# Sugar alcohol cookies, IBS, & persistent diarrhea?



## canadian1984 (Nov 29, 2012)

Hi folks, I found this site a couple weeks ago as I was doing research after some lengthy diarrhea (or loose stools).

I am not sure if I have IBS. I just heard about this condition this month. I have never been "regular" but never really experienced stomach pain either, which seems to be a symptom of IBS.

Here's my situation! Just over a few weeks ago, I purchased a pack of cookies, brand: VOORTMAN. There were 10-cookies in a pack, I ate 8 of them over the course of evening/wee hours (1-3am) of the night. These cookies contained a product called MALTITOL, SORBITOL and one other ingredient. On the back of the pack, there was a warning it could act as a laxative.

Anyhow, the next day I started feeling like I had an upset stomach. I had diarrhea for several days, which turned into gas and loose stools for the next couple. After the 2nd week, it slowed down but everything still comes out lose inside of me. I read that sugar alcohols, such as MALTITOL could trigger IBS in some people.

I have found at least 3 other people who suffered for at least 2-weeks from the very same cookies.

I would like to know if any members could describe their experiences with these products, and in your opinions, what is the likliehood I am suffering from IBS due to the sugar free cookies.

Thanks, Chris


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## Kathleen M. (Nov 16, 1999)

I don't think the sugar free cookies make someone who is healthy have IBS (where you eat the cookies for a few weeks and then will have IBS for years ever after). When I have seen medical articles on -itol caused diarrhea none mention it causes IBS.

Sugar alcohols can loosen the stools in all people. Healthy people included. But the effect should stop when you stop eating the cookies, or other thing with -itols in it (sugar free gum can cause this especially in people who go through several packs of gum a day but like I said usually the diarrhea stops once the -itol consumption goes back to normal levels in the diet. This is something in your diet anyway if you eat fruit, just usually not as much as if you eat processed foods sweetened with the -itols).

Diarrhea caused by a laxative is not IBS. Osmotic laxatives doesn't seem to trigger chronic diarrhea (for IBS diagnosis you need at least 6 weeks of diarrhea after you stop taking the laxative). If so we would see a lot of people getting IBS at 50 right after their first screening colonoscopy and that doesn't seem to be the case. Now once you get the diarrhea going it may not go away the exact day you stop the cookies but 2 weeks after you stop is not long enough to get out of "acute" and into "chronic" and IBS is chronic (long-lasting) symptoms when you aren't taking laxatives (dietary or otherwise) or medications, etc that would keep the symptoms going just from the effect of the laxative/medication (just like someone taking pain meds after surgery does not have IBS-C even if they are constipated for a week after they stop taking the medication).

IBS most commonly starts after a GI infection (as the immune system does damage the body a bit as it fights off any infection). Inflammation is damaging. The -itols do not cause inflammation, they just add a lot of water to the stools.

That all being said. IBSers on the D side of things do tend to be more sensitive to the -itols, but -itol induced diarrhea is usually not considered IBS (just like diarrhea in heavy drinker that stops if they go on the wagon isn't IBS, it is just alcohol-induced diarrhea).

Also all that being said, even if the effects are acute and you don't get decades of diarrhea from the cookies, people do need to know they can really upset the system and just because they are sugar free doesn't mean it is a good idea to eat a bunch of them rather than the 1 or 2 that is the serving listed on the package.

Hope you feel better soon.


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## canadian1984 (Nov 29, 2012)

Hi Kathleen, thanks for explaining that to me.

1) Does diarrhea mean at least 3 loose stool movements a day?
2) If you only had one per day, or sometimes two per day, but it was coming out as "loose stool", would that constitute diarrhea still?

I feel it effected me badly, for just over two weeks, but the diarrhea went away after a couple days and became just loose stool.

I am worried because that never happened to me for this long, and aside from eating the cookies, no changes in my diet.


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## Kathleen M. (Nov 16, 1999)

There are two aspects to diarrhea

Frequency and consistency. Sometimes one is more of a problem than the other

Loose is kinda on the way to diarrhea and up to three BM's a day is normal.

Fretting over the stool consistency may be actually keeping it loose. Try not to worry about it if the only thing going on is stool is a bit loose.

Watery diarrhea is a lot more concerning, and it may be you just need a bit of time to get everything rebalanced in there after being cleaned out. You may have flushed out some of the normal bacteria so if you really feel you need to do something maybe eat some yogurt or get a probiotic bacteria and see if that helps get you back on track faster.


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## canadian1984 (Nov 29, 2012)

Kathleen M. said:


> There are two aspects to diarrhea
> 
> Frequency and consistency. Sometimes one is more of a problem than the other
> 
> ...


So if one had to go just once a day, but it came out loosely, that wouldn't be diarrhea?

After the first 1-5 days I had this, but after each day it would improve - but I had the condition for two weeks.

Thing that confuses me, before this I had a sore throat for two days and started to get a congestion.

So I realized what I ate, and found all sorts of stuff about people who suffer from IBS warning each other about it.

Same as diabetics, as they are the biggest consumer of sugar free products.

Thanks for the information again.

if you see these cookies, don't walk away.... but run


















...unless you have bowels of steel.










Just can't believe with all those who suffer from this product, that the warning is not bigger or that it's legal at all.


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## Kathleen M. (Nov 16, 1999)

Well it is on the D side of things, but it may not the kind of diarrhea that is a huge red flag for something dasterdly going on.

If you need to call it anything you can call it mild diarrhea. I'd probably just call it loose stools.

If you really upset the GI system it can take a few weeks to get everything all completely and totally regulated again. Worrying a lot about the loose stool and focusing on how now you must have a life long chronic illness may keep the system upset for a lot longer than just assuming your body will sort itself out if you just relax and let it do so.

Well if you are going to completely ban all sugar alcohols from food you can never have apples or pears again. That is part of why they are legal. They are a normal part of foods people eat every day.


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## canadian1984 (Nov 29, 2012)

Kathleen M. said:


> Well it is on the D side of things, but it may not the kind of diarrhea that is a huge red flag for something dasterdly going on.
> 
> If you need to call it anything you can call it mild diarrhea. I'd probably just call it loose stools.
> 
> ...


When you say "3 weeks to clear up", does that mean it's normal or not so unsual if one has loose stools (that gradually get better) after the first few days?

I am worried. I also had a sore throat before it started for a couple days.

I ate another pack of sugar free cookies yesterday, just to see how my body would react... so far, a little bit of grumbling but nothing.


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## Kathleen M. (Nov 16, 1999)

Basically any acute assault on the gut (anything that upsets the system) can take from 10 minutes to a few weeks to resolve.

That is the definition of acute. It lasts for a short period of time.

A good flush out of the gut (watery diarrhea) can disrupt the gut flora and it doesn't come back the instant the diarrhea stops. It takes a bit of time to regrow and sometimes it takes a bit for you and it to get back in sync with each other.

Having 3-4 weeks of symptoms is NOT IBS as IBS is chronic issues lasting over 6 weeks or over 6 months depending on who is counting.

So two weeks of very mild symptoms is probably not worth the amount of worry that seems to be going on. For some reason every time I seem to try to reassure you that chances are in the next week or two if you stop poking at it (emotionally or by eating a bunch of what you know triggered the diarrhea) it has a good chance to go away.

This message isn't getting through and YES IT IS NORMAL for it to take a bit for the colon and the bacteria in it to get it's act together so it can do the very complicated process of getting a perfect stool to the rectum at the exact perfect moment rather with the exactly perfect amount of water pulled out of it pefectly and exactly. If it is off just a little bit, the stool will be an hour or two underprocessed and be loose.

I just don't know how to reassure you that so far nothing really serious seems to be going on and that maybe if you didn't worry about it so much that would allow it to heal up and re-regulate itself faster.

I mean it is even NORMAL for healthy people to have loose stools fairly regularly during the summer when fruits that loosen up the stools are in season and healthy people tend to eat them. The summer fruits tend to loosen stools with the exact same sugar alcohols that are in the cookies. (just maybe not quite as concentrated). So if sugar alcohols regularly cause permanent damage than every kid who ate one too many peaches once in their life would be disabled.


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## canadian1984 (Nov 29, 2012)

Thanks again Kathleen.

Yes, I am worried. I just went to Walmart and bought a pack of sugar free Reeses w/ Maltitol, ate all 12 (minis), which is 40gr of sugar alcohol.

So far nothing, including with the cookies. Feeling a little bubbly.

Only leads me to believe what caused my 2-3 weeks of 'discomfort' was a different type of viral infection.

Unless these things take a day or two to wreck havoc in your system, can't remember how the cookies came about.


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## Kathleen M. (Nov 16, 1999)

Some gurgling from the gas is pretty normal.

Could have been a viral something or other if these -itol things don't normally bother you. It often takes a few weeks to get back on track after a bout of viral diarrhea/GI "flu".


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## canadian1984 (Nov 29, 2012)

Kathleen M. said:


> Some gurgling from the gas is pretty normal.
> 
> Could have been a viral something or other if these -itol things don't normally bother you. It often takes a few weeks to get back on track after a bout of viral diarrhea/GI "flu".


Does it also take 3 weeks to get back to normal if these 'itol' things do bother you? Or only viral takes that long?


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## Kathleen M. (Nov 16, 1999)

Either could take awhile.

It has to do more with how flushed out you were and how much that may have disrupted your colon flora, and if there was inflammation or not (so viral more likely to cause this).

They overlap substantially. Also....Depends on how mild or how severe something is. Depends on your particular genetics, how you developed, what previous assaults your GI tract had to heal from, what kind of diet you eat and if it supports normal gut functioning or not, etc.

I could make up a list of days for each thing, but then the cats in the tubes of the interwebs would convert it from snarkiness to fact.

There just isn't some hard fast rule that says something must cause exactly X number of days of disruption, no more, no less and none of them overlap at all, so it is diagnostically good enough to tell you what caused the diarrhea in the first place.

I find I get all kinds of reactions to things. Especially after IBS. Sometimes I bounce back the next day, sometimes it takes awhile. And I won't know even if I compare how bad the diarrhea was this time compared to last time. Had a really bad histamine reaction to some badly canned tuna (happens if you eat enough tuna, sooner or later you get one that sat on the boat a couple of hours too long). Severe diarrhea. But as soon as it passed, pop, right back to normal. Other times something upsets the system just a little bit and it takes time before I feel settled again. Just depends. There are just way too many variables to predict.


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## canadian1984 (Nov 29, 2012)

Kathleen M. said:


> Either could take awhile.
> 
> It has to do more with how flushed out you were and how much that may have disrupted your colon flora, and if there was inflammation or not (so viral more likely to cause this).
> 
> ...


When I ate those cookies, I was starving - just had returned from the gym, exercising.

Consumed 8/10, totally paid for it (unless it was viral...)

Found two people who had the same symptoms for me, for at least 2+ weeks who ate the same brand of cookies (one only ate *3*)

Just I started out with a soar throat, then came this. Then I felt dehydrated and not sure if I had a fever.

Noticed less energy trying to work out, so badly I noticed I got hot quickly so I left and took a few days totally off.

Hopefully all it was, was intolerance to Maltitol or Sorbitol. Just felt like it hit me again, but let's see if it will last more then a day or two...

One other thing that baffles me, is I was trying to consume all my protein (since I never cook) in powder.

I would mix this protein formula with power - started to notice when this began, it was effecting me too.

Overall, it seems so variable. Since I have not really had "regular" bowel movements as many people do, I thought perhaps it was IBS. Hopefully it is not something else, worse.

Thanks for your help.


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## Kathleen M. (Nov 16, 1999)

Like I said it could just be normal GI upset that any healthy person can have.

It is not like a light switch.

Because it is not like a light switch you have to WAIT about 6 weeks to 6 months to see if it calms down all by itself and everything is fine or you have IBS.

It is still WAY too early to know if it is IBS.

And if after a couple more months nothing has changed it seems unlikely to be something worse. You are describing symptoms of the mild end of the spectrum for IBS and not seeming to have frequent attacks of bloody diarrhea or anything like that.

Can you calmly wait and see what happens and not eat foods to try to provoke an attack to convince yourself you have a chronic illness rather than just hope that like most people it goes back to normal in a relatively short period of time .

I do think that getting 100% of any food group from artificial, highly processed, food like substances probably isn't the best idea. It isn't what our guts ever had to deal with before so not really what we are designed for. You really can't cook or microwave anything and have to get all your food from highly processed stuff? You can't even heat up any of the microwavable protein sources?


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## canadian1984 (Nov 29, 2012)

Kathleen,

I do buy things like frozen pizza, eat cheese, chickpeas sometimes, but I never cook beef or chicken. Not even fish.

I was trying to lift weights again, exercising daily, so I would try to consume larger then normal amounts of protein - so powder was my option.

I have yet to conclude whether that aided my problems (since I took it in the past w/o problems), I am doubtful.

Wondering if it was the milk residue on the bottle?

Anyhow, my stomach reacted again to 12 pieces of Reese's sugar free (Maltitol, Aspartame) cups.

It might sound crazy, but I hope it lasts for a week so i can conclude what is wrong with me.


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## canadian1984 (Nov 29, 2012)

Well an update:
About 4-days ago, or on Saturday, I went to Walmart and bought those Reeses (they have Maltitol but not Sorbitol). Almost immediately, my stomach felt like landmines were going off but it didn't match up to what I experienced with the Voortman cookies last month.

So tonight, I went to Walmart and bought the very same cookies (Maltitol, Sorbitol & Acesulftane Potassium) -- just consumed 8 of them. So far, I don't really feel it. They are not chocolate coated like the Reeses were, they are styled to look like a homebaked cookie (does a cookie take longer to process then say, a hard candy that would melt or a Reeses cup?) Last month, I didn't notice it right away - I noticed it the next day and it was quite intense. After the first couple days, it just turned into loose stool. Sometimes I felt I had to go when I didn't have to go. It was not what I would have considered to be "diarrhea" prior to reading what constitutes diarrhea (loose stool as I saw in the Bristol Chart of Poo)..

Question for Kathleen, if you can: Does stomach build up immunity to sugar alcohol? Would it have been possible to experience it last month, but not again?

At the time, I felt I had a cold or a possible onset of a fever. But while I had the loose stool, I felt totally fine.

I am just scared it could be something else.

Please share your knowledge if you can.


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## canadian1984 (Nov 29, 2012)

Also, if Acesulfame Potassium is also aspartame - I have drank a lot of diet pop over the years, and never had a problem.

I do remember 10-years ago eating these Sorbitol candy's and having explosive bowel movements all day.

But why is it not happening now -- ? Does that mean it wasn't the cookies, or my body has become use of it?

I read this about this product on LiveStrong.com:

* Acesulfame Potassium and Stomach Pain*

_Stomach pain is a common side effect of food additive sensitivity. Not everyone's body reacts the same way to artificial ingredients. You may be able to digest other artificial sweeteners without any side effects, but acesulfame potassium may trigger a chemical reaction in your body that results in *gastrointestinal inflammation* and swelling. The Asthma and Allergy Foundation of America states that food additives sensitivity symptoms may vary in severity from person to person. Other common symptom may include sweating, nausea, diarrhea and vomiting._
[background=rgb(255, 255, 255)]
Read more: http://www.livestrong.com/article/489713-stomach-pain-in-reaction-to-acesulfame-potassium/#ixzz2EEhxioRZ[/background]​
[background=rgb(255, 255, 255)]So just as you noted earlier as a potential problem -- swelling -- it mentions immflamation which could prolong repairment to stomach lining. All of this time, I had been relentlessly searching on Maltitol and Sorbitol, well I do know that in 'large' amounts, both of these products most definetely cause my immediate stomach pain, I had not researched this product.[/background]​
[background=rgb(255, 255, 255)]I wonder if Canada is different then the US in terms of what they put in diet pop. Here it is aspartame.[/background]​
[background=rgb(255, 255, 255)]Apparently this is a different product.[/background]​


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## Kathleen M. (Nov 16, 1999)

Also, if Acesulfame Potassium is also aspartame...Different artificial sweeteners.

You may never know...do you have to know?

If it was a one off and your gut is back close to normal it is unlikely to be something serious. Lots of healthy people have a week or two of GI distress every so often. You really can't expect to never have any sort of acute reaction or illness ever in your life. Life happens. Life includes occasional illness or reactions to things.

One of the problems with all the artifical sugars of any kind is we tend to think if it is sugar free it is OK in large amounts. If you would eat one cookie with sugar, then only eat one cookie if it is sugar free (or fat free or whatever free...free doesn't mean eat in unlimited quantities).


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## McMahon IBS (Nov 20, 2012)

For it to be IBS, it has to be six months or longer according to the Rome III Criteria. The Rome III Criteria is used by Gastroenterologists as part of the diagnosis process. It seems that you are experiencing a lot of anxiety. There is a lot of focus on your gut and a lot of focus on the food you are eating. This in itself is going to upset the gut. What you really need to do is learn some techniques of redirecting your thoughts away from your stomach. I think you will then find your metabolism will change and everything will calm down nicely. A good technique that you can use is mindfulness meditation and also some self-hypnosis. Mindfulness involves focussing you attention exclusively on the breath for 10-20 minutes per day. I hope this is useful for you.
Pete


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## destiny_driven (Jun 19, 2018)

This thread hasn't been active for several years, but it was relevant to the events I am having with Voortman Peanut Butter Wafers. Those cursed things are straight from Hell, tasting so good that you just can't stop eating them. I ate two packages in a four day period and experienced two weeks of urgent diarrhea, followed by a week of gas and loose stools. I do not have any type of gastro intestinal problem. The only thing different in my diet was the cookies.

So, my experience mirrors that of the poster that started the thread. Being that I had the same exact symptoms and do not have IBS, then it is safe to say that their problem may not have been associated with IBS. Since their post was initiated six years ago, you would have thought that by now Voortman would have found a replacement for the chemicals that give their customers this experience. It's hard to believe that they are still using this stuff. I guess we don't complain enough. I am going to lead the charge by becoming a PITA on their social media site. Join me!


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