IBS—Free at Last!

FODMAPS in Skin Care Products

Have you ever picked up a skin care product containing honey or sorbitol, both FODMAPS, and wondered if it could have any effect on your IBS?

If you've discovered your symptoms are triggered by ingesting FODMAPS carbohydrates, all the action is in your large intestine, where the fermentability and osmotic activity that are characteristics of FODMAPS come into play. I can't think of any way that FODMAPS applied to your skin could possibly cause symptoms via the FODMAPS scenario, since there is no route for it to travel into the lumen of the colon from there.

Of course, some substances are absorbed through the skin into the bloodstream, so it is still possible that certain ingredients or chemicals in skin care products might trigger inflammatory reactions in the body via immune-mediated pathways, but that is a different kettle of fish altogether.

Polyols 101

Many of my clients tell me that even a few small pieces of sugar-free candy or gum cause diarrhea. Ditto for the well-know effect of prunes or cherries. What do these foods have in common? They contain polyols, also known as "sugar alcohols".

Technically, they are FODMAPS carbohydrates, and they are sweet! Most polyols are poorly absorbed, and wind up in the large intestine when they are consumed. In the large intestine, polyols are fermented by gut bacteria. They are also capable of drawing water into the large intestine. Together, the excess gas and excess fluid can cause distension of the colon, which cause bloating, flatulence and looser stools for the IBS sufferer. In a double whammy, eating or drinking sugar alcohols worsens fructose intolerance!

Some sugar alcohols, such as sorbitol, occur naturally in fruits such as apples, pears, and the "stone fruits," which include plums, prunes, apricots, peaches, cherries and so on. Sugar alcohols are often used to sweeten "sugar-free" foods (such as candy, gum, low-carb items, and bubbly water) and liquid medications. They can be recognized on the food label's list of ingredients by the ending "-ol". Examples are xylitol and maltitol.

Note that erythritol seems to be an exception. Studies have shown it is well absorbed and unlikely to cause GI symptoms.