Are Stevia and IBS Compatible?

Are Stevia and IBS Compatible?

The relationship between stevia and irritable bowel syndrome (IBS) is still in the early stages of investigation, and more research is needed.  Either way, I decided to dig a little deeper into this, to properly answer the frequently asked question: are stevia and IBS compatible?

The short answer to this question is yes, but unfortunately it’s not that simple.  Read on to get the full story, so you can learn how to have your stevia and eat (or drink) it too – even with IBS! 

Disclaimer: This isn’t medical nutrition advice! Make sure you’re working with a doctor and a holistic dietitian / functional dietitian if you’re navigating IBS.

What is stevia?

Stevia rebaudiana or “stevia” is a type of naturally growing herb with leaves that are very sweet.  (Maybe that’s an understatement!)

Stevia leaf extract is estimated to be about 250-300 times sweeter than sucrose (table sugar), while specific constituents of stevia, called “steviol glycosides” are be about 200-400 times sweeter than table sugar, for zero calories. (1, 2)

Since this plant has become increasingly popular as a modern-day non-nutritive sweetener, Stevia rebaudiana cultivation has expanded far beyond its origins of Peru and Brazil to tropical regions globally, and sold in mass quantities in countries all around the world.

You may or may not have seen stevia listed on a nutrition label as “stevia,” “Truvia,” “PureVia” or “Enlighten.”

IBS and SIBO: food for thought

IBS is a chronic, functional gut disorder which modern-day research is still beginning to understand.  (More on IBS here!)

Small intestinal bacterial overgrowth (SIBO), on the other hand, is a condition in which there are microbes in the small intestine that ferment certain types of food, leading to unwanted symptoms that disguise as IBS.  

There’s generally a lot of overlap between IBS and SIBO in terms of the symptoms and also the underlying root-causes. (This is all relevant!)

All of that said, there are certain things we know to be true about IBS and SIBO, which are impacted by stevia:

  • Most if not all IBS cases seem to be linked with underlying dysbiosis – aka an imbalance in the gut microbiome (ecosystem of microbes that live in your gut) (3, 4, 5, 6, 7, 8, 9)
  • Gut motility (the movement and contraction of muscles that help us digest are food) is dictated by a component of our enteric nervous system called the “Migrating Motor Complex” (MMC)
    • The MMC can’t be ON at the same time as while we’re eating or when we are stressed. It only works between meals and while we’re in a relaxed state.
    • While there’s more to learn about this MMC, people with IBS and/or SIBO seem to often have a dysfunctional MMC. (10, 11, 12)

Okay, so that was a LOT of science. Now you’re probably wondering, what does any of that have to do with stevia? (Keep reading!)

Stevia and IBS / SIBO

There are a few things to consider when it comes to whether not stevia is compatible with your IBS and/or SIBO:

  1. How does it impact the gut microbiome?
  2. Is stevia high or low FODMAP?
  3. Does it contain prebiotics?
  4. Are there any downsides/contraindications?

Stevia and gut microbes

On a positive note, in-vitro studies are finding that stevia actually seems to have a positive effect on the gut microbiome diversity, in that it inhibited activity of “bad” pathogenic microbes, while preserving healthy probiotic microbes. (13)

Another study also concluded that stevia does alter gut microbes, but unlike other types of non-sugar sweeteners (like sugar alcohols), stevia can get broken down and absorbed into the bloodstream through the gut. (14)

In other words, if you have dysbiosis (a root-cause of IBS), you can likely consume stevia in moderation without any negative interactions from a gut microbiome standpoint!  Still the amount and frequency of stevia intake matter.  Moderation is key!

Is stevia high or low FODMAP?

Stevia leaf extracts (but not the roots) are low in FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) in that they can get broken down by the microbes in your gut and absorbed into your bloodstream.  

Extracts derived from stevia leaves won’t worsen symptoms of IBS or SIBO.

However, The roots of Stevia rebaudiana contain inulin and fructans, which are high in FODMAPs.

Is it prebiotic?

Aside from being high FODMAP, inulin and fructans are prebiotic constituents which help feed healthy probiotic microbes. These constituents were found in a study to improve the growth of select probiotic strains (bifidobacteria and lactobacilli) which are important for a healthy gut. (14)

The downsides of stevia for people with IBS/SIBO

Stevia and your gut motility

While you can most definitely enjoy stevia-sweetened products during a meal, keep in mind that drinking stevia-sweetened beverages (or any other type non-nutritive sweetened beverage) between meals may actually shut down your migrating motor complex / “MMC” (the regulator of your gut motility). (15)

This is because stevia binds MMC receptors in your gut (and the sweet taste hits your sweet taste receptors on your tongue), essentially tricking your brain into thinking you’re eating something. (Remember: when we’re eating, or when our brain THINKS we’re eating, the MMC is shut off!)

  • If you’re drinking stevia-sweetened beverages all day in between meals (i.e. adding stevia to coffee, iced tea, sugar-free sports drinks, etc.), your body and brain will operate under the false impression that you’re eating something the entire day.  
    • As a result, your migrating motor complex (MMC) will be turned off, ultimately compromising your gut motility unnecessarily, which leads into a slew of potential IBS/SIBO issues like dysbiosis and more.

Long story short, make sure to only include stevia during meals or snacks!

Beware of stevia-based sweeteners cut with other stuff

Buyer beware: just because a product is stevia-based (such as Truvia) doesn’t mean it’s safe.

When in doubt, always look at the ingredient list!

For example, Truvia® (the first stevia-based sweetener fit for coffee/tea) is most often nowadays cut with sugar alcohols like erythritol. (Just read the fine print!)

  • While research on erythitol and IBS is mixed, in my clinic anecdotally I’ve observed most of my clients with IBS and/or SIBO seem to have adverse reactions to erythritol.
    • That said, make sure to read labels to ensure that what you’re consuming is 100% stevia leaf extract!

Additional resources

If you’d like to learn more about my perspectives on other types of sweeteners pertaining to IBS, feel free to check out the following articles:

Conclusions

All-in-all, stevia and IBS are generally compatible if you’re consuming it in moderation, with meals/snacks (versus in stevia-sweetened beverages which will shut down your gut motility).  

Stevia may actually support healthy diversity and post-biotic production in the gut microbiome, which is likely beneficial for most people with IBS.

SIBO is a condition often mistaken for IBS, so SIBO is impacted by stevia in ways that are very similar to IBS.  (If you’re someone who has sipped on stevia-sweetened beverages all day for many years, and you now have IBS, you may want to consult your doctor about testing for SIBO.)

Make sure you aren’t drinking stevia-sweetened beverages throughout the day in between meals, to avoid tricking your body and brain into thinking you’re eating a meal.

If you have SIBO and/or you’re on a low FODMAP diet, make sure to opt for products made with stevia leaf extract but not stevia root, which contains high-FODMAP prebiotic constituents fructans and inulin.

Lastly, make sure to read ingredient lists to ensure that you’re not consuming stevia-based products that have been cut with other types of sweeteners which could aggrevate your IBS/SIBO! Knowledge is power. 😉

Thank you for reading this! I hope it was helpful for you.  If so, please feel free to share this article with your family members, friends, or online peers who are navigating IBS so we can take IBS awareness to the next level!

XO – Jenna