Fructose and Lactose tests
#366245 - 10/11/11 04:10 AM
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Dear All,
Does anyone have any thoughts on if these (fructose and lactose) tests are really necessary? Given the costs and time involved. Presumably it would be easy enough to 'self administer' a fructose and lactose test at home by drinking, on an empty stomach, a glass of high fructose juice (for example, pear/apple), and a glass of milk? Obviously not at the same time!
Best Wishes,
S
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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.
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If you want a definitive answer then have the test. If you feel comfortable that you can figure it out for yourself then there is no harm ingesting a good load of lactose or fructose and see how you feel.
You might what to use high fructose corn syrup or honey instead of pear/apple juice for the fructose test. They contain more excess fructose than apples or pears -- about 1 gram of excess fructose per tablespoon. The test is usually done with a 20-25 gram load of pure fructose.
Tell us how it goes. 
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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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Thank you Syl. As recommended I avoid dairy products, therefore, a lactose test wouldn't be required. However, fructose is more complicated. I do have problems with fruit; however, I'm not certain if it is the excess fructose or the insoluble fibre. Your advice to try the fructose test with honey/glucose-fructose syrup would help resolve that issue.
I have a feeling, however, that I may have undiagnosed celiac disease. Although I've been tested (blood test, not biopsy), I was avoiding wheat (following the FODMAP guidelines), and I know this can mask the disease. I'm planning on a trial of eliminating gluten to see if that improves my symptoms and looking into a biopsy. I realise that it is possible to have both celiac and IBS.
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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.
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Hi mradams1 ,
Just posting to say Hello as one of those people with Celiac Disease and IBS ! I would definitely encourage you to go ahead with a biopsy to determine whether you actually have celiac. (Be sure to be eating plenty of gluten in your daily diet for several weeks before the biopsy for accurate results) There are just so many other diseases and cancers and health issues that can result from undiagnosed celiac. Some people know they have problems with wheat, but don't get a definitive answer on the celiac (an autoimmune disorder!) When you don't know for sure that you have the actual disease it's tempting to "cheat" and eat gluten from time to time (as long as you don't "notice" any problems). The trouble is that not everyone feels anything noticeable every time they eat gluten. My own diagnosis was delayed for years because the doctors said I didn't have the right symptoms. By the time I was diagnosed (at 34), I already had osteopinea.
I hope this is helpful- I definitely don't want to come across as pushy...just sharing from my own experience.
Good luck to you!
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Hello, I was interested in your post because about 8 years ago after having a blood test that said I was sensitive to gluten I had an endoscopy w/ intestinal biopsy for the definitive answer and I was told by my gastro it was negative that I do not have celiac. I do suffer from reflux and strongly believe I am allergic to soy. I have recently begun to remove dairy as I have gone back to gas, stomach pains, diarrhea and dramping after 1 bout of diverticulitis. I am now revisiting this whole "gluten sensitivity" in my mind.
ANyway my question is does anyone know if it is possible to b "sensitive to gluten" but not have celiac? My gastro said the biopsy was the gold standard test.
Also does nayone know if gluten sensitivity can progress to celiac, and if these intestinal biopsies need to be repeated, or if 1 negative is all
you need ot know. Thanks so much in advance!
it is great to have this resource!
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Welcome to the board,
The biopsy is the gold standard for celiac disease.
There have been a couple of small clinical trials looking for the possibility that gluten sensitivity exists without having celiac disease. So far no mechanism has been identified and the evidence for its existence is scarce. The medical research is inconclusive at this point. See references below.
On the other hand, there is clinical evidence to show that an indigestible food constituent found in wheat, rye and some vegetables called fructans can cause bloating and gas when fermented in the colon which can exacerbate IBS symptoms. You can read more about it in the first to links in my signature.
Refences
Verdu, E. F., D. Armstrong, and J. A. Murray, 2009, Between Celiac Disease and Irritable Bowel Syndrome: The "No Man's Land" of Gluten Sensitivity : American Journal of Gastroenterology, v. 104, p. 1587-1594.
Biesiekierski, J. R., E. D. Newnham, P. M. Irving, J. S. Barrett, M. Haines, J. D. Doecke, S. J. Shepherd, J. G. Muir, and P. R. Gibson, 2011, Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: A Double-Blind Randomized Placebo-Controlled Trial : American Journal of Gastroenterology, v. 106, p. 508-14.
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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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Syl, what's your opinion on lectins and phytates which are also found in grains? Do you believe they are hard on the gut?
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IBS-C, lots of spasm and trapped gas.
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Hi Renee,
I don't know a lot about them. I do know that both are ubiquitous in nature not just in grains. It is a complicated area and there is a lot of misinformation floating around the Web. If you want to avoid then you would have to stop eating
Lectins are proteins that are usually destroyed during cooking and in beans by soaking them in water. They are found in about 30% of foods including salads, fruits, spices, dry cereals, and roasted nuts. You may find this article of interest - Food Lectins in Health and Disease: An Introduction. Although I cannot vouch for its correctness. Cornell University has an excellent write-up on plant lectins. A search of research literature does not show anything particularly interesting and definitely nothing to be concerned about regarding IBS if foods are prepared and cooked properly.
Phytates also known as inositol (vitamin B8) is the salt form of phytic acid. Inositol is found in different forms and it is found in every cell. It is a way organisms store phosphorous - an important constituent in cellular energy storage and DNA/RNA synthesis. The highest amounts of phytates - a type of inositol - occurs in nuts and seeds (2-6% dry weight) and there are usually lesser amounts in cereal grains and beans (0.5-2% dry weight). Inositol in the form of phytates are not digestible by humans. In high amounts it can chelate some minerals such as iron and zinc. In developing countries the excessively high consumption of bran and seeds contributes to mineral deficiencies. They don't present a problem in a normal diet.
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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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Hi Kelly,
Thanks for taking the time to reply. I appreciate your advice and while I'm reluctant to add gluten back into my diet, because I know it exacerbates my symptoms, I guess if I want a definitive answer, regarding celiac, I will need to do so. I'm awaiting a response from my GI specialist as to the best way to proceed with this matter. I realised that wheat/gluten was a problem for me, approximately four years ago, however, was diagnosed with IBS only 2-3 years ago. I'm keen to know, gluten-free aside, what your diet looks like. Do you follow the EFI/FODMAP guidelines? And, generally speaking, how are your day-day symptoms.
Best Wishes
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IBS A. Managing my symptoms with the EFI/FODMAP diet and probiotics.
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I was interested to see you mentioned lectins; I have recently been cutting down on them in my diet because I realized after eating them I often become bloated and constipated. I have also been soaking the small amount of grains I do eat, which seems to be helping control these symptoms.
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-Natalie
IBS-C & bloating, dairy free
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