If you use sugar substitutes but have heard artificial sweeteners can upset your stomach, rest easy. Artificial sweeteners are just one type of sugar substitute, and they are not the type that causes an upset stomach.
Artificial sweeteners are regulated and generally recognized as safe by the U.S. Food and Drug Administration (FDA).
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Can Artificial Sweeteners Upset Your Stomach?
"The big three artificial sweeteners are aspartame, sucralose and saccharin," says board-certified gastroenterologist Peter J. Mannon, MD, professor and chief of gastroenterology at University of Nebraska Medical Center in Omaha.
"These sugar substitutes have been studied for years," he says. "There is no evidence that artificial sweeteners cause digestive symptoms. If you have an upset stomach from a sugar-free food, it is probably due to another added ingredient."
"Studies do not show that artificial sweeteners affect the motility of the gastrointestinal tract," Dr. Mannon says, "nor do they cause any changes in gut hormones. There is no evidence that they cause irritable bowel syndrome or any other digestive health disorders."
How Safe Are Artificial Sweeteners?
Artificial sweeteners (a synthetic type of sugar substitute) are also called intense sweeteners because they may be significantly sweeter than table sugar (sucrose), according to the Mayo Clinic.
Artificial sweeteners are commonly found in:
- Soft drinks
- Baked goods
- Canned foods
- Dairy products
Some people prefer them over sugar, per the Mayo Clinic, because:
- They do not cause tooth decay.
- They add no calories.
- They do not affect your blood sugar.
That said, according to the National Cancer Institute (NCI), questions arose early on about a link between artificial sweeteners and cancer based on animal studies. But the doses of these sugar substitutes in animals were much higher than humans would ever take in, and several studies have shown there is no link to cancer in humans, per the NCI.
Sugar Alcohols May Be the Culprit
In fact, according to the FDA, foods that contain the sugar alcohols sorbitol and mannitol must carry a warning on their label that high consumption of the product could come with a laxative effect.
Sugar alcohols are not the same as alcohol in alcoholic beverages, and they do contain some sugar, according to the Mayo Clinic. And, per the FDA, unlike artificial sweeteners — because sugar alcohols do have some carbohydrates — they can raise blood sugar (though less than table sugar). They exist in small amounts in fruits and veggies, but they can also be manufactured.
That said, you can find the manufactured types in processed foods and other products (often in combo with artificial sweeteners), according to the Mayo Clinic and the FDA, such as:
- Chewing gum
- Baked goods and desserts like cakes, cookies, pies and ice cream
- Flavored jams and jellies
- Ready-to-use frostings
Per the FDA, sugar alcohols are used because they:
- Have a sweeter taste with fewer calories per gram than sugar
- Add texture and bulk
- Help retain moisture
- Prevent browning during heating
- Do not cause cavities
When it comes to digestive symptoms and sugar substitutes, sugar alcohols are the likely culprit, a result of the fact that they are not completely absorbed in the intestines and ultimately ferment in the large intestine, leading to gas, bloating and diarrhea for some people, according to the FDA.
And the takeaway on those artificial sweeteners: "By and large, although different foods affect different people differently, there is no human data linking artificial sweeteners to digestive health problems," Dr. Mannon says. "Pay attention to labels, and check for the other ingredients."
- FDA: “High-Intensity Sweeteners”
- Peter J. Mannon, MD, board-certified gastroenterologist, professor of medicine and chief of gastroenterology and hepatology, University of Nebraska Medical Center, Omaha
- Mayo Clinic: “Artificial Sweeteners and Other Sugar Substitutes”
- National Cancer Institute: “Artificial Sweeteners and Cancer”
- FDA: "Sugar Alcohols"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.