How Safe Is It To Drink Tapioca Pearls in Bubble Tea?

Here's what you need to know about what's in this popular tea drink.

In 2019, a story about a teenager who reportedly had more than 100 undigested bubble tea pearls in her abdomen went viral. Sounds scary, right? Well, it might not be as frightening as it seems. Doctors are skeptical about whether this could actually happen.

According to the story, it all began when a 14-year-old girl from China told her parents she had been constipated for five days, wasn't able to eat, and had serious stomach pain. A CT scan revealed about 100 "unusual spherical shadows" in the girl's abdomen. Those spheres were undigested bubble tea pearls, her doctors supposedly said. The girl claimed that she drank only one bubble tea five days earlier, but her doctors said she would have needed to consume much more than that to have those symptoms.

Here's what to know about bubble tea and how safe it is to drink the pearls.

What, Exactly, Are Bubble Tea Pearls?

Bubble tea pearls, also called boba pearls or tapioca pearls, are usually made out of tapioca, a starch extracted from the roots of cassava plants. Water and sugar are often added to the tapioca to make the pearls gummy. These pearls are what puts the "bubble" in bubble tea, aka pearl milk tea or boba milk tea. One cup of bubble tea can contain dozens of pearls.

And this is where things get interesting. Doctors here in the US who looked into the case of the teenager in China said that tapioca and other ingredients typically found in bubble tea pearls wouldn't show up on an X-ray or CT scan. There had to be something unusual in the pearls the girl consumed for them to show on the scan.

Vladimir Kushnir, MD, specialist in gastroenterology at Washington University Physicians in St. Louis, Mo., told Health that an indigestible additive may have been in the pearls, but it isn't clear what kind of additive that would be.

To make matters even more interesting, a 2017 case study published in the Journal of Acute Medicine likewise reported pearl-like spots showing up on a CT scan of an 18-year-old. The spots were 6 to 8 millimeters in size, consistent with the size of bubble tea pearls. The study suspected that the reason these spots showed up in the teenager's stomach and first part of the small intestine called the duodenum was because the patient had consumed the bubble tea earlier that day.

How Safe Are Bubble Tea Pearls?

For all you bubble tea fans, don't worry. Odds are pretty low of developing constipation and pain from your tea drink. However, Dr. Kushnir said that an additive sometimes used in bubble tea pearls, called guar gum, can cause constipation. Guar gum is a fiber that helps hold the balls together; it also expands when it comes in contact with water. Guar gum can actually be used to treat digestive issues, but when consumed in high amounts, and with insufficient water, it can lead to constipation.

And there's even good news. The bubble tea pearls may even have some health perks, at least for your oral health. A study published in F1000 Research in 2021 found that the bubble tea pearls could improve the quality of your saliva. Specifically, the researchers found lower levels of CRP, a protein linked to inflammation, in the saliva of people who drank bubble tea for three days.

But here's the caveat: Because bubble teas can be high in sugar and calories, people who drink them can be at higher risk of developing obesity and diabetes. In fact, just one 16-ounce bubble tea has more added sugar than what is recommended by the 2015 US Dietary Guidelines Advisory Committee, according to a 2016 article published in Food Science & Nutrition.

So, there are a few reasons to enjoy this sweetened beverage in moderation. Drinking too much of it may increase your chances of developing diet-related disease and could leave you constipated. "One to two cups a day should be fine, but you shouldn't consume anything in excess," advised Dr. Kushnir. "If you're drinking five or six cups a day, and you're noticing a change in your bowels, it could be a sign that you need to cut back or drink more water."

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