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A Middle Schooler can get IBS too!

by Valerie Polley | Jan 17, 2019 | 0 comments

I asked the mother of one of my clients if she would like to write about her son's journey with IBS. Below is a very condensed version of his story. Some people are "fixed" quickly, while others, the pieces of the puzzle take a lot longer to fall into place. This client's mother was his biggest advocate and she deserves so much praise for getting her son where he is today.

Seeing my son in his first year of high school, enjoying the life of a typical teenager, I am grateful to Valerie Polley at Blue Tree Nutrition for helping him along his journey to better health.

For more than two years, digestive issues, headaches, dizziness and insomnia were making it impossible for my son to function normally. The problems began with a stomach virus, which ran a normal course with other family members, but persisted with my son. Because there were no physical signs the diagnosis became “school anxiety”. We felt that something else might be wrong, but experts were telling us otherwise.
Allergy testing came back negative. Counseling sessions didn’t seem to be helping. We homeschooled to avoid the pressure on all of us to get him to school no matter how he felt. We changed pediatricians when we realized that the first doctor wasn’t listening to our concerns.

After a while symptoms seemed to get better, so he returned to traditional school for junior high. Occasional symptoms occurred, but we told our son he had to tough it out and go to school as the medical professionals had told us to do. This worked until 8th grade when the GI issues and other symptoms began to occur daily. The new doctor had me keep a detailed record of symptoms and eating. He prescribed some medication which didn’t help.

The physician made a referral to a GI specialist. When we met the GI doctor in December 2016, she took time to get to know my son and to look at the records we had kept. She saw a pattern in the symptoms and told us that she thought that my son had IBS, a diagnosis that was confirmed with more testing.

It seemed that with a proper diagnosis and the right medication my son’s symptoms would go away, but that didn’t prove to be the case. We learned quickly that trial and error would be necessary, first to find a medication without troublesome side effects, and then to find the right diet. The third medication tried seemed to be the best, but symptoms were still occurring. The specialist had only provided us with clues about diet- “natural foods” and a note in a handout about something called, the Low FODMAP diet. The office scheduled an appointment for us with hospital dietician- in a month. I found the Low Fodmap App and began using it to find “safe” foods. We found that following the diet caused a decrease in symptoms, but my son was still having a lot of pain and not sleeping well at night.

I looked on the internet for dieticians specializing in the Low FODMAP diet and that is when I learned about Blue Tree Nutrition. Valerie was able to take more time with us and had a much better knowledge of how foods affect IBS than the doctors we had been working with. She gave me information on troublesome ingredients and ingredients hidden in food. She made many suggestions of appropriate products and recipes. After our meeting, she followed up with us several times to see how things were going and make suggestions for further changes. She is knowledgeable about the gastroenterologists in the area and helped us find a doctor that is more appropriate for my son.

Now taking the morning IBGard supplement suggested by the new doctor, medication at night, and avoiding the FODMAPs that cause reactions, my son is a healthy and happy 14 year old.

Our gut microbiome (the community of trillions of microbes that live in our gut) plays a key role in maintaining metabolic and immune health. Gut dysbiosis occurs when the composition and diversity of our gut microbiome shift. This could include overgrowth of harmful bacteria or a decrease in beneficial bacteria. Gut dysbiosis has been linked to a wide range of negative health outcomes, including increased levels of inflammation and changes in metabolism.

Many people switch to non-nutritive sweeteners like sucralose, aspartame, and stevia for health reasons, and for decades, we've believed that they pass through our bodies without affecting us. But emerging research shows that these compounds interact directly with our gut microbiome and may have potential negative effects on our health. 

This article will review what we currently know about the relationship between non-nutritive sweeteners (including artificial sweeteners and calorie-free natural sweeteners) and the gut microbiome, plus practical advice for navigating sweeteners.

Sucralose

Sucralose (Splenda) is an artificial sweetener commonly used in baked goods, gums, and sugar-free beverages and is approximately 600 times sweeter than sucrose (table sugar). However, recent research has linked it to adverse health effects such as systemic inflammation, metabolic disease, and gut dysbiosis. For example, a 2022 study found that sucralose consumption increased harmful bacteria and reduced beneficial bacteria, which was associated with changes in insulin and glucose levels.

Additionally, a 2025 randomized controlled trial examining the effects of replacing added sugars with sucralose found that people with type 2 diabetes who consumed sucralose experienced reductions in both alpha diversity (the number and types of species present in a single person) and beta diversity (differences in microbial composition between people). Interestingly, the people with overweight and obesity without type 2 diabetes did not experience the same changes.

