Review article: fructose malabsorption and the bigger picture
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Fructose is found widely in the diet as a free hexose, as the disaccharide, sucrose and in a polymerized form (fructans), which is not hydrolysed or absorbed in the small intestine.Abstract:
Fructose is found widely in the diet as a free hexose, as the disaccharide, sucrose and in a polymerized form (fructans). Free fructose has limited absorption in the small intestine, with up to one half of the population unable to completely absorb a load of 25 g. Average daily intake of fructose varies from 11 to 54 g around the world. Fructans are not hydrolysed or absorbed in the small intestine. The physiological consequences of their malabsorption include increasing osmotic load, providing substrate for rapid bacterial fermentation, changing gastrointestinal motility, promoting mucosal biofilm and altering the profile of bacteria. These effects are additive with other short-chain poorly absorbed carbohydrates such as sorbitol. The clinical significance of these events depends upon the response of the bowel to such changes; they have a higher chance of inducing symptoms in patients with functional gut disorders than asymptomatic subjects. Restricting dietary intake of free fructose and/or fructans may have durable symptomatic benefits in a high proportion of patients with functional gut disorders, but high quality evidence is lacking. It is proposed that confusion over the clinical relevance of fructose malabsorption may be reduced by regarding it not as an abnormality but as a physiological process offering an opportunity to improve functional gastrointestinal symptoms by dietary change.read more
Citations
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Evidence-based dietary management of functional gastrointestinal symptoms: the FODMAP approach.
TL;DR: The evidence base for restricting rapidly fermentable, short‐chain carbohydrates (FODMAPs) in controlling functional gastrointestinal symptoms is described.
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The Relationship Between Intestinal Microbiota and the Central Nervous System in Normal Gastrointestinal Function and Disease
TL;DR: Gaining a better understanding of the relationship between behavior and the microbiota could provide insight into the pathogenesis of functional and inflammatory bowel disorders.
Journal ArticleDOI
Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome
Derrick K Ong,Shaylyn B Mitchell,Shaylyn B Mitchell,Jacqueline Susanne Barrett,Susan Joy Shepherd,Peter M. Irving,Jessica R Biesiekierski,Stuart C. Smith,Peter R. Gibson,Jane G. Muir +9 more
TL;DR: Reduction of short‐chain poorly absorbed carbohydrates (FODMAPs) in the diet reduces symptoms of irritable bowel syndrome, and symptoms produced in response to diets that differed only in FODMAP content are compared.
Journal ArticleDOI
Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence.
TL;DR: In patients with IBS and fructose malabsorption, dietary restriction of fructose and/or fructans is likely to be responsible for symptomatic improvement, suggesting efficacy is due to restriction of poorly absorbed short-chain carbohydrates in general.
Journal ArticleDOI
Fructose metabolism and metabolic disease
TL;DR: The biology of fructose metabolism as well as potential mechanisms by which excessive fructose consumption may contribute to cardiometabolic disease are reviewed.
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