From the Guidelines
Excessive sugar consumption can lead to foul-smelling, yellow diarrhea due to malabsorption of carbohydrates, particularly fructose and sorbitol, which can cause an osmotic load to the gastrointestinal tract. This occurs because large amounts of sugar can overwhelm your digestive system's ability to properly absorb it, causing malabsorption, as seen in the study on fruit juice in infants, children, and adolescents 1. When undigested sugar reaches your colon, it becomes food for gut bacteria, which ferment it and produce gases and acids that can cause diarrhea with a distinctive rancid odor and yellowish color.
Key Points to Consider
- The malabsorption of carbohydrate that can result from large intakes of juice is the basis for some health care providers to recommend juice for the treatment of constipation, particularly in infants, as noted in the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition constipation guideline 1.
- Fructose and sorbitol have been implicated most commonly in carbohydrate malabsorption, but the ratios of specific carbohydrates may also be important, as discussed in the study on fruit juice in infants, children, and adolescents 1.
- People with specific conditions like lactose intolerance, fructose malabsorption, or those taking certain medications may be more susceptible to sugar malabsorption.
- To address this issue, reduce your sugar intake, particularly from sources like candy, soda, fruit juices, and processed foods, as recommended by the Dietary Guidelines for Americans 1.
- Stay hydrated with water and electrolyte solutions if diarrhea occurs, and if symptoms persist beyond a few days, are accompanied by fever, severe abdominal pain, or blood in stool, consult a healthcare provider as these could indicate a more serious condition requiring medical attention.
Management and Prevention
- Pediatricians play a central role in children’s health and nutrition by providing guidance to pediatric patients and their parents on healthy dietary choices, including encouraging whole fruit consumption over fruit juice, as suggested in the study on fruit juice in infants, children, and adolescents 1.
- A basic premise of the Dietary Guidelines for Americans is to focus on nutrient-dense foods, and fruit is one of the key focus foods, with an emphasis on whole fruit rather than fruit juice 1.
From the Research
Gastrointestinal Effects of Sugar Consumption
- Excessive sugar consumption has been linked to an imbalance of gut microbiota, which can lead to increased pro-inflammatory properties and decreased capacity to regulate epithelial integrity and mucosal immunity 2.
- A high sugar intake may promote metabolic endotoxemia, systemic inflammation, and the development of metabolic dysregulation 2.
- Sugar alcohols, such as sorbitol and xylitol, can cause gastrointestinal disturbances, including diarrhea, in some individuals 3.
- A dietary intervention with reduction of starch and sucrose has been shown to reduce gastrointestinal and extra-intestinal symptoms in patients with irritable bowel syndrome (IBS) 4.
Diarrhea and Sugar Consumption
- While there is no direct evidence linking excessive sugar consumption to foul-smelling, yellow diarrhea, a high sugar intake can contribute to gastrointestinal disturbances and diarrhea in some individuals 2, 3, 4.
- The type and amount of sugar consumed, as well as individual tolerance and gut microbiota composition, may play a role in the development of diarrhea and other gastrointestinal symptoms 2, 3, 4.
Mechanisms and Potential Consequences
- The mechanisms by which sugar consumption affects gut health and gastrointestinal symptoms are complex and involve changes in gut microbiota composition, inflammation, and epithelial barrier function 2, 4.
- Excessive sugar consumption has been linked to a range of negative health effects, including metabolic dysregulation, cardiovascular disease, and increased risk of certain cancers 2, 5.