Fructose malabsorption


Fructose, also called fruit sugar, is a monosaccharide, but it differs from glucose in that it has a keto group located at the second carbon atom. Therefore, it is digested only in the liver.

Most people take in more than their digestive system can handle. Also, most people cannot properly absorb all the fructose they take in daily with a normal and seemingly healthy diet.

If you are consuming large amounts of fruit and think this is healthy, better think again. A normal healthy adult is able to properly digest 25-50 grams of fructose per day.

Many people are affected by this digestive problem.

Here are some examples of the fructose content of some of the most commonly consumed high fructose foods:

• Apples – 35 g/kg;
• Asparagus- 11 g/kg;
• Watermelon – 23 g/kg;
• Soft drink most often 20-35 grams in a bottle of 200 ml.

If you “stick” to a high-fructose diet, these are possible consequences:

• If your digestive system is able to absorb all of the fructose, you are at risk for weight gain, liver cirrhosis, hepatic steatosis, and other symptoms of liver abuse commonly seen in people who consume too much alcohol.

• However, if your digestive system cannot absorb all of the fructose, then you will experience the symptoms of fructose malabsorption.

What is fructose malabsorption /FM/?

It is a common digestive disorder in which the absorption of fructose or other sugars such as lactose and sorbitol in the small intestine is impaired. About 30-40% of people suffer from FM.

Fructose intolerance – unlike malabsorption is a rarer eating disorder, affecting 1 in 10,000 people and a potentially fatal condition in which the levels of liver enzymes that break down fructose are insufficient.

If you eat more fructose, the small intestine cannot absorb it and it passes into the colon. And in the large intestine, fructose prevents the absorption of water. This leads to the expulsion of watery stools and poor absorption of vitamins and minerals from food.

What are the symptoms?

Eating disorder symptoms resemble those of irritable bowel syndrome, food allergies, and food intolerances.

High amounts of sugar in the colon is food for bacteria and fungi that release hydrogen, carbon dioxide and methane. These gases create pressure in the colon, which causes bloating, pain and gas.

Immediate symptoms – appear within a few minutes after consumption up to about 3 days:

• Flatulence;
• Bloating – from fermentation in the small and large intestines;
• Diarrhea and less often constipation;
• Indigestion and stomach pains;
• Fatigue, lack of energy and general malaise;
• Brain fog and negative emotions;
• Nausea or even vomiting when consuming larger amounts of fructose;

Long-term symptoms

• A constant need to consume sweet things or, more rarely, an aversion to sweets;

• Poor absorption of vitamins and minerals causes anemia, malnutrition and general poor health. Often the levels of vitamins, folic acid, tryptophan, zinc, iron, magnesium, calcium and other minerals are low.

• Poor condition of hair, skin and nails;

• Underweight and difficulty gaining weight but it is also possible to be overweight;

• Early signs of depression, constant feeling of dissatisfaction;

• Increased levels of triglycerides in the blood;

• Heart diseases;

Treatment for fructose malabsorption

Doctors say there is no known cure for the eating disorder. The cure is in the hands of the patient and there is strong evidence that dietary changes can eliminate all symptoms, restore normal digestion and maintain good health.

After you have been symptom-free for several months, you can include fructose-containing foods in your diet. Glucose helps the absorption of fructose and therefore during treatment you can consume foods containing glucose.

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