ATTN: Syl ? on fructose malabsorption
#349767 - 09/07/09 09:08 PM
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Hi Syl,
I have posted before regarding my daughter who has rett syndrome. I am wondering if she could possibly have fructose malabsorption on top of IBS-C. I have read the articles you have mentioned in other peoples questions to you and I do find that many of the foods mentioned in the article are ones that are problematic for Rosie. Still though it is hard to discern. What has led me to wonder more seriously is that recently a friend recommended some Isotonix supplements for us to try with my daughter. But they caused her lots of diarrhea (which is unusal for her) and tremendous amount of discomfort. As I looked at the package more closely it said the first inactive ingredient was fructose. So I was wondering if this was the cause of her diarrhea and that maybe she has some fructose malabsorption issues. I was wondering if you could share with me how you found you had it. Diarrhea has never been an issue for my daughter but since we tried these supplements 2 weeks ago. (we stopped after 3 days on them) she has continued to have very, very loose stools) Your input would be greatly appreciated. Thank you,
Sincerely, Teresa
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A recent study showed (reference below) that fructose malabsorption can occur in 27-50% of individuals with any subtype of IBS (IBS-C, IBS-D and IBS-A). When the amount of excess fructose is high D maybe the predominant symptom. At lower levels discomfort, gas and bloating may be the dominat symptom. It is important to remember that even normal individuals can have problems with fructose.
There are two general methods for diagnosing fructose malabsorption. One way is the hydrogen breath test and the other way is by eliminate foods high in excess fructose from the diet. The breath test isn't available where I live so my diagnosis was done by eliminating foods high in excess fructose from my diet.
It is a bit perplexing that the D has continued even after discontinuation of the supplement. Is she still eating foods with more fructose than glucose such as apple, pears, melons, etc fruits and fruit juices?
I hope this helps. Good luck 
Reference
Barrett, J. S., P. M. Irving, S. J. Sheperf, J. G. Muir, and P. R. Gibson, 2009: Comparison of the prevalence of fructose and lactose malabsorption across chronic intestinal disorders. Alimentary Pharmacology & Therapeutics, 30, 165-174.
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Hi Syl,
Thank you so much for your response. What you wrote makes a lot of sense. There were 3 different supplements and each had the fructose as main inactive ingredient so Rosie probably got a large load of free fructose that led to the diarrhea. Her stools the last 2 days have been more like oatmeal so they are starting to thicken up. Prior to trying the supplements, Rosie did have some foods that had fructose such as fruit juices (juicy juice brands), canned peaches/mandarin oranges and some onions in her turkey burgers. THe rest of her diet consists of chicken breast, turkey burgers, pork chops occassionally, white rice, pretzels, canned peas/green beans, some spinach, potatoes, strawberries and grapes and also some brown rice cakes. Since reading about fructose malabsorption, I discontinued the fruit juices, canned fruits, pretzels, grapes and onions in the turkey burgers and