Fructose Malabsorption Symptoms and Diet That You Should Know

Fructose malabsorption or dietary fructose is a digestive disorder. It is a situation when absorption of fructose is impaired the reason being deficiency of fructose carriers in a small intestine’s en...

Fructose malabsorption or dietary fructose is a digestive disorder. It is a situation when absorption of fructose is impaired the reason being deficiency of fructose carriers in a small intestine’s enterocvtes. Hence there is an increased concentration of fructose in the entire intestine. This condition is commonly observed in patients who are suffering from irritable bowel syndrome. Of course, occurrence in these patients is in same magnitude as in the normal population. Often patients with fructose malabsorption are having same profile of those with irritable bowel syndrome. Some patients with both fructose malabsorption as well as lactose intolerance lactose also suffer from celiac disease. It is the effect of excessive concentration of fructose in the digestive track.

It is in fact the deficiency of enzyme and aldolase B. Aldolase B has fuction of fructose-1-phosphate into glucose. This conversion process becomes less efficient. Simply it is a sugar, found in fruits and honey. 

General symptoms generally are: bloating, diarrhoea, constipation, flatulence mild, chronic, acute and erratic stomach pain vomiting due to excessive consumption and early signs of mental depression but the clinical symptoms seen are bad abdominal pain, and hypoglycaemia. Patients are advised to have a fructose free diet.

Foods to be avoided to take care of possibilities of fructose malabsorption are: more than 0.5 grams and in excess of glucose per 100 kg in Fructose and beverages, food rich in fructans along with fermentable oligo and high fructose corn syrup or honey. Foods with excessive fructose than glucose are considered unfavourable food for individuals.

Advisable diet is stone fruit, berry fruit, citrus fruit like lemon and orange. Other fruits like ripe banana, jackfruit, kiwi fruit, passion fruit, and pineapple are advised and favourable diet. You are also advised to take herbal supplements to control diabetes.

Fructose malabsorption is observed in up to 30% of the population of Western countries.

Pathophysiology

Fructose is generally absorbed in the small intestine in absence of help of digestive enzymes. It is also observed that even in healthy persons only about 25-50 gram of fructose can be properly absorbed at a time. Persons having the problem of fructose malabsorption absorb less than 25 gram per sitting. Fructose that hasn't been adequately absorbed in the large intestine reduces the absorption of water. It is metabolized by normal colonic bacteria. Fatty acids and the gases hydrogen, carbon dioxide and methane are short chained. Hydrogen breath test can detect abnormal increase in hydrogen. 

The result and effect of fructose malabsorption are increasing osmotic load and providing substrate for rapid bacterial fermentation. Changing gastrointestinal motility, promoting mucosal bio film, altering the profile of bacteria is also observed. These results are additive with other short-chain that are inadequately absorbed carbohydrates like orbital. The importance of these events depends upon the response of the bowel to such changes. It is observed that they have a higher chance of inducing symptoms in people with functional gut disorders compared to asymptomatic subjects. Reducing dietary intake of free fructose and/or fructans may provide symptom relief in a high proportion of patients with functional gut disorders. 

Foods and beverages containing greater than 0.5 gram fructose in excess of glucose per 100 gram, greater than 3 gram fructose in an average serving quantity regardless of glucose intake and greater than 0.2 gram of fructans per serving are advised.  Foods rich in Fructose and sorbitol are preferred.