Sorbitol is used in bacterial culture media to distinguish the pathogenic Escherichia coli O157:H7 from most other strains of E. coli, as it is usually incapable of fermenting sorbitol, but 93% of known E. coli strains are capable of doing so.
Sorbitol Liquid and Powder combined with kayexalate, helps the body rid itself of excess potassium ions in a hyperkalaemic state. The kayexalate exchanges sodium ions for potassium ions in the bowel, while sorbitol helps to eliminate it. The FDA has discouraged this combination when in 2010 it issued a warning of increased risk for GI necrosis
Sorbitol also may aggravate irritable bowel syndrome, and similar gastrointestinal conditions, resulting in severe abdominal pain for those affected, even from small amounts ingested.
Sorbitol Liquid and Powder has been noted that the sorbitol added to SPS (Sodium Polystyrene Sulfonate, used in the treatment of hyperkalemia) can cause complications in the GI tract, including bleeding, perforated colonic ulcers, ischemic colitis and colonic necrosis, particularly in patients with uremia. The authors of the paper in question cite a study on rats (both non-uremic and uremic) in which all uremic rats died on a sorbitol enema regimen, whilst uremic rats on non-sorbitol regimens - even with SPS included - showed no signs of colonic damage. In humans, it is suggested that the risk factors for sorbitol-induced damage include "... immunosuppression, hypovolemia, postoperative setting, hypotension after hemodialysis, and peripheral vascular disease." They conclude that SPS-sorbitol should be used with caution, and that "Physicians need to be aware of SPS-sorbitol GI side effects while managing hyperkalemia."
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