# Fructose malabsorption



## Dar14 (Dec 12, 2009)

Anyone here considered fructose malabsorption as the cause of their IBS-D?? I have been googling and reading lot's again today and came across this......while the diet I read about was similar to the SCD diet I have also been considering getting on this one wasn't so restrictive.What grabbed my attention was how they diagnosis you for this.....hydrogen breath test.......just like SIBO......they do have you drink pure fructose......or the lactulose stuff to determine if you have SIBO.This also can give someone what appears to be IBS-D symptoms.Anyone ever been tested for this??Here are some links I found very interesting.......I am thinking I need to get tested for SIBO & FM......instead of just making myself crazy about all this! If I knew those 2 other options were off the table then I could at least stop wasting time thinking I may have FM or SIBO instead of just IBS-D.LINK TO ARTICLEIf you google about it many info sites come up......fodmaps elimantion diet also is another one.Please share your thoughts on this.I edited this as I accidentally posted a second link that was incorrect......sorry about that!


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## searching4answers (Mar 4, 2010)

I would get tested. Do it because it might really help. I have SIBO and was diagnosed through a hydrogen breath test. Now i want to be tested for FM. because i noticed that those foods bother me. Also ppl with FM usually can't handle wheat products. Do those bother you also?


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## Kathleen M. (Nov 16, 1999)

For specific carbohydrate malabsorption (fructose, lactose) you have to drink the exact sugar they are testing for.Lactulose is not absorbed by any human so all of it gets turned into bacteria food and they look for WHEN you get peaks, not IF you get peaks.For fructose and lactose someone who is tolerant should make little to no hydrogen, but someone who is intolerant will make gas when it gets to the colon, so this is an IF you get peaks type of test.


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## faze action (Aug 6, 2009)

I've been considering asking my GI doc to test me for fructose malabsorption, mainly because the symptoms are so close to the symptoms I experience with the IBS-d/ SIBO... I wonder if there is a difference in testing between the two? Do GI docs tend to differentiate between SIBO and other malabsorption issues? Does fructose have to be ingested during the test for it to be accurate?


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## Kathleen M. (Nov 16, 1999)

SIBO is *not* primarily a malabsorption issue. It is bacteria living in the small intestine when they shouldn't be in there.Now in severe cases it can block the ability of the small intestine to do it's job, but the small intestine can do it's job.In carbohydrate intolerance problems you can't absorb or digest the sugar, that is a job the small intestine cannot do under any circumstances.Fructose malabsorption has to be tested with fructose. You can't use another sugar and get the answer.You really can't tell the gut issues apart by symptoms all that much. The gut only goes wrong in a limited number of ways so all the syndromes and diseases have a lot of overlap symptom wise, however if you get symptoms after a HFCS soda and are fine when you drink milk or visa versa that is an indication that only one of the two sugars may be a problem for you.


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## searching4answers (Mar 4, 2010)

you mentioned carbohydrate intolerance. is there a test for that? wuold it even matter if i did get one? would that change anything like would i get put on a special diet? Gluten free is generally low-carb right? cause it's not really starchy. Like Quinoa noodles?


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## Kathleen M. (Nov 16, 1999)

Gluten free does not mean starch free, fructose free, lactose free, tree nut free or any other thing anyone could be intolerant or allergic to, etc.The test for EVERY carbohydrate any human can be intolerant of is the hydrogen breath test where you take a whole bunch of the carbohydrate (lactose or fructose are the common ones, but even rare ones like sucrose would be tested this way--but most sucrose intolerant people won't eat anything sweet so usually don't need to get tested as they have a strong avoidance of anything that tastes the least bit sweet) and see if you make too much gas when it hits the colon.There isn't some other test. It is the same test. It is similar to the SIBO test but that is a carbohydrate that can cause a gas spike in every single human being on the planet even one that is completely and totally healthy in every possible way and seeing WHEN the hydrogren spikes, not IF it spikdes.Potatoes are gluten free and very high in starch. If you want to limit all carbs across the board you have to eliminate all of them, not just the gluten containing ones. Gluten is NOT starch, gluten is a protein.If you want to eliminate starch you have to avoid most all the grains and starchy veggies and many people do well to avoid beans (different carbs no human digests) and a few other veggies.


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## faze action (Aug 6, 2009)

Kathleen M. said:


> SIBO is *not* primarily a malabsorption issue. It is bacteria living in the small intestine when they shouldn't be in there.Now in severe cases it can block the ability of the small intestine to do it's job, but the small intestine can do it's job.In carbohydrate intolerance problems you can't absorb or digest the sugar, that is a job the small intestine cannot do under any circumstances.Fructose malabsorption has to be tested with fructose. You can't use another sugar and get the answer.You really can't tell the gut issues apart by symptoms all that much. The gut only goes wrong in a limited number of ways so all the syndromes and diseases have a lot of overlap symptom wise, however if you get symptoms after a HFCS soda and are fine when you drink milk or visa versa that is an indication that only one of the two sugars may be a problem for you.


Yeah, I know that SIBO is not a malabsorption issue... not really sure why I typed that sentence the way I did. I do tend to get symptoms after drinking soda (I drank the rare one today at lunch and I got pretty bloated and gurgly, even after only a little food), but I wouldn't say that I get symptoms every single time I consume something with fructose (maybe like 75% the time though). Maybe it depends on the amount I'm consuming? Carbs generally are a problem for me. I can't really think of anything I can do other than limit them in my diet... and I love them!


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## Kathleen M. (Nov 16, 1999)

There often is a threshold and sometimes people on a good IBS day tolerate things that may bother them on a bad IBS day (when the IBS is bad for some non-food reason like weather or poor sleep, you may have a different threshold).Also sometimes what you consume the fructose with may influence how well it is absorbed. I think some people aren't completely unable to abosorb it, but may not absorb it as efficiently (and it isn't the most efficient thing to start with).The ratio of fructose to glucose will effect absorption, and some HFCS have more fructose per glucose than others.Unfortunately a lot of IBSers find carbs bother them, a few things you might try.1. Limit the amount per meal, actually stick to the higher glycemic index carbs (so jasmine rice rather than bread).2. See if probiotics help. They do not fully digest carbs so what they get a hold of isn't digested by other bacteria that do make the gas.3. Some people may find simethicone if taken with each meal may help. You need it in the colon with the food so taking it only after symptoms hit won't do much good.


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## searching4answers (Mar 4, 2010)

Thanks. that explains why today when I thought i was safe making a gluten free bread and was definately wrong because i suffered the consequences. What's a safe bread for ppl trying to avoid carbs?


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## Kathleen M. (Nov 16, 1999)

Not sure how you make a really low carb bread without having to put something in it that may be a problem.Some people will tolerate rice so a rice cake can be used for spreadables, or you can wrap food in a lettuce leaf to make a wrap sandwich.If you google the words low carb bread there are several made with nut or flax meal, but a lot of them add wheat gluten (which may be OK if you really aren't gluten sensitive) to give it the right texture.Do you have to have bread?


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## faze action (Aug 6, 2009)

Kathleen M. said:


> There often is a threshold and sometimes people on a good IBS day tolerate things that may bother them on a bad IBS day (when the IBS is bad for some non-food reason like weather or poor sleep, you may have a different threshold).Also sometimes what you consume the fructose with may influence how well it is absorbed. I think some people aren't completely unable to abosorb it, but may not absorb it as efficiently (and it isn't the most efficient thing to start with).The ratio of fructose to glucose will effect absorption, and some HFCS have more fructose per glucose than others.Unfortunately a lot of IBSers find carbs bother them, a few things you might try.1. Limit the amount per meal, actually stick to the higher glycemic index carbs (so jasmine rice rather than bread).2. See if probiotics help. They do not fully digest carbs so what they get a hold of isn't digested by other bacteria that do make the gas.3. Some people may find simethicone if taken with each meal may help. You need it in the colon with the food so taking it only after symptoms hit won't do much good.


Thanks Kathleen. That's good info. I may put myself back on Align for a couple of weeks since I seem to be in a bit of a "flare" lately.


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## searching4answers (Mar 4, 2010)

Well kinda. what else can is there to eat for lunch when i go back to school? I'm not really sure if wheat is the problem for ppl who have SIBO, i used to think that was the case but now i'm not sure. Because those things that had wheat in them that bothered me also had plenty of other ingredients. Because that gluten free bread i made had potatoe starch and i'm thinking that was the culprit. So for ppl with SIBO is it only the starches that's problematic not the wheat? Do we all just have that confused?


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## Kathleen M. (Nov 16, 1999)

You might check out Pimentel's book he has a diet for SIBO. I think it limits all starches, not just wheat.Any low carb cook book should have plenty of low carb lunches you can pack. If nothing else make a salad and bring one of the packets of tuna or chicken (the kind you don't have to drain) and some salad dressing and put it together and eat.And like I said you can roll up sandwich meat in a lettuce leaf with a bit of whatever condiment you like (a bit of mustard or mayo, even add some herbs to the mayo) and they eat like any other sandwich wrap.


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## shyanna von banana (Jun 4, 2009)

what if some fruits just make my head heavy but dont immediately give me d? does tht mean anything? I think whoever said tht ppl with fructose malabsorbtion have trouble with wheat too was right b\c wheat gives me problems as well but its harder to tell.


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## shyanna von banana (Jun 4, 2009)

what food is safe to eat if you have FM?


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