Fructose
#314829 - 09/11/07 01:15 PM
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Jordy
Reged: 08/12/06
Posts: 2095
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Can fructose only cause problems with D? Or can people with pain, bloat, C also have problems with it? If so, what would those be?
Thanks
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IBS-C with pain and bloat
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Here is a quote from a recent review article (reference below)
Quote:
Patients judged adherent to the diet [excess fructose free diet] on specific criteria (77% of the group) did significantly better than those who were not. An important feature of this retrospective analysis was the high adherence rate (presumably related to the ongoing efficacy of the diet) which compared favourably with previous rates reported between 26% and 56%. The durability and high rate of symptomatic benefit across patients with both diarrhoea- or constipation-predominant IBS were encouraging.
The authors claim:
Quote:
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 ca rbohydrates such as sorbitol.
It is known that in some people excess fructose produces D by drawing water into the GI tract which can have a laxative effect. The exact mechanism of how fructose causes C is not fully understood. There is evidence that suggests it passes through the GI tract to the colon where certain bacteria may ferment it producing methane gas. C increases as methane in the colon increases. I believe I told you about methane in an earlier email.
Glad to see you didn't leave the board 
Reference
Gibson, P. R., E. Newham, J. S. Barrett, S. J. Shepard, and J. G. Muir, 2007: Review article: fructose malabsorption and the bigger picture. Alimentary Pharmacology & Therapeutics, 25, 349-363.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
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Thanks, Syl. I really am unsure of how much and which fruits would be "safe" in a given day. Or, how to replace the fruits I currently eat with other food selections and still obtain both nutrition and fiber.
Breakfast, I always have papaya or strawberries. Lunch is kiwi or nectarine or peeled apples. Dinner is mango sauce or canned peach slices.
I don't know if this is too much fructose in a day....or if everyone with IBS even has to watch the amount of fructose in the diet. Any food intolerance that may occur in IBS scares me.
Thanks for the welcome back. I'm really not "back". I need to stop reading the boards as I find they tend to cause me fear, anxiety, and eating disorder tendencies. It's time to move on to a new diet approach too. It's been too long with no improvement, for me, personally.
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IBS-C with pain and bloat
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Jordy
Try limiting your fruit to kiwi, slightly ripe bananas and citrus fruits like oranges, grapefruits, tangerines, etc for 3-4 weeks. Don't eat apples, pears, mangos, papaya or melons OR any foods or drinks containing juices from these fruits. Also, remove honey and all foods containing honey, HFCS, molasses and syrups from your diet. Be especially careful with commercial sauces, particularly sweet sauces, because they usually contain fruit juices or other high fructose food products. Also, don't eat fruits like peaches, cherries and plum which contain the sugar sorbitol. This sugar exacerbates fructose problems
If you have problems with fructose you should notice difference within a couple of weeks on this diet if you are very strict about eliminating high fructose foods from your diet. AND if a food tastes quite sweet then it likely contains excess fructose. Fructose is the sweetest known sugar. It is nearly twice as sweet as white sugar.
I love and crave sweet things. And now that I have my fructose problem under control I crave sweet things even more  Oh well – although I still have the cravings for sweet things I don't have the bloating, gas and pain that comes from eating high fructose foods.
Good luck
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
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The Role of Food & Dietary Intervention in IBS
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How can I find a place that performs fructose intolerance testing?
Thanks for all the advice, Syl. I respect your scientific backgroup! And you are so willing to share that knowledge to others.
I just realized the bread I eat uses fruit juices or honey to sweeten. I also just made pulled chicken which contains 1 T molasses divided by 4 servings. Is that still too much? This is gonna be quit challenging as my entire meal plan is so dependent on these fruits.
Tell me, what do you eat for B, L, D, Desserts to substitute these healthy foods? All I can think of to substitute them with aren't as healthy...like baked corn chips or baked potato chips. 
Oh, Stevia doesn't contain fructose, does it? This is still safe?
oh, bananas constipate me, so they are out, too. Any other fruits okay?
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IBS-C with pain and bloat
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I don't know where you can get a fructose malabsorption test done you area. You will have to ask your doctor or a medical agency of some sort.
The problem with a fructose malabsorption test is that it does not tell you how sensitive you are to excess fructose. Usually they give you 25 grams of fructose to drink and then they measure hydrogen in your breath. If the test is positive then it simply tells you that your body cannot absorb fructose at a load level of 25 grams. I cannot tolerate a load of 1 gram of fructose. Drinking 25 grams would give me serious problems and lots of pain
The simplest test is to eliminate fruits with excess fructose from you diet and see if makes a difference. However, you have to be dilegent about removing foods with excess fructose. Leaving just one food in can make all of the difference in the world. I have been caught by surprise a number of times.
My daily diet is very simple with relatively little variation. Typically it looks like the following:
Breakfast - oatmeal with banana or deseeded kiwi
Lunch - light curried chicken and shrimp with carrots and zucchini on 1/2 cup slightly reheated white basmati rice
Dinner - chicken, pork tenderloin, lean bison, fish or seafood prepared in a variety of ways with white rice, potatoes or pasta and carrots and/or peas, zucchini or other safe well cooked peeled veggies.
My snacks consist mostly of sourdough bread, matzo and other low fat wheat based products. Usually I make my own snacks from scratch. I rarely eat commercially prepared snacks and definitely no chips of any kind
Stevia is safe. There are plenty of berries and other fruits that don't have excess fructose. Unfortunately, they are probably not as sweet as you might prefer I hope this helps
Good luck.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Very helpful. Thank you again.
My doctor doesn't believe in fructose testing...he says to eat anything I want, so he's no help. Sounds like you don't think they are necessary, though.
Is maple syrup okay? And how the heck do you deseed a kiwi? 
Oh, and the bread with added fruit juice is out? As well as the chicken with 1/4 T of molasses per serving?
what types of snacks do you make yourself? Or is that the bread and matzo you were referring to?
Slightly rip banana means not to the point of brown spots? But further along than plain yellow color? Sorry so many questions!
BTW, oranges have lots of citric acid. That's okay to eat them or grapefruit or tangarines? I love those!
And what's wrong with chips?
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IBS-C with pain and bloat
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I would stay away from maple syrup and molasses until you know if you have problesm with fructose. If you find eliminating foods with excess fructose is a benefit to you then you can start adding things like maple syrup and molasses and see what happens. You may be able to tolerate some excess fructose but you will have to determine how much you can handle.
Sometimes I make cinnamon buns using only brown sugar, cinnamon and a little bit of olive oil. However, generally my snacks consist of simple things like toast and moisten motzo with a sprinkle of salt
Yes - bananas that don't have any brown spots. In other words, the banana is quite firm.
If citric acid doesn't bother you then by all means eat oranges, grapefruits and tangerines.
There is nothing wrong with baked chips. I just choose not to eat them
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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I Syl. I found this website food nutrients which allows you to search out all sorts of foods and sauces, plug in the amount, and it gives you a reading of the amount of grams of so many things in it.
For fructose, it gave nectarines a very low rating (and peaches as well)...and bananas where much higher...as were kiwi. Maybe it's not accurate??? I remain confuse. Any thoughts?
But thank you so much for your input. Do you try to stay under a certain gram amount of fructose per day?
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IBS-C with pain and bloat
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I know that web site well. I use it alot.
If you read my posting on fructose you will notice I tend to use the term excess fructose and by excess I mean excess in comparison to glucose. For example, consider 100 grams of banana. The USDA database gives the average amount of fructose to be 4.85 grams and the average amount of glucose to be 4.98. Fructose and glucose occur in bananas in almost equal amounts.
In fact, brown and white sugar are composed of sucrose which has exactly one molecule of fructose for each molecule of glucose. These sugars don't affect individuals with fructose malabsorption because these two sugars occur in equal amounts. Strange as it may seem your body handle foods with equal amounts of glucose and fructose differently than it handles the excess fructose alone.
Now consider, 100 grams of apple. The amount of fructose is 5.90 grams and the amount of glucose is 2.43 grams. 100 grams of apples can cause people with fructose malasborption problems because it contains 3.5 grams of excess fructose.
Peaches and plums are low in excess fructose but they are high in a sugar called sorbitol. This sugar also causes problems for individuals with fructose malabsorption problems.
A detailed explanation is given in this review article. Table 1 in this article give typical amounts of glucose, fructose and sorbitol in a variety of fruits.
I hope this helps
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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