Overall, animal studies and limited human studies suggest that sucralose may trigger intestinal inflammation, likely through its effects on the gut microbiome. However, since most of the evidence we have comes from test tube or animal studies, these results should be interpreted cautiously.

Aspartame

Aspartame is another commonly used artificial sweetener that is about 200 times as sweet as sucrose. While it does contain some calories, because you don't need much of it to reach the same sweetness levels as sucrose, these calories are negligible.

Like sucralose, most of the research into the gut effects of aspartame has been done in animals. However, we do have some very small human studies. A 2022 randomized controlled trial (RCT) involving 20 healthy adults found that participants taking aspartame showed changes in both probiotic (beneficial) and pathogenic (harmful) bacteria, but the changes were specific to each individual. 

Why the differences? It's likely due to the "responder vs. non-responder" phenomenon. We all have differences in our "baseline" microbiome. While certain bacterial species are common in healthy populations, our microbiome is as unique as a fingerprint. Whether an artificial sweetener has positive or negative effects on our microbiome may depend on which species are already present in our gut, as well as on our habitual diet. This difference in responses makes it very challenging to draw firm conclusions about whether artificial sweeteners are harmful.

Stevia

Many people choose stevia because it's a "natural" zero-calorie sweetener. Studies have shown mixed results regarding the effects of stevia on the gut microbiome. For example, while some in vitro (test tube) and in vivo (animal) studies have reported potentially harmful effects of stevia on the gut microbiome, others have found no impact, and some even reported beneficial effects through inhibition of inflammatory pathways.

Additionally, a 2024 human study found that stevia had no significant effect on the gut microbiome. This highlights the importance of not forming conclusions based solely on test tube and animal studies. Overall, it appears that stevia is a potentially less-harmful alternative to artificial sweeteners like sucralose and aspartame.

Practical Advice for Navigating Sweeteners

Since the research on artificial sweeteners is still evolving, the decision to include or avoid them comes down to personal preference. Here are some tips for including them in your diet in moderation:

  • Try gradually reducing the amount you use: If you typically use two packets of sweetener in your coffee or tea, try gradually reducing to one packet. Our taste buds are highly adaptable, and you may find that one packet is sweet enough once you get used to it.
  • Check your labels: Low- or no-calorie sweeteners (such as sucralose, aspartame, and sugar alcohols like erythritol) are often hidden in low-sugar foods like protein bars, yogurt, and diet sodas. Awareness is the first step to reducing your intake.
  • Rotate your sources: If you do use artificial sweeteners, try switching up the types you use. Since different sweeteners may affect your gut microbiome in different ways, this may reduce the concentrated impact on your gut.
  • Switch to stevia: While animal and test-tube studies show mixed findings, human research indicates that stevia has a limited effect on the gut microbiome, making it a better choice for people seeking to support their gut health.

Another way to support your gut if you regularly use artificial sweeteners is to rebuild gut diversity with fiber and fermented foods, while focusing on whole-food sweeteners.

  • High fiber prebiotic foods (like legumes, whole grains, garlic, onions, asparagus, and under-ripe bananas) act as "fuel" for your healthy gut microbes. Aim to include a variety of these foods in your diet to support the microbes already in your gut.
  • Add fermented foods, like unpasteurized sauerkraut and kimchi, kefir, or kombucha, to your diet. Some fermented foods contain live, beneficial bacterial cultures, while others are rich in "postbiotics" (beneficial compounds like short-chain fatty acids, which are produced when bacteria break down prebiotics).
  • Try using whole-food sweeteners instead of artificial ones. For example, sweeten plain yogurt with vanilla extract and berries or add dates to smoothies or homemade energy bites.

Final Thoughts

Emerging research suggests that certain low- or no-calorie sweeteners, including sucralose and aspartame, may affect the gut microbiome, whereas stevia appears to have a less negative effect. While individual responses can vary with a person's unique baseline microbiome, certain artificial sweeteners may increase inflammation or reduce gut microbiome diversity.

If you need personalized support navigating sweeteners or supporting your gut health, Blue Tree Nutrition can help. Click here to get in touch!

 

 

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Hello, I am

Valerie

My name is Valerie Polley. I am a Indianapolis-based registered dietitian and owner of Blue Tree Nutrition. I consult with clients both local and far away.
I have a bachelor’s degree in nutrition from Purdue University and I have been practicing for 20 years.
I thoroughly enjoy helping clients through their gut health journey. I see a range of GI issues including, but not limited to celiac disease, IBS and SIBO. I also specialize in the FODMAP elimination diet.

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