fructose Malabsorption

Discussion in 'Fibromyalgia Main Forum' started by swedeboy, Apr 20, 2007.

  1. swedeboy

    swedeboy Member

    here's some info on fructose Malabsorption. Rich Carson discussed it in the CFS e-newsletter and How Dr.De Merieler (SP?) says many people with CFS have it.

    Fructose malabsorption or Dietary Fructose Intolerance is a dietary disability of the small intestine in which the fructose carrier in enterocytes is deficient. Medical tests are similar as in lactose intolerance, requiring a hydrogen breath test for a clinical diagnosis.

    Fructose Malabsorption is not to be confused with fructose intolerance or Hereditary Fructose Intolerance (HFI), a hereditary condition in which the liver enzymes that break fructose up are deficient. In patients with fructose malabsorption, the small intestine fails to absorb fructose properly.

    In the large intestine the unabsorbed fructose osmotically reduces the absorption of water and is metabolized by normal colonic bacteria to short chain fatty acids and the gases hydrogen, carbon dioxide and methane. The abnormal increase in hydrogen is detected with the hydrogen breath test.

    There is no known cure, but an appropriate diet will help. However, it is very difficult for undiagnosed sufferers to see any relationship between the foods they eat and the symptoms they suffer, even if they keep a daily diet diary. This is because most foods contain a mixture of fructose and glucose.

    Foods with more fructose than glucose are a problem, as are foods with a lot of fructose (regardless of the amount of glucose). However, depending upon the sufferer's sensitivity to fructose, small amounts of problem foods could be eaten (especially when they are not the main ingredient of a meal).

    Foods with a high glucose content actually help sufferers absorb fructose.

    Symptoms:

    This condition is common in patients with symptoms of irritable bowel syndrome. A small proportion of patients with both fructose malabsorption and lactose intolerance also suffer from coeliac disease.

    Typical symptoms of fructose malabsorption include:

    * bloating
    * diarrhea and / or constipation
    * flatulence
    * stomach pain (due to muscle spasms, which can vary from mild and chronic to acute but erratic)


    Other possible symptoms of fructose malabsorption include:

    * aching eyes
    * fuzzy head
    * fatigue
    * depression


    Hydrogen Breath Test:

    A Hydrogen Breath Test (or HBT) is used as a clinical medical diagnosis for people with irritable bowel syndrome, and common food intolerances. The test is simple, non-invasive, and is performed after a short period of fasting (typically 8 hours).

    Tests vary from country to country, so the following information is provided as a rough guide to typical uses of the hydrogen breath test:

    Fructose malabsorption - the patient takes a base reading of hydrogen levels in his/her breath. The patient is then given a small amount of fructose and / or sorbitol (typically 20 to 25 g), and then required to take readings every 15 to 30 minutes for two to three hours.

    If the level of hydrogen rises to 20 points or more above the base reading, and is sustained for at least two readings, then the patient has fructose malabsorption.

    Lactose intolerance - the patient takes a base reading of hydrogen levels in his/her breath. The patient is then given a small amount of pure lactose (typically 20 to 25 g), and then required to take readings every 15 to 30 minutes for two to three hours.

    If the level of hydrogen rises to 20 points or more above the base reading, and is sustained for at least two readings, then the patient has lactose intolerance. A particular spike pattern is required to be diagnosed with lactose intolerance, with the earlier spike caused by the bacteria in the small intestine and a later one caused by the bacteria in the colon.

    The excess hydrogen is typically caused by an overgrowth of otherwise normal intestinal bacteria.

    I'll search for a list of fructose levels in foods, but if anyone finds one first then please post it, thanks, Sean
    [This Message was Edited on 04/20/2007]
  2. swedeboy

    swedeboy Member

    Foods with high fructose content

    Foods with a high fructose content include:

    * apples 7.6%
    * coconut milk
    * figs dried 26.0%
    * fruit juice (especially from apples and pears)
    * guavas 1.7%
    * high fructose corn syrup (very widely used to sweeten beverages in the U.S. present in soft drinks, and used to make sushi rice stick together) 37.4%
    * sucrose 50%
    * honey 42.4%
    * lychees
    * mangos 2.9%
    * melons
    * pawpaws
    * pears 6.4%
    * persimmons
    * prunes (dried) 14.8%
    * quince
    * raisins 33.8%

  3. Slayadragon

    Slayadragon New Member

    Hi Sean,

    This is a very interesting topic, considering how enthusiastic Dr. de Meirleir seems to be about it. karinaxx went to see him recently, and he did identify problems. I will keep an eye out for whether she and her son (or daughter? I think son though) benefit from avoiding it.

    I wonder if my doctor has that machine, or how common they are.

    Those symptoms seem like the ones I get from yeast. If I can get rid of the yeast, those symptoms don't seem to bother me.

    If this really is a major problem for CFS sufferers, it would be useful to know before attacking yeast, I would think.

    Thanks for sharing the info.

    Best, Lisa
  4. swedeboy

    swedeboy Member

    Yeah it must have some significance if Rich Carson made it part of his "Founders Corner" and if Dr DeMeirleir has studied it. I just wonder what the solutions are. Like is it as simple as avoiding particular foods containing significant amounts of fructose?