Association of Natural and Artificial Nonnutritive Sweeteners on Gastrointestinal Disorders: A Narrative Review

Introduction: Non-caloric sweeteners (NCS) are natural or chemical additives, found in food products and beverages as a measure to reduce their energy content. Several studies report possible effects on the gastrointestinal tract, especially in patients with predisposition such as Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD). The aim of this review is to describe the association between NCS consumption and changes in bowel habits.Methods: The PubMed, Scopus and Embase literature from 1980 to 2017 was reviewed and we included those that relate aspects of change in bowel habit, microbiota and NCS consumption.Results: Studies have shown possible effects on intestinal motility and microbiota, through increased secretion of hormones and microbiota regulation however, available studies have been heterogeneous in the population studied. Consumption of NCS especially sucralose and polyols were associated with symptoms in patients with IBS and IBD by intervention in the microbiota and immune system.Conclusion: We conclude that increased use of NCS worldwide may increase the symptoms of patients with IBS and IBD, however, it is important to conduct further human studies to assess this association.