Will apple juice give you diarrhea?

Apple juice is a popular beverage enjoyed by many for its sweet taste and variety of health benefits. However, some people experience digestive issues like diarrhea after drinking apple juice. In this comprehensive guide, we’ll explore the reasons why apple juice may cause diarrhea and how you can avoid it.

What’s in Apple Juice That Could Cause Diarrhea

Apple juice contains four main components that could contribute to diarrhea:

• Fructose
• Sorbitol
• Fiber
• Bacteria

Fructose

Apple juice is high in fructose, a natural sugar found in fruits. While fructose is fine in moderation, consuming too much can overwhelm the body’s ability to absorb it.

The excess fructose travels to the large intestine, drawing water into the bowel from surrounding tissue via osmosis. This process causes loose, watery stools characteristic of diarrhea.

Sorbitol

Sorbitol is a sugar alcohol that occurs naturally in apples. Like fructose, it pulls water into the large intestine to cause diarrhea when consumed in large amounts.

People with fructose malabsorption lack the transporters needed to properly absorb excess sorbitol and fructose. This makes them more prone to osmotic diarrhea from apple juice.

Fiber

Apple juice contains soluble fiber from apples. Soluble fiber from fruits can sometimes cause loose stools, although usually not full-blown diarrhea.

People with sensitive digestive systems may experience diarrhea from the fiber content. However, for most people fiber aids healthy digestion.

Bacteria

Unpasteurized apple juice may contain harmful bacteria like E.coli or Salmonella that can cause foodborne illness. Diarrhea is a common symptom of contamination.

Pasteurization kills pathogens, so only unpasteurized apple cider poses a risk.

Why Apple Juice Causes Diarrhea in Some People

Several factors can determine whether apple juice gives you diarrhea or not:

Fructose Malabsorption

People with fructose malabsorption lack the transporters needed to properly absorb fructose in the small intestine.

Consuming apple juice floods the bowel with unabsorbed sugars that pull in fluids from tissues via osmosis, causing osmotic diarrhea.

Irritable Bowel Syndrome

Those with irritable bowel syndrome (IBS) often have difficulty tolerating excess fructose. Their intestines are hypersensitive and easily irritated.

The high fructose content of apple juice can trigger cramping, gas, bloating, and diarrhea in those with IBS.

Small Intestinal Bacterial Overgrowth

Small intestinal bacterial overgrowth (SIBO) occurs when excess bacteria grow in the small intestine.

The bacteria ferment fructose and sorbitol into hydrogen gas, causing gas, bloating, and loose stools. SIBO can make apple juice-induced diarrhea worse.

Gastroparesis

Gastroparesis causes delayed stomach emptying. Undigested apple juice sits in the stomach and ferments, producing excess gas that can induce diarrhea.

Dose

Consuming a large amount of apple juice in one sitting provides excess sugars and fiber that can overwhelm digestive capacity.

Drinking juice slowly, in moderation, and with meals can help prevent diarrhea.

Groups at Highest Risk of Apple Juice Diarrhea

Certain groups should exercise caution with apple juice:

• Infants under 1 year old – their guts are still maturing
• Toddlers – prone to taking in too much juice
• Those with fructose malabsorption
• People with IBS
• Individuals with SIBO
• Those with diabetes – impaired carbohydrate digestion
• Elderly – decreased digestive enzymes

These groups are more likely to experience osmotic diarrhea from the fructose and sorbitol in apple juice. They should limit intake to 4-6 oz per day.

How Much Apple Juice Causes Diarrhea?

Age	Recommended Max per Day
Infants under 6 months	None
Infants 6-12 months	4 oz
Toddlers 1-3 years	4-6 oz
Children 4-8 years	8 oz
Older children and adults	12 oz

Exceeding these amounts of apple juice per day raises diarrhea risk. People with bowel disorders may need to stick to even lower thresholds.

Tips to Prevent Apple Juice Diarrhea

You can take steps to enjoy apple juice without diarrhea:

• Drink 100% juice – avoid added sugars
• Consume small amounts – 4-6 oz at a time
• Dilute with water – decreases sugar concentration
• Drink during meals – slows digestion
• Avoid on empty stomach – can cause dumping syndrome
• Start slow if sensitive – build tolerance
• Avoid unpasteurized juice – contains bacteria

Adding apple juice to smoothies or mixing with sparkling water can also help minimize digestive issues.

What to Do If You Get Diarrhea from Apple Juice

If you experience diarrhea after drinking apple juice, try these remedies:

• Stop drinking apple juice temporarily
• Rehydrate with water, broth, or electrolyte drinks
• Eat bland foods like bananas, rice, applesauce, and toast
• Take over-the-counter anti-diarrheal medication
• Rest and avoid stress
• Consult your doctor if symptoms persist

Diarrhea lasting over 3 days may require medical attention. Seek emergency care for severe dehydration.

When to See a Doctor

Consult your doctor if you experience:

• Diarrhea over 3 days
• Bloody or black stools
• Severe cramping
• Dehydration symptoms like dizziness
• Fever over 102°F (39°C)

These may indicate an underlying condition like fructose malabsorption, IBS, or infection requiring treatment.

Also see your doctor if diarrhea persists after eliminating apple juice or recurs each time you drink it.

Long-Term Precautions

Those with chronic diarrhea following apple juice should take these long-term precautions:

• Avoid apple juice – drink other juices like grape, cranberry, or orange
• Limit high fructose fruits – apples, pears, mangoes, cherries
• Try enzyme supplements – lactase, alpha-galactosidase
• Follow a low FODMAP diet
• Get tested for fructose malabsorption
• Treat underlying bowel diseases

Making dietary modifications tailored to your tolerances helps prevent recurring diarrhea episodes.

The Bottom Line

Apple juice contains high amounts of fructose and sorbitol that can pull water into your intestine and cause diarrhea if consumed in excess. Those with fructose malabsorption, IBS, SIBO, gastroparesis, and the very young and elderly are at highest risk.

Drink apple juice in moderation, dilute it, and consume with meals to minimize likelihood of diarrhea. Stop drinking it if diarrhea occurs and see a doctor if it persists. Tailoring your diet can help manage long-term sensitivity.

With some care and awareness of your individual tolerance, apple juice can still be enjoyed by most people without issue.