Pure xylitol does not normally contribute to gastrointestinal upset as much as other sugar alcohols. However, products that do not use pure xylitol may produce this effect. Some manufacturers add other sugar alcohols such as sorbitol or mannitol to reduce the cost of xylitol, which is rather expensive to formulate. These other fillers tend to cause more digestive issues. Further, acids decrease the effectiveness of xylitol. To avoid this dilemma, seek high-grade xylitol products and steer away from items that include acids.

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