Fructose and IBS?
#273342 - 07/10/06 12:25 PM
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Hi,
I'm new to this board. I have had a sensitive stomach and an IBS diagnosis for many years but have been symptom-free for a long time until about 2 months ago. As I try to figure out the cause of my recent symptoms I searched the internet and found several sites listing fructose intolerance as a cause. I'm curious if anyone has been diagnosed as fructose intolerant and whether this is really as common as the internet makes it out to be.
Thanks,
Anna
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Fructose malabsorption is extremely common. Fructose intolerance is an inherited disease and is quite rare.
When the fructose load is high enough everyone has difficulty digesting it. This has been confirmed using hydrogen and methane breath tests. However, unlike individuals who cannot absorb fructose properly normal individuals don't exhibit the extreme bloating, pain, etc that IBS suffers do.
A 2003 study of 183 patients with unexplained GI symptoms found that 134 (73%) exhibit an inability to absorp fructose after drinking a solution of 100 ml of water containing 50 grams of fructose. 119 (75%) patients of the 134 patients that exhibited a positive breath test for fructose malabsorption also experience the symptoms that lead them to have a GI evaluation.
For details see Choi, Y. K., F. C. Johlin, R. W. Summers, M. Jackson, and S. S. C. Rao, 2003: Fructose Intolerance: An Under-Recognized Problem. The American Journal of Gastroenterology, 98, 1348-1353.
Fructose malabsorption is real. It is beginning to look like it is one of the most common IBS triggers. Some people with these triggers cannot tolerate any foods that have excess fructose (i.e more fructose than glucose such as honey, apples, pears, melons and some vegetables). Others can tolerate some of these foods in moderate amounts.
For a detailed review see Skoog, S. M. and A. E. Bharucha, 2004: Dietary Fructose and Gastrointestinal Symptoms: A Review. American Journal of Gastroenterology, 99, 2046-2050.
http://www.bashaar.org.il/files/101022005111814.pdf
Informative web sites are
http://en.wikipedia.org/wiki/Fructose_malabsorption
http://www.merck.com/mmhe/sec23/ch282/ch282b.html
http://allergyadvisor.com/Educational/sept2002.htm
http://www.uihealthcare.com/topics/medicaldepartments/foodandnutrition/dfi/index.html
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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
Edited by Syl (07/15/06 03:39 PM)
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what are the low fructose fruits (and veggies) that you consume? This is very interesting....but I love fruit so much! Is there a limit to the amount of fruits you can eat in a day? What about products made with fruit juices? Is that too much fructose or not since it's baked within an entire product?
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IBS-C with pain and bloat
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I use two databases to get information about fructose in foods. I use the USDA Nutrient Data base
http://www.ars.usda.gov/main/site_main.htm?modecode=12-35-45-00
and the Finnish Food Composition Database
http://www.fineli.fi/index.php?lang=en
The USDA database gives the total sugar and for some but not all foods the amount of free fructose and free glucose. For example, 100 grams of raw apples without skins has
10.10 grams of sugar which is composed of
0.82 grams of sucrose
3.25 grams of glucose
6.03 grams of fructose
The Finish database only gives total sugar, sucrose, lactose and fructose. You have to subtract the sum of sucrose, lactose and fructose from the total sugar to calculate the amount of glucose. A neat thing about the Finish database is that for some foods it gives you the total amount of fibre and insoluble fibre. You can calculate the amount of soluble fibre by subtracting the amount of insoluble fibre from the total amount of fibre.
There is a short table on the second page of the follow paper that will give you a quick overview of the amount of fructose, glucose and sorbitol in a few foods
http://www.bashaar.org.il/files/101022005111814.pdf
Generally speaking I stay away from fruits and veg with more fructose than glucose. The reason for this is that the research suggests that when the two sugars are in equal amounts - at least up to a few grams - glucose helps the fructose to be absorbed properly across the intestinal wall into the blood stream. Strawberries, peaches and apricots are on the OK list. Vegetables like asparagus have more fructose than glucose but the amounts are relatively low. When I am having a good time I eat it because I love it. However, when I am having a bad time I stay away from it and other fruits too.
In particular I stay away from honey, apples, pears, melons and any product containing these fruits or their juices. Also, I stay way from any product that contains corn syrup of any kind. There are many different kinds and names for corn syrup. For example glucose-fructose is one that is found in almost every carbonated beverage. A good web site that explains the various names for types of sugars is
http://www.sugar.org/consumers/sweet_by_nature.asp?id=277
Note I also stay away from any foods containing sorbitol because it reduces the absorption of fructose.
I hope this helps.
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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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It does help. Thank you.
I was surprised to see peaches are okay...as well as apricots. I thought I had read that peaches were bad for the intestines and that apricots cause gas. 
So, you basically stick to peaches, apricots and strawberries?
I'm gonna have to look up some of my staples to see how they measure up! I like fruit spread, but that contains juices of grapes and apples too. 
Did you have a fructose test done? What symptoms does it cause for you?
Thanks again!
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IBS-C with pain and bloat
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