Fructosemalabsorption and fructan malabsorption are associated in patients with irritable bowel syndrome. Food malabsorption and intolerance is implicated in gastrointestinal symptoms among patients with irritable bowel syndrome (IBS). Key triggers include fructose and fructan. Prior studies examined fructose and fructan malabsorption separately in IBS patients. None have concurrently assessed fructose solution or 10 g fructan solution, followed by breath hydrogen readings every 30 min for 3 h. Patients were positive for fructose or fructan malabsorption if breath hydrogen levels exceeded 20 ppm. Of 186 IBS patients, 71 (38.2%) were positive for fructosemalabsorption and 91 (48.9%) were positive for fructan malabsorption. Of these patients, 42 (22.6%) were positive for fructosemalabsorption
Gene variants of the SLC2A5 gene encoding GLUT5, the major fructose transporter, do not contribute to clinical presentation of acquired fructosemalabsorption. While role of ALDOB-related gene variants for hereditary fructose intolerance is well established, contribution of gene variants for acquired fructosemalabsorption (e.g. SLC2A5, GLUT5) is not well understood. Patients referred to fructose breath test were further selected to identify those having acquired fructosemalabsorption. Molecular analysis of genomic DNA included (I) exclusion of 3 main ALDOB gene variants causing hereditary fructose intolerance and (II) sequencing analysis of SLC2A5 gene comprising complete coding region, at least 20 bp of adjacent intronic regions and 700 bp of proximal promoter. Among 494 patients, 35
Prevalence of FructoseMalabsorption in Patients With Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth Fructosemalabsorption (FM) mimics symptoms of irritable bowel syndrome (IBS), and its prevalence has increased. Diagnosing FM in IBS is challenging because of its overlap with small intestinal bacterial overgrowth (SIBO). We assessed the prevalence of FM
ChREBP-Knockout Mice Show Sucrose Intolerance and FructoseMalabsorption We have previously reported that 60% sucrose diet-fed knockout mice (KO) showed body weight loss resulting in lethality. We aimed to elucidate whether sucrose and fructose metabolism are impaired in KO. Wild-type mice (WT) and KO were fed a diet containing 30% sucrose with/without 0.08% miglitol, an α-glucosidase inhibitor , the hepatic fructose content in KO was much higher owing to decreased hepatic mRNA expression. Taken together, KO showed sucrose intolerance and fructosemalabsorption owing to decreased gene expression.
Adding glucose to food and solutions to enhance fructose absorption is not effective in preventing fructose-induced functional gastrointestinal symptoms: randomised controlled trials in patients with fructosemalabsorption. In healthy individuals, the absorption of fructose in excess of glucose in solution is enhanced by the addition of glucose. The present study aimed to assess the effects of glucose addition to fructose or fructans on absorption patterns and genesis of gastrointestinal symptoms in patients with functional bowel disorders. Randomised, blinded, cross-over studies were performed in healthy subjects and functional bowel disorder patients with fructosemalabsorption. The area-under-the-curve (AUC) was determined for breath hydrogen and symptom responses to: (i) six sugar
Fructosemalabsorption in people with and without gout: A case-control study. Higher fructose intake has been associated with hyperuricaemia and gout. Some individuals malabsorb fructose in the small intestine. The aims of this study were to determine the rate of fructosemalabsorption and the effects of gout and fructosemalabsorption on serum urate in people with and without gout. A total of 100 people with gout (cases) were age and gender matched with one control without gout. After a low fructose diet, fructosemalabsorption was measured using a hydrogen and methane breath test with a 35g fructose load. In a subgroup of 35 cases and 35 controls, serum urate response to the fructose load over 240 minutes was measured. There was no significant difference in the rate of fructose
Fructosemalabsorption Incomplete intestinal absorption of fructose might lead to abdominal complaints such as pain, flatulence and diarrhoea. Whether defect fructose transporters such as GLUT5 or GLUT2 are involved in the pathogenesis of fructosemalabsorption is a matter of debate. The hydrogen production by colonic bacteria is used for diagnosis with the hydrogen breath test. However , the appropriate fructose test dose for correct diagnosis is unclear. Subjects with fructosemalabsorption show increased breath hydrogen levels and abdominal symptoms after fructose administration but do not report any symptoms when fructose is given together with glucose. This beneficial effect of glucose, however, cannot be explained yet but might be used for clinical care of these subjects.
FructoseMalabsorption in Systemic Sclerosis. The deleterious effect of fructose, which is increasingly incorporated in many beverages, dairy products, and processed foods, has been described; fructosemalabsorption has thus been reported in up to 2.4% of healthy subjects, leading to digestive clinical symptoms (eg, pain, distension, diarrhea). Because digestive involvement is frequent in patients with systemic sclerosis (SSc), we hypothesized that fructosemalabsorption could be responsible for intestinal manifestations in these patients. The aims of this prospective study were to: determine the prevalence of fructosemalabsorption, in SSc; predict which SSc patients are at risk of developing fructosemalabsorption; and assess the outcome of digestive symptoms in SSc patients after
Fructosemalabsorption syndrome. Fructosemalabsorption is associated with gastrointestinal symptoms. This review examines new findings on the physiology, assessment and therapy of fructosemalabsorption in functional gastrointestinal disorders. Additional GLUT transport mechanisms that regulate fructose absorption might be involved in symptom adaptation to high-fructose diets. Although glucose
Lactose and fructosemalabsorption in children with recurrent abdominal pain: results of double-blinded testing. To investigate malabsorption of lactose and fructose as causes of recurrent abdominal pain (RAP). In 220 children (128 girls, mean age 8,8 [4.1-16.0] years) with RAP, hydrogen breath tests (H(2) BT; abnormal if ΔH(2) > 30 ppm) were performed with lactose and fructose. Disappearance in 24/38 patients with lactose malabsorption, and in 32/49 with fructosemalabsorption. Open provocation with lactose and fructose was positive in 7/23 and 13/31 patients. DBPC provocation in 6/7 and 8/13 patients was negative in all. However, several children continued to report abdominal symptoms upon intake of milk or fructose. Lactose intolerance nor fructose intolerance could be established
Oral xylose isomerase decreases breath hydrogen excretion and improves gastrointestinal symptoms in fructosemalabsorption - a double-blind, placebo-controlled study. Incomplete resorption of fructose results in increased colonic hydrogen production and is a frequent cause of abdominal symptoms. The only treatment available is diet. To study whether orally administered xylose isomerase (XI ), an enzyme that catalyses the reversible isomerisation of glucose and fructose, can decrease breath hydrogen excretion in patients with fructosemalabsorption. Patients received 25 g fructose in 100 mL water together with either placebo or XI capsules. Primary endpoint was the reduction in breath hydrogen excretion, as assessed by the area under the breath hydrogen curve over 4 h (AUC). A secondary
to be present along the length of the small intestine. In this situation, fructose molecules are likely to remain in the small-intestinal lumen for longer and exert their osmotic effects over much of its length, with or without “spill-over” into the colon (i.e., fructosemalabsorption) [46,54]. The fructose that reaches the large intestine is then available for colonic fermentation, creating by-products of hydrogen and methane that can be measured in expired air. * Fructosemalabsorption: Incomplete absorption of a given dose of fructose in the small intestine, resulting in “spill-over” into the large intestine. Fructosemalabsorption has been shown to be a normal phenomenon, occurring in approximately 35% of healthy individuals [79]. * Fructose intolerance: This occurs when consumption of fructose induces
and carbon dioxide, hydrogen and methane. FODMAPs increase small intestinal water volume and colonic gas production, with secondary effects on small and large intestine motility. These factors may lead to symptoms of IBS, especially in those with visceral hypersensitivity and/or gastrointestinal motility abnormalities. Although lactose intolerance may be associated with IBS, fructosemalabsorption, where
Is abnormal 25 g fructose breath test a predictor of symptomatic response to a low fructose diet in irritable bowel syndrome? Fructosemalabsorption may trigger gastrointestinal symptoms in irritable bowel syndrome patients and a low fructose diet seems to improve digestive symptoms. The aim of our study was to determine whether fructosemalabsorption detected by a 25g fructose breath test could be a predictor of the efficacy of a low fructose diet. 88 patients (73 women, median age, 45.5 years, range 18-69) with irritable bowel syndrome according to Rome III criteria were included in this prospective, controlled study. All 88 patients had a 25 g fructose breath test; 37 had a positive test result defining fructosemalabsorption. All 88 patients followed a low fructose diet for 2 weeks, blinded
Recent insights into the role of ChREBP in intestinal fructose absorption and metabolism Fructose in the form of sucrose and high fructose corn syrup is absorbed by the intestinal transporter and mainly metabolized in the small intestine. However, excess intake of fructose overwhelms the absorptive capacity of the small intestine, leading to fructosemalabsorption. Carbohydrate response element
Relationship Between Abdominal Symptoms and Fructose Ingestion in Children with Chronic Abdominal Pain Limited valid data are available regarding the association of fructose-induced symptoms, fructosemalabsorption, and clinical symptoms. To develop a questionnaire for valid symptom assessment before and during a carbohydrate breath test and to correlate symptoms with fructose breath test results in children/adolescents with functional abdominal pain. A Likert-type questionnaire assessing symptoms considered relevant for hydrogen breath test in children was developed and underwent initial validation. Fructosemalabsorption was determined by increased breath hydrogen in 82 pediatric patients with functional abdominal pain disorders; fructose-induced symptoms were quantified by symptom