Diet and fructose malabsorption
#353892 - 01/04/10 04:05 AM
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Recentely I realized my sensitivity to fructose. I was hoping someone could take a look at what I eat moslty and let me know if they think this would be safe..thanks!
Cream Of Farina(original, brown sugar, and maple syrup)
almond drink (unsweetened and sweetened), sweet potatoes, mashed squash, birds eye frozen turnips and butternut squash, thomas' plain bagels. arnold white bread, flour tortillas, grilled chicken, cold cut turkey, Trader JOes water crackers, crumpets, and animal crackers, trader joes chocolate cat cookies, organic cocoa powder, cranberry juice (no fructose with beet sugar? is that ok), organic lemonade, zico coconut water (14 g of natural sugar ok with fructose sensitivity?), pillsbury biscuits, dried pineapple and papaya, pasta, chocolate mate tea, stevia, rice, fruit strips (with apple juice concentrate not really good right?), Trader JOes Pumpkin bread mix, peppermint candies and jelly beans, rice milk, sorbet, Trader JOes Gluten free waffles( fruit juice sweetener one of last ingredients)
Thats the main foods i eat.. any help I would very much appreciate it, this can be confusing!! 
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Here is a link to a web site with some good information on fructose malabsorption particularly the table at the bottom of the web page. It gives foods safe to eat, eat in moderation and avoid. And here is another good web page at Boston University. The article linked to in my signature has some great information too but it is quite technical.
Here are some coments on your diet. I have made bold the problematic foods.
Cream Of Farina(original, brown sugar, and maple syrup)
almond drink (unsweetened and sweetened), sweet potatoes, mashed squash, birds eye frozen turnips and butternut squash, thomas' plain bagels. arnold white bread, flour tortillas, grilled chicken, cold cut turkey, Trader JOes water crackers, crumpets, and animal crackers, trader joes chocolate cat cookies, organic cocoa powder, cranberry juice (no fructose with beet sugar? is that ok), organic lemonade, zico coconut water (14 g of natural sugar ok with fructose sensitivity?), pillsbury biscuits, dried pineapple and papaya, pasta, chocolate mate tea, stevia, rice, fruit strips (with apple juice concentrate not really good right?), Trader JOes Pumpkin bread mix, peppermint candies and jelly beans, rice milk, sorbet, Trader JOes Gluten free waffles( fruit juice sweetener one of last ingredients)
I cannot tell about some of the commercial foods. It will depend on the ingredients. Apple and pear juice are frequently found in commercially prepared foods so you will have to read the label.
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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 just want to add here, even if you don't have fructose malabsorbition, that high consumers of fructose
"Other examples of food substances causing diarrhea would be high consumers of caffeine or alcohol which can stimulate intestinal secretion or with the latter, pull water into the bowel (osmotic diarrhea). The same would be true for overdoing certain poorly absorbed sugars that can cause an osmotic type of diarrhea Sorbitol, found in sugarless gum and sugar substituted foods can also produce such an osmotic diarrhea. Even more naturally, people who consume a large amount of fruits, juices or other processed foods enriched with fructose, can get diarrhea because it is not as easily absorbed by the bowel and goes to the colon where it pulls in water. So if you have IBS, all of these food items would make it worse."
http://www.ibshealth.com/ibsfoods2.htm
So even high consumers of fructose who don't even have IBS, could get some d from it, because its not easily absorbed.
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My website on IBS is www.ibshealth.com
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Shawneric,
Interesting post. However, a short note.
Fructose that is in exact balance with glucose is not a problem. For example, white and brown sugar have exactly the same amount of glucose and fructose. It isn't a problem for IBS. The reason as I explained in a previous posting to you, is that when both sugars occur in equal amounts they are absorbed by the body differently that fructose that is not accompanied by an equal amount of glucose. When they occur in equal amounts the fructose is completely absorbed and metabolized in the liver.
Only the excess fructose, i.e. that is the amount of fructose that is above the amount of glucose, is poorly absorbed.
Also, excess fructose need not cause diarrhea although it can in high enough doses. It can also cause cramps, gas and bloating in IBS-D, IBS-C and IBS-A.
For a more detailed technical example read the article linked to in my signature or read this article Malabsorption of Fructose and Other Short-chain Carbohydrates. Both articles explain how fructose is absorbed in the GI tract.
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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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Thanks so much for your reply. I just had a question as to the frozen turnips and squash. That totally makes sense, I always wondered why mashed squash would make me so sick..but the frozen turnips dont seem to be bad for me. COuld this be because they have added ingredients like soybean oil and brown sugar? Also, the coconut water, is that all fructose the 14 grams of sugar?
