Fuctose Malabsorption (FM) is a digestive disorder where defficient fructose carriers in the small intestine's enterocytes impairs absorption of fructose from foods OR very simply the inablity to absorb fructose.
Symptoms of Fructose Malabsorption
Fructose Malabsorption can cause cramps, gas, and diarrhea and therefore can easily get confused with Coeliac Disease symptoms. In addition to these symptoms FM can also cause bad breath.
What is Fructose?
Fructose is the sugar found in most of the things we eat including in fruits and sugars. Fructose and glucose
are very simple sugars and require very little digesting and are usually easily absorbed by the body.
Why is Fructose Malabsorption a problem?
Usually, fructose is absorbed by the body within the intestines, but when it passes further down the digestive system and into the bowels, the number of bacteria in the bowels thrives and rapidly increases. The bacteria consume the fructose and produce waste profucts such as methane and hydrogen gas. These gases cause bloating, cramps, gas, diarrhea and bad breath.
Testing for Fructose Malabsorption
Fructose Malabsorption can be tested by measuring for the hydrogen in the breath. The hydrogen is released from the bacteria after digesting the fructose which is absorbed into the blood, then removed by the lungs and then exhaled in the breath,
Why do I have Fructose Malabsorption?
There are a number of reasons which would render the body unable to absorb fructose.
1. There maybe a genetic link, a hereditary factor which prevents the body aborsbing frucose, but this is very rare.
2. The bowels could be moving too slowly and therefore the fructose is not being absorbed and the bactria have time to feed and cause symotoms.
3. The GLUT2 and GLUT5 transporters are deficient and inefficient when moving the fructose across the intestinal wall and into the blood.
4. The overgrowth of bacteria in the small intestine devours the fructose in the small intestines before it can be transported acoss the intestinal wall into the blood stream.
5. Celiac disease patients can find they suffer from Fructose Malabsorption.
Coeliac Disease and Fructose Malabsoprtion
A number of studies have shown that Fructose Malabsorption may be a primary cause of Coeliac Disease and other studies show that overexposure to fruit once on a gluten free diet can cause Fructose Malabsorption.
How can I avoid high fructose containing food?
Avoiding fructose containing foods will alleviate symptoms. Abstaining from eating certain foods should imporve all symptoms. It is worth stopping eating these sugars completey for a short while to starve the bacteria. Avoid eating fructose, sucrose and sorbitol.
Apple, grapes, cherries, pear, guava, mango, watermelon, quince, paw paw, lychee, guava, pomegranate, dried fruit, fruit juice, star fruit, tomatoes, tomato paste.
Apple, raisins, fig, date, pear, sultana
Onion, garlic, spring onion, shallot, leek, asparagus, artichoke, Jerusalem artichoke, witlof, chickory, radicchio, endive and dandelion greens.
Honey, coconut milk and cream, wheat, brown rice, fructose, artificial sweeteners (ie sorbitol and xylitol), agave nectar, and high fructose corn syrups (which are used a lot in soda drinks.
Sports drinks, sweetened milk, fortified wines, fruit juice sweeteners (apple or pear juice concentrate),
Which foods are safer to eat?
It is worth noting that these foods are generally safer to eat and can cause less symptoms than the above foods, but there still can be accumulation effect. These are lower fructose foods.
Apricot, nectarine, peach, plum (nb— these fruits contain sorbitol);
Strawberry, raspberry, blueberry, blackberry, cranberry, boysenberry, loganberry
Lemon, lime, kumquat, grapefruit, mandarin, orange, tangelo
Ripe banana, kiwi fruit, pineapple, jackfruit, passion fruit, rhubarb, tamarillo.
Living with Coeliac Disease and Fructose Malabsorption
Many gluten free products including milks and breads can be sweetened with fructose. Avoid inulin which is high in fructose and is widely used in gluten free and fairy free products.