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Fructose Intolerance & Fructose Malabsorption

How common is fructose malabsorption and fructose intolerance?

What is the difference between fructose malabsorption and fructose intolerance

What are the symptoms of fructose malabsorption and fructose intolerance?

How is fructose malabsorption and fructose intolerance identified?

How did I get fructose sensitivity?

How is fructose malabsorption and intolerance treated?

When will I be cured from fructose malabsorption or intolerance?

How Sorbitol Causes Irritable Bowel Syndrome

FREQUENTLY ASKED QUESTIONS

FAQ	Aspects	Answers	Comments
How common is fructose malabsorption and fructose intolerance?	Occurrence	Hereditary Fructose Intolerance is quite rare (less than one in 10,000). It is inherited and lasts for life. It should not be confused with Fructose Malabsorption which is quite common. Up to one in three people* has some level of sugar sensitivity - most commonly to Fructose. However around half of these people show no symptoms at all. Fructose is found in processed foods like soft drinks and confectionery. Compare your symptoms in the Symptoms Matrix (must register first - it's free)	Sensitivity to sugars like lactose, fructose and sorbitol is largely undiagnosed, but responsible for stomach bloating and intestinal distress in millions. These substances are used extensively in manufactured foods due to sweetening power and low cost.
What is the difference between fructose intolerance and fructose malabsorption?	Difference	Hereditary Fructose intolerance (HFI) is a quite rare genetic condition where the enzyme for breaking down Fructose is not produced. With HFI it is vital to observe a strict Fructose-free diet. Otherwise there is risk of serious disease including liver failure (sometimes fatal). Fructose malabsorption on the other hand is much more common and affects about 30% of people. Certain special cells (epithelial cells) on the surface of the intestine are not available to assist the digestive process.	Symptoms of these two conditions are similar: Gastro-intestinal symptoms, especially Irritable Bowel Syndrome. Treatment of Fructose Intolerance (HFI) is a very strict Fructose-free diet with NO FRUIT or fruit juice for life. But treatment of Fructose Malabsorption is a Fructose-free diet with some concessions. Also you can find a threshold level where you can eat some Fructose without getting symptoms.
What are the symptoms of fructose malabsorption and fructose intolerance?	Symptoms	For both: Gastro-intestinal distress: flatulence, bloating, diarrhea, fatigue, low iron or other nutrient deficiency. In Fructose Malabsorption there is clinical evidence associating it with mood disturbances and depression. Sugar cravings are strongly associated with Fructose sensitivity. See the Symptoms Matrix (register first, it's free)..	The symptoms of Fructose sensitivity are very similar to Lactose Intolerance so they can be misdiagnosed. Long term effects of malabsorption are anaemia; poor skin, nails and hair; general ill health and even osteoporosis.
How is fructose malabsorption and fructose intolerance identified?	Diagnosis	The hydrogen or H2 breath test can be used as a GUIDE ONLY for fructose, lactose or sorbitol malabsorption. The doctor may also use stool analysis in some cases. If it turns out you are Fructose- sensitive it is vital to rule out HFI as there are serious health issues. See Boston University link below. You can partly identify it by comparing your symptoms in the Symptoms Matrix (register first - it's free). Your particular sensitivity can be easily identified using the Detection Diet in The Food Intolerance Healing Program.	Using specially sequenced phases the Detection Diet identifies the offending food - whether it is Fructose, Lactose or something else. It is imperative to keep a journal of foods eaten and observations, because reactions can be delayed up to 3 days. You need a properly laid out journal to keep notes. See Detection Diet Journal in The Food Intolerance Healing Program.
How did I get fructose malabsorption or fructose intolerance?	Causation	A very small percentage of people have hereditary Fructose Intolerance (less than 1 in 10,000 people.) Fructose Malabsorption is less well understood. But may be somewhat self-imposed by our modern diets. Humans have not yet evolved systems to cope with such high sugar consumption.	Consider the high level of sugars we ingest: soft drinks, confectionery, desserts and thousands of processed foods and pharmaceuticals. Fructose sensitive people improve dramatically on a Fructose-free Diet. Find it in The Food Intolerance Healing Program.
How is fructose malabsorption and fructose intolerance treated?	Treatment	A Fructose-free or low-sugar diet is the best treatment. But many processed foods contain added Fructose under aliases like 'corn syrup'. (For Lactose intolerance go to Dairy Intolerance page.)	Fructose is present in most fruits and vegetables and thousands of processed foods and medications. For guidance on doing a Fructose-free diet, see the Compleat Guide to Fructose-free in The Food Intolerance Healing Program.
When will I be cured from fructose malabsorption or fructose intolerance?	Prognosis	The rare HFI (Hereditary Fructose Intolerance) cannot be cured. For this a strict Fructose-free Diet must be maintained in the long term. The much more common Fructose Malabsorption however is much easier to manage. By using a journal and monitoring yourself, you will find a threshold level that is tolerable. That is - you will be able to eat some Fructose without suffering symptoms.	It is important to keep a journal of food eaten and symptoms on a daily basis, until you come to know your body's limits. The Detection Diet Journal in The Food Intolerance Healing Program helps you discover your threshold of intolerance. Then you can eat some sweet foods without symptoms.

How Sugars Break Down in Malabsorption

Sugar malabsorption is the inability (in some people) of the small intestine to break down sugars like fructose (most common), lactose or sorbitol into smaller molecular fragments for digestion. So the sugars progress down to the colon (large intestine) where bacteria break it down into short chain fatty acids and the gases carbon dioxide and hydrogen. These gases create enormous pressure in the intestine causing bloating, pain, diarrhea and flatulence.

In these people, because fructose (or lactose or sorbitol) is not absorbed by the intestine the condition is known as malabsorption, or an inability to be absorbed. But the molecule gets up to other mischief: it arrives in the colon where it drives an "osmotic purge". This means it attracts fluids back into the colon, making bowel motions loose and watery.

The main danger is that any other nutrients present can be lost from the body, like calcium and iron. Fructose malabsorption therefore is not only associated with gastro-intestinal distress but also the inability to absorb all kinds of nutrients which can lead to serious diseases like anaemia and osteoporosis.

Fructose malabsorption is notoriously undiagnosed and misdiagnosed. Recent findings are that Fructose malabsorption is associated with the early stages of depression and mood disturbances.

Remember the easiest and most accurate way to check yourself out for Fructose sensitivity is to do the Detection Diet in The Food Intolerance Healing Program. If you do get a positive result then you should see your doctor and rule out HFI.

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Author: Deborah Manners B.Sc. (Hons) Grad. Dip.Ed is not a medical or healthcare professional.
Ms Manners has multiple food intolerances and presents information from the point of view of the consumer.

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