Also, another question about sourdough pretzel nibblers, any reason why they would give me slight gas. I feel like all the ingredients are safe right? THis seems to happen every time I eat them though. I feel like salty foods do this, could that be true? thanks again
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Sometimes the variety makes a difference. I can eat small amounts of butternut squash but not other squashes. I don't eat turnip so I cannot speak from experience. Personally I stay away from foods with soybean oil. The brown sugar should be fine. I would worry more about added spices and onion/garlic powder
I doubt if the all of the sugar in coconut water is fructose. Sometimes you have to try things to figure out what load of fructose you can tolerate. While the test tells you that you cannot handle a 25 gram load it is quite possible that you can handle a few grams of excess fructose. Unfortunately, you can only tell through trial and error.
I looked at the ingredients for the Synder's sourdough pretzel and they look fine. I couldn't find the nibblers. I doubt is salty foods plays much of a role in 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
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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what is wrong with turnips, butternut squash, and maple syrup? Is pumpkin considered low fodmap?
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I really don't know.
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what about coconut oil???? And nuts and nut butters? or almond milk? Or brown rice syrup? rice cheese?
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I am asking for help. And not getting any replies, even though you have been logged on a few times. Please help.
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I have been busy.
You cannot seem to grasp the fundamentals of the diet. FODMAPs are carbohydrates. Fat & oils are not carbohydrates.
I suggest you look for a registered dietitian in your area who can guide you though the diet.
Good luck
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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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These foods are not fats or oils. what is wrong with turnips, butternut squash, and maple syrup? Is pumpkin considered low fodmap? Or other FOODS I asked about. I don't understand why you go out of your way to tell people about the fodmap diet but refuse to answer my questions. I'm taking it personally...thanks.  Very hurt that you aren't willing to help me when you know the answers.
And I wouldn't know how to find a dietician who works with fodmap and even if I could, they are very expensive. I'm on my own, here. I know the dietician in the eating disorder program i went to never heard of fodmap.
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Syl's links and his advice in general is the best you'll ever get.
While there is no definitive list of what you should eat, if you were to eat only these below for 2 weeks, you should start to feel better and then you may experiment with introducing some other foods ONE BY ONE. but these are v safe:
porridge (cooked in water), boiled/baked potatoes (no skin), cooled white rice, grilled chicken breast, shrimp, white fish, boiled carrots, peeled baked peppers, peeled cooked courgette (ie zucchini), tomato paste, orange juice, no-pulp-berry juice and a BIT of fat with each meal (salmon/olive oil to mention two of the healthiest options, one yellow banana daily.
this should not be confusing for you, stick to these foods for 2-3 weeks and see how your bowel movements and everything normalise.
good luck.
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now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)
before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010
FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml
[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]
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thanks for the support, but there have been changes/limitations on certain foods that differ from Syl's links. I have been researching Patsy Castsos (IBS-Free at Last), the Monash University where the fodmap diet started, as well as Kate Scalata's site and they all have differing info than what syl's current links state. And I know Patsy says that fresh tomato is lower in fodmap than the paste or canned...so I'm not sure tomato paste is okay.
Plus, I really believe I need more foods than what you listed as v safe. That diet just depresses me! I do want to feel better, though.  I'm ready to give up.
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Instead of giving up, how about giving that diet a chance? It's for 3 weeks, not for ever and once you have easily passable BMs more than 3 times per week but less than 3 times a day, you may start introducing the various foods ONE BY ONE from your most uptodate source on FODMAPs. Even that may be too liberal mind, it takes time for you to find what you can tolerate and in what amounts. once that is established then you may look for which nutrients you are missing out on.
Chances are that you'll have to take iron and calcium supplements at the v least and vit B complex can't hurt either. But everything else you will have even with that v limited diet. You are aware that if your diet is as varied as a normal person's but you have more than 3 BMs a day you are probably still not getting all the nutrients absorbed from the food you eat, as you have basically constant diarrhoea. so I fail to see why it'd be such a disaster to go on a diet that will calm your gut and get you all the vitamins and minerals (with the exception of calcium and iron).
Syl I believe is as sensitive to fructose as they come and he eats tomato paste, it's highly ulikely that you'd have problems from it.
I'd give that basic diet a go if I were you, and see if things return to normal after a few weeks. (If they don't then you may have some other underlying issue and my first recommendation would be to go ask for a thyroid test from your doctor).
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now: stable through EFI+FODMAP dieting (no lactose/no fructose/some fructans and some polyols)
before: IBS-D(pseudo-diarrhoea), bloating, often unbearable pain esp from too much fat: Apr 2007- Dec 2010
FODMAPs: http://www.todaysdietitian.com/newarchives/072710p30.shtml
[I've tried VSL#3 -> I could tolerate v good amounts of IF (even with less SF), it worked great (but overall I find it too expensive)]
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