Dietary Fructose Malabsorption

Dietary Fructose Malabsorption

The pain of gas and bloating can be debilitating and can limit your desire and ability to socialize around food. If these are your symptoms, I suggest that you contact your gastroenterologist and ask to be tested for fructose malabsorption, lactose intolerance, gluten intolerance and small bowel bacterial overgrowth (SIBO). If you find that you have one or more of these, then I can help you implement a specific diet to avoid the offending substance. If you are not sensitive to any one of these, your doctor may call your symptoms functional bowel disease of irritable bowel disease (IBS) and recommend that you try the FODMAP diet, which can help reduce your symptoms by limiting a variety of foods that can cause gas and bloating. I can provide detailed guidance on this diet.

But for those of you who have been diagnosed with fructose malabsorption, there is a diet that will help you. I have worked with GI doctors and studied fructose malabsorption for several years. Most of my clients report feeling better in just a few days, by following my diet for fructose malabsorption. All of my fructose malabsorption clients are invited to attend my fructose malabsorption support group.

Symptoms: My clients diagnosed with fructose malabsorption report symptoms such as painful gas and bloating, distended abdomen area after eating, diarrhea or constipation, and nausea or vomiting. Many report that these symptoms started occurring after a significant stressful life event such as a death, divorce or surgery.

Diagnosis: A GI doctor will diagnose you via a non-invasive hydrogen breath test. You will drink a sweet beverage on an empty stomach, followed by blowing into a tube periodically over a 4-hour period. Hydrogen gas should not be produced if your body properly absorbs fructose. It is only produced after intestinal bacteria metabolize carbohydrates/fructose.

Fructose Malabsorption Process: Dietary fructose malabsorption is caused by impaired absorption of fructose. It is not life threatening. Fructose is a type of sugar that is naturally found in fruits, honey, agave syrup and some vegetables. It is always in combination with glucose. After food is digested in the stomach, a carrier protein and glucose help transport fructose into the small intestine for absorption. The process is not entirely understood, but when the glucose content of a food is equal to or higher than the fructose content, there is no malabsorption of fructose. However, foods with more fructose than glucose can result in inefficient absorption of fructose. This allows fructose to reach the large intestine, along with extra water. Intestinal bacteria rapidly ferment fructose into hydrogen, carbon dioxide and short chain fatty acids. When the bacteria multiply and migrate back up to the small intestine (small intestinal bacterial overgrowth or SIBO), gas/flatulence, bloating, abdominal pain and motility changes (diarrhea or constipation) occur.

How did I get this? Fructose malabsorption may be inherited (primarily from central European descent), but non-genetic factors may also play a role. The amount of fructose tolerated varies widely among individuals: some may have problems with less than 1 gram of fructose, and others can easily eat 20 grams without any problem. It is estimated that approximately 35-50% of the population is unable to completely absorb more than 25 grams per day. Average daily intake of fructose around the world is estimated to be 11-54 grams.

What foods are high in fructose?

Fructose is found in 3 main forms in the diet:

  • As Free Fructose—present in fruits, honey, and agave syrup.
  • As a component of Table Sugar (sucrose). Sucrose is a disaccharide made up of equal parts of glucose and fructose.
  • As Fructans—a long chain of several fructose molecules (fructo-oligosaccharide) found in some vegetables and wheat.

Fructose accounts for 10% of total calories from sweetened beverage, baked products, and fruit juice. All Fructose is absorbed, digested, and metabolized in an identical manner, no matter if it is from fruit juice or a food additive. Total removal of fructose from the diet is nearly impossible due to its abundant presence in our food supply.

Set and appointment with Linda: If you want more detail on this diet and individualized help to avoid excess fructose intake, call me today!