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Fructose Malabsorption

Fructose malabsorption is described as the body’s failure to absorb fructose – a simple sugar found in fruits and vegetables. This condition could either be inherited, develop due to bacterial overgrowth or as an adverse effect of a digestive problem or medical procedure. People who are not able to absorb fructose will experience horrible digestive symptoms, such as cramping, gas and diarrhea. Nutritional deficiencies and anemia will likely occur if the condition is left untreated.

There is no definite cure for fructose malabsorption (FM), but it can be managed effectively. All it takes is to identify the foods that are high in fructose and avoid them. Sufferers will also benefit from consulting a qualified dietitian and learn how to read food labels to manage FM effectively.

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Causes of Fructose Malabsorption

FM happens when the body fails to absorb fructose, a form of sugar naturally found in fruits and vegetables and commercially available as fructose-glucose syrup. It does not arise due to the lack of digestive enzymes that break fructose down because it is already in its simplest form, so the body can readily absorb it. Just like other types of food intolerance, malabsorption of fructose runs in the families. the Failure of the body to absorb fructose could also be due to:

  • Slow bowel transit time

Slow moving bowels allow bad bacteria to indulge on it and not absorbed by the body.

  • Insufficient GLUT2 and GLUT5 protein transporters

These protein transporters direct the fructose to the intestinal wall and blood, so fructose absorption does not happen without them.

  • Bacterial overgrowth in the small intestine

Bad bacteria feed on fructose while it is still in the small intestine, thus preventing absorption from happening altogether.

Fructose malabsorption could also be attributed to some medical conditions, like Dumping syndrome and Celiac disease, or adverse effects of radiation or chemotherapy in the small intestine.

Effects of Fructose Malabsorption

It should be noted that FM is the inability of the body to absorb fructose; it is not an allergic reaction to fructose, so the patient does not experience hives or itchiness. When fructose is not absorbed in the intestinal wall and bloodstream, it will travel down to the large intestine and consumed by the bad bacteria. The by-products produced by the bad bacteria causes the symptoms associated to FM such as:

  • Gas
  • Bloating
  • Cramping
  • Diarrhea
  • Bad breath

Managing Fructose Malabsorption

Those who have the symptoms should confirm whether they are truly suffering from fructose malabsorption by undergoing hydrogen breath test. The doctor may also conduct other tests to rule out other food intolerance issues, like lactose intolerance and carbohydrate malabsorption. A test called lactulose breath test may be done to determine if there is small intestine bacterial overgrowth.

Fructose malabsorption can usually be managed by:

  • Low-fructose diet

This should only be designed by a qualified dietitian who has experience in treating fructose malabsorbers.

  • Avoiding high fructose foods

It is only possible to avoid high fructose foods if the patients know what these are.

  • Making it a habit to read food labels

Fructose is commercially available as high fructose corn syrup. Patients should also watch out for foods with high contents of inulin, another form of fructan which is also a variety of fructose. Inulin is widely used in breads.

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