fructose malabsorption question
#364879 - 05/24/11 07:57 PM
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http://webcache.googleusercontent.com/search?q=cache:MARoqMS54G4J:www.healthhype.com/nutrition-guide-for-fructose-malabsorption.html+sweet+potatoes+fructose&cd=8&hl=en&ct=clnk&gl=us&source=www.google.com
This chart says to avoid things I thought were safe with FM like orange juice, ginger, stevia? Is this true. I always did have trouble with stevia and didn't know why.
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Alisonmary,
I have actually made that chart and have put stevia in the "to avoid" column, because I've interviewed some people with FM and some said stevia was not good for them. There were some people who were surprised about that, so I later wanted to move that in "to try" column, but I cannot access this article right now.
It would be very nice from you, if you can tell something about stevia and do you have FM or any other GI disorder.
If you search in Google for "fructose malabsorption stevia", you can see different experiences with it. I was trying to find "reliable" charts made by known FM researchers, but those charts are either not complete or the authors require some sort of registration or personal contact...
I haven't found any theoretical explanation why would stevia be problematic in FM, but even healthy people may have some food triggers of GI symptoms. Stevia is NOT problematic for everyone with FM, though.
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I don't have IBS.
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There are quite a number of errors in that chart.
The references below were written by the Australian researcher who did the original work on fructose malabsorption and later FODMAPs for managing IBS and other functional GI disorders. They did a detailed chemical analysis of many common foods to determine their safety for individuals with fructose malabsorption.
Oranges and pure orange juice are fine because it has equal amounts of glucose and fructose. In fact navel oranges have about 2 grams of fructose and 3.2 grams of glucose per 100 grams. I drink a glass or so each day. I am just going to have a glass of Florida OJ before my morning 1 km swim 
Ginger root is fine too. It has about 0.1 gram of fructose and 0.45 grams glucose per 100 grams. Of course it is high in insoluble fiber.
Stevia an artificial sweetener that does not contain any fructose and it isn't a polyol. It is not mentioned in any article on fructose malabsorption or FODMAP diet by a knowledgeable author. The problem with asking people if they have problems with stevia is that this product frequently contains FOS which is a problematic fructan. Many individuals don't read the label they just assume a product maybe pure stevia.
Reference
Muir, J. G. et al. Measurement of Short-Chain Carbohydrates in Common Australian Vegetables and Fruits by High-Performance Liquid Chromatography (HPLC). Journal of Agricultural and Food Chemistry 57, 554-565 (2009).
Muir, J. G. et al. Fructan and Free Fructose Content of Common Australian Vegetables and Fruit . J. Agric. Food Chem. 55, 6619-6627 (2007)
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
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I don't know, the chart actually makes a lot of sense based on my past experiences with oranges, ginger and stevia. I do buy 100% pure stevia and it gives me a similar reaction though not as intense, as if I were to have sorbitol or sucralose. Also, this ginger drink Ive bought on many occasions also makes me sick. I had asked you once and you said the rest of the ingredients were fructose safe. Orange juice doesnt seem to be too much of a problem with one glass a day but more than that it does.
Why do you think this chart listed these as things to avoid if it is incorrect? They must of got the info somehow, hwree do you think it came from and how do we know what is correct and incorrect?
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Yea for me I think stevia is on the avoid list. I can not be sure that it is from fructose malabsorption I suppose but makes a lot of sense seeing it on this chart. A I said in my other post, it gives me a similar reaction as does sorbitol and sucralose so makes sense it would be the fructose malabsorption.
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They way one knows what is and is not correct is to read and understand the information written by knowledgeable individuals who developed the understanding of the physiology involved and apply it to their patient base. Unlike functional GI disorders like IBS the physiology of fructose malabsorption is quite well understood. The difficulty is finding reliable chemical analysis of foods that give accurate fructose and glucose content. That is the reason the Australian research prepared the information given in the two references in my previous response.
The second reference in my signature and the two references given in the previous email are some examples of excellent information sources. Google searches are unreliable because there is plenty of misinformation on the web. If you are in doubt then you should talk to a knowledgeable GP or GI doctor
As for ginger it is high in insoluble fiber it does not have excess fructose. It is easy to confuse IBS triggers foods with excess fructose foods when you have both fructose malabsorption and IBS. 
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
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Syl,
your references are paid articles.
My chart would certainly need a revision by an experienced dietitian. You can see from that chart that it tends to be overly strict and I would move some foods from red to green area.
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I don't have IBS.
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why do you think then that I react to stevia and ginger juice (not root)? It jsut seems like it would make sense it may have something to do with the fructose malabsorption especially since it is documented in several charts. Did you ever try these yourself? Possibly its not the fructose content but something else that is similar among those with FM?
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Problems with stevia could be due to something else but it is unrelated to fructose content since stevia does not contain any fructose - it contains steviol glycosides . Some of the additives in Stevia products might. A chemical analysis of ginger root clear shows it does not have excess fructose. What else was in your ginger juice?
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
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They are articles published in regular subscription medical and scientific journals that you can access for free at a university library. Or if you belong to a university then you can access them on-line. Most of the reliable research information on FM and FODMAPs are found in these journals. Once in a while the author of these articles will post them on their institutional web site such as the Gibson and Shepherd article - the second reference in my signature - and you can get them without a subscription or going to a university library. Otherwise due to copyright restrictions you have to get them from a source such as a university library that subscribes to these journals or buy them on-line.
The first reference in my signature was written by a dietitian with knowledge about FM and FODMAPs. It is quite good. Although she says citrus fruits such as oranges & grapefruits contain polyols which is not confirmed in the references I listed in the previous message. There maybe polyols in the skins but they are not ingested.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
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I was also wondering I have found info that brown sugar is not safe becasue it is coated with molasses. I do have trouble with a brand of bagel that contains brown sugar which I thought was fructose safe. I have found charts listing it as unsafe and this also makes sense to me based on my symptoms. What do you think about brown sugar?
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I forget but you told me they were all fructose safe. It is possible that it contained too much sugar. I really think plain sucrose in large quantities is a trigger for me too. I do remember having trouble with the gingert juice I bought from the ginger people though, which I beleive was pure ginger juice.
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Brown sugar contains 4-6% molasses. The darker the brown sugar the more molasses. Molasses has about 1 gram of excess fructose per 100 grams. A tablespoon of brown sugar contains less than 0.1 grams (< 1/16 teaspoon) of excess fructose. Most individuals with fructose malabsorption can handle that small amount of excess fructose. I don't have problems with brown sugar but I cannot eat pure molasses. Perhaps you are more sensitive to it than me.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
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I've read the articles you have SYL. If I start an elimination diet on fructose, should I just pick one type of safe fruit or vegetable on the list at first? How long should I give it?
I've been off of dairy and wheat but mixed results w/o much relief of heavy gas so this is my next try.
I can't seem to get a breath test ordered from my doctors. Feeling desperate and could use advice.
Thx.
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You should have a good idea in a week or so. Yes, try fruit and veggies on the safe FODMAP list but be careful of the insoluble fiber content as recommended by Heather.
As you probably know sucrose which has equal amounts of glucose and fructose is not a problem. Some people claim that sucrose can be a problem but so far the clinical tests have not shown this to be the case at least when consumed in moderation.
I blend the EFI and FODMAP approaches successfully but you have to pay attention to detail such as insoluble fiber content. Unfortunately, the FODMAP approach leaves issues regarding known IBS triggers such as insoluble fiber, fat, caffeine, etc to the health professional advising the patient.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
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@Islandsguy123
The quick way to make an elimination diet trial to find out if you have lactose intolerance or fructose malabsorption (FM) is to remove all suspected foods on the beginning, so a complete low-FODMAP diet:
- no lactose (no dairy, and no lactose as a food additive: read labels, or simply avoid all commercial food)
- no fructose (no fruits, fruit products, honey), anything containing "HFCS", "FOS", "oligofructose", "GOS" and "inulin" (read labels, plus avoid wheat, onions, artichokes, asparagus, chicory and leeks)
- I would also avoid sucrose and other sweeteners to be sure.
Avoid commercial foods and drinks (processed, packaged, canned, sweetened...) during the trial to make it simple. You can still eat plain meats and fish, eggs, most vegetables (including white potatoes and white rice), barley, oats, rye, buckwheat...
If you manage to get rid of most symptoms within a week, then you can be quite sure you can lactose intolerance or fructose malabsorption. Then you can start to introduce foods back, one by one. So, you can, for example, drink a glass of milk and give it two days to see if you can tolerate it. If you can, you do not likely have lactose intolerance. And than you add foods which are problematic in FM, but you start with less problematic ones: oranges, grapefruits, bananas, then berries.., then, if all ok, you can try wheat and so on.
If you feel nauseated or ill, please do not loose time with these diets and see a doctor.
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I don't have IBS.
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@AllisonMary, what fruit and veggies cán you eat?
It looks like we have some alike triggers besides the 'normal' EFI&FM stuff. Like glucose, corn starch, berries (juice).
(Do sucrose & corn give you the same reaction as fructose does?)
My diet is still really restricted, and I keep having problems constantly with the food I'm trying.
I cán eat bananas, (cooked) courgettes, carrots and yellow/red peppers. Rice syrup. Wheat, potatoes & white rice. Chicken & fish. (that's about what I eat in my basic diet)
I'm (still) not sure about beets, broccoli, green beans, peaches, orange juice.
Probably not: asparagus, spinach.
Defenitely not: tomatoes  , corn (starch).
***Can anyone explain to me what happens in your bowel when you have glucose sensitivity? I cannot google it, everything I find is about the blood-glucose level. That level is fine for me.
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PI-IBS-C/A nausea & very bad gastric pain
meds: lansoprazol+macrogol
started EFI +FODMAPs 1/2011. 'Relapse' for 8 months. Now partly back on track again with the diet..
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Glucose
#365144 - 06/15/11 08:47 AM
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Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
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Many of the foods you listed contain glucose in one form or another. For example, carrots, courgettes, orange juice and bananas contain 1, 1, 2.3 and 5 grams of glucose per 100 grams as well as other sugars such as sucrose which is 50% glucose and 50% fructose.
Glucose is the most fundamental form of energy the body consumes. As Heather says "For glucose concerns, your body eventually breaks down all carbohydrates (simple and complex, and no matter what the source or how much/which type of fiber they contain) into glucose, as this is the only fuel the brain can use."
The only way glucose sensitivity can likely occur would be through its effect on blood sugar levels. This why a Google search does not reveal anything about glucose sensitivity but only blood glucose levels.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
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Re: Glucose
#365146 - 06/15/11 11:18 AM
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mavera
Reged: 12/28/10
Posts: 108
Loc: The Netherlands
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Yes, I see that the fruit and veggies I mentioned contain glucose.
Although sucrose and corn starch contain a lot more glucose per 100g I guess (?)
But I cán tolorate potato starch and wheat, I guess that'll contain an almost equal amount of glucose?
I see the contradiction. But I don't understand it at all?!
The reactions I get from eating sucrose or corn starch are totally different as from eating high fructose food. Sucrose and corn give me likewise reactions as milk, meat etc (ibs-triggers).
Isn't it possible that my bowel can't process too much glucose at once? Which will trigger and IBS-attack..?
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PI-IBS-C/A nausea & very bad gastric pain
meds: lansoprazol+macrogol
started EFI +FODMAPs 1/2011. 'Relapse' for 8 months. Now partly back on track again with the diet..
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Re: Glucose
#365147 - 06/15/11 12:24 PM
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Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
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Sucrose contains 50 grams of glucose and 50 grams of fructose per 100 grams but the two sugars are joined together by a chemical bond making it one molecule called sucrose. The bond has to be broken in digestion in order to separate glucose from fructose. Sucrose is absorbed in the small intestine. The glucose and fructose molecules are not released as individual molecules until they reach the blood stream. It rarely reaches the colon.
Potato & wheat starch are similar to corn starch. They contain similar amounts of glucose which is close to 99%. By definition starch is a carbohydrate consisting of a large number of glucose molecules joined together by chemical bonds.
Glucose is rapidly absorbed small intestine. In the amounts normally consumed it rarely, if ever, reaches the colon. An IV given in a hospital frequently contains glucose as well as electrolytes and water. It is an important fuel for the body. It is not known to directly have negative effects on IBS symptoms.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
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Re: Glucose
#365150 - 06/15/11 01:57 PM
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mavera
Reged: 12/28/10
Posts: 108
Loc: The Netherlands
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Thank you for the information!!
But now I'm really confused..?!
The nausea I get from corn starch, sucrose etc feels like my small intestine is working too quickly (gastrocolic reflex?). I feel movements, pulsation, a circling feeling in my intestines.
I've always thought (felt) the problem isn't my colon, but my small intestine.
Although the final reaction is my colon to slow down..(?)
I'm really confused what this info means to me. How is it possible I can tolorate potato&wheat starch, but no corn?
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PI-IBS-C/A nausea & very bad gastric pain
meds: lansoprazol+macrogol
started EFI +FODMAPs 1/2011. 'Relapse' for 8 months. Now partly back on track again with the diet..
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Re: Glucose
#365151 - 06/15/11 03:07 PM
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Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
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It is possible that you have an food sensitivity to corn. Perhaps during the preparation of the corn starch a small amount of corn protein remains which triggers symptoms. Corn starch is on the list of know food intolerances
Have you seen an allergy doctor?
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
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Has anyone tried dextrose as a sweetener instead of table sugar? I saw this available and may try it if I find that fructose is my problem.
http://www.amazon.com/Now-Foods-6925-Dextrose-Powder/dp/B000T3HX3K/ref=sr_1_1?ie=UTF8&qid=1308180275&sr=8-1
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Re: Glucose
#365155 - 06/15/11 05:20 PM
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Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
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I use it from time to time. It isn't as sweet as white/brown sugar. It is sold as corn sugar at health food stores.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
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Yea that sounds like me too. I can eat some banana and veggies I can do potatoes usually.
I would look in to the bacterial overgrowth and really try to cut down on sugar. Thats what I am trying to do, it's so hard for me though. I love sugar. DO you crave sugar often?
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Which veggies can you eat?
I eat no (table)sugar at all, because of the symptoms. I've been cutting out table sugar for almost a year now, fructose for the last few months, since I found out the FODMAP diet works. I only use rice syrup and banana as sweets actually at the moment.
I don't really have sugar cravings anymore. I've always been a sugar junkie and I really hate that I can never eat things like (normal) cookies or ice cream. I hate that I can't eat out and just order what I want, have an ice cream or pancake with my daughter.. Or eat things like lasagna or pizza, perhaps I miss those things even more. It really frustrates me.
But even on special occasions, it's 'easy' for me not to eat the good things. The good taste for a few minutes doesn't outweigh the 3 days of misery I'll have afterwards
But that doesn't mean I'm ok with it, it's very hard for me to accept it. But I guess everybody here feels that way.
I think the sugar craving will subside when you really stop eating it. It's an addiction.
But I use a lot of rice syrup now I'm really scared I can't even tolorate that in the future...
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PI-IBS-C/A nausea & very bad gastric pain
meds: lansoprazol+macrogol
started EFI +FODMAPs 1/2011. 'Relapse' for 8 months. Now partly back on track again with the diet..
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Re: Glucose
#365159 - 06/16/11 03:31 AM
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mavera
Reged: 12/28/10
Posts: 108
Loc: The Netherlands
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Hmm, yeah that could be..
But I developed all my symptoms at once after a stomac flu. It's all so hard to believe this all came at once!
I haven't been to an allergy doctor. I have had bioresonance testing. He only found sugar and honey to be issues for me.
Regular docs don't really want to/can help me. They say don't know what to do anymore.. (just live with it!!!  )
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PI-IBS-C/A nausea & very bad gastric pain
meds: lansoprazol+macrogol
started EFI +FODMAPs 1/2011. 'Relapse' for 8 months. Now partly back on track again with the diet..
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Re: Glucose
#365160 - 06/16/11 03:39 AM
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mavera
Reged: 12/28/10
Posts: 108
Loc: The Netherlands
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I've tried dextrose once as sugar replacer in home made waffles. I got the same reaction as I have with fructose (?)
But I eat small amounts of it in processed food (white bread and chicken-filet). That doesn't bother me.
(The dextrose I have is called 100% 'grape-sugar' in the ingredients, I see now?? So perhaps it contains fructose!?)
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PI-IBS-C/A nausea & very bad gastric pain
meds: lansoprazol+macrogol
started EFI +FODMAPs 1/2011. 'Relapse' for 8 months. Now partly back on track again with the diet..
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I really only eat potatoes and squash. I think I need to experiment with more though. Lettuce on a sandwich seems to be ok sometimes.
You should go to the vitamin store and purchase the black walnut, clove, wormwood herbal supplement. It kills any parasites in your system and helps restore intestinal flora. Its really worth a try because I feel like nauseousness from sugar often has to do from bacteria or parasites. Or at least have your stool tested. Not to freak you out or anything but seriously its worth a try!
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@ mavera "Dextrose" is a commercial name and "grape sugar" a source-descriptive name for glucose. Both are pure glucose.
Lactose is called milk sugar, fructose is fruit sugar, sucrose (table sugar) is cane sugar...
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I don't have IBS.
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So I've been trying the fructose diet for a couple of days. I got an upset stomach last night even though all I ate was potatoes, oatmeal, fish, chicken, rice, spinach yesterday. I got really ill this morning too. I'm baffled. I'm seriously tired of these elimination diets as I can't find an intolerance to one type of food, and feeling horrible.
I'll probably go back to eating "normally" for a while. I'm seeing a new GI doctor next month. Just trying to keep up hope, it's really depressing.
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Spinach is high insoluble fiber. It is on Heather's insoluble fiber list under greens. Greens including spinach cause difficulties for many individuals. They are big problem for me.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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I'm sorry that the diet(s) is not working for you (yet?)
Spinach doesn't do me good too..
I know it's very hard, it took me a few months to find out what is MY personal basic diet, when my symptoms really subside.
I combined the EFI and FODMAP diet. At first I only ate banana, carrots and courgette for fruit/vegs. I started feeling somewhat better, but it took me a while to find out corn is a problem too.
It's really really hard when you're trying so hard and still get ill. We all know I guess .
And still, now I know what I should eat, the diet's still frustrating, mainly because it's so restricting and I keep getting sick by trying out new stuff But, it's better than not knowing and being sick every single day... 
Good luck!
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PI-IBS-C/A nausea & very bad gastric pain
meds: lansoprazol+macrogol
started EFI +FODMAPs 1/2011. 'Relapse' for 8 months. Now partly back on track again with the diet..
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Thanks for the encouraging words mavera. I think I will try to work on stress and anxiety reduction for a while.
And yeah, I doubt I will be eating straight up veggies and fruit for a while. The EFI diet tips on smoothies and putting them in bread may be a good idea for me to try more.
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try the parasite cleanse!
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What's the name of that cleanse? NM, It's the black walnut, clove, wormwood herbal supplement right?
Edited by Islandsguy123 (06/17/11 06:22 AM)
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Parasites are not the cause of IBS. If you think you might have parasites it is best to see a doctor for a stool, blood, etc test. Each parasite may need to be treated in a different manner. Check the CDC web site for information on diagnosising parasites.
Be cautious with intestinal cleansers such as parasite cleansers as they may contain ingredients such as insoluble fiber and laxatives that can exacerbate IBS symptoms.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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I doubt I'll go buy a cleanser without diagnosis. I'm tired of spending a lot of money on supplements. I think I'm feeding my anxiety on all of this. It'll be helpful to not over think it and self diagnose myself.
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