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A sweetener used in sugar-free chewing gum, some toothpastes and thousands of other products could be a severe health risk, doctors warned.
Sorbitol, also known as E420, can trigger severe weight loss, abdominal pain and diarrhoea.
A report in the British Medical Journal today highlights the cases of patients who lost up to a fifth of their bodyweight.
The cause was eventually traced to excess intake of sorbitol - one was eating 14-20 sticks of gum a day.
Dentists recommend chewing sugar-free gum to increase saliva production, which reduces cavities and strengthens teeth.
Wrigley, which owns many of the brands sold in the UK, has seen its sales in Europe grow by a third since sorbitol is also used in sugar-free sweets, some cereals and foods aimed at diabetics.
But gastroenterology experts in Germany say many consumers - and even some doctors - are unaware of the laxative side-effects of sorbitol, which can also hinder the absorption of nutrients into the small intestine.
Professor Herbert Lochs and Dr Juergen Bauditz, from the University of Berlin, studied two patients with chronic diarrhoea, abdominal pain and substantial weight loss.
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They underwent extensive investigation before a detailed analysis of their eating was undertaken. It found both had been consuming large amounts of sugar-free gum and sweets.
The first, a 21-year-old woman, chewed around 15 sticks of gum a day. Her weight plunged by almost 2st to just 6st 6lb.
The second patient, a 46-year-old man, chewed 20 sticks of gum and ate up to 200g of sweets each day. He lost more than 3st in a year.
After they started a sorbitol-free diet, their diarrhoea stopped and they gained weight.
Professor Lochs said the cases were unusual because the consumption of sorbitol was not enormously high yet the effects had been serious. He said the public, particularly diabetics who buy low-sugar or sugar-free foods, should be warned that too much sorbitol may be "dangerous".
The professor said warnings about possible side-effects were usually "in the small print" of packaging - and people who suffered gastrointestinal problems might not make the connection. Doctors also needed to be alert to the possibility.
Professor Lochs said men and women should not try to lose weight using sugar-free gum because their intake of nutrients would be affected.
Wrigley said last night: "It is well documented in medical literature, with studies going back more than 20 years, that excessive consumption of polyols such as sorbitol can have a laxative effect in some individuals.
"Those studies generally indicate that people can consume up to 40g of sorbitol without experiencing a laxative effect - subject to the individual and other diet components - a level not even approached by normal consumption of sugar-free chewing gum."
The company said its labelling carried warnings required by EU regulations.
Jemma Edwards, care adviser and registered dietician at Diabetes UK, said: "We already know that many sweeteners have a laxative effect.
"Diabetes UK does not recommend 'diabetic' food because there are no added nutritional benefits and it is often more expensive. People with diabetes can eat normal food as long as they have a healthy, balanced diet."
i use most if not all o thm!!!
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