
- 2017-07
- Volume
- 8
- Issue
- 4
- Pages
- 587-596
- ISSN
- 2156-5376 (ISSN-L)
- 2161-8313
- PMC
- PMC5508768
- OpenAlex
- W2751987943
- Cited by
- 160
- References
- 79
- Citations by year
- 2026: 25 · 2025: 29 · 2024: 20 · 2023: 24 · 2022: 28 · 2021: 16 · 2020: 5 · 2019: 8 · 2018: 4 · 2017: 1
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Advances in Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Nursing › Nutrition and Dietetics › Microbial Metabolites in Food Biotechnology
- Keywords
- sugar alcohols, irritable bowel syndrome, gut health, intestinal dysmotility, gut microbiota, Bifidobacterium, prebiotics, flatulence, laxative effect, dietary fiber, FODMAPs
- MeSH terms
- Gastrointestinal Microbiome, Fruit, Humans, Malabsorption Syndromes, Polymers, Vegetables, Randomized Controlled Trials as Topic, Gastrointestinal Tract, Irritable Bowel Syndrome, Gastrointestinal Absorption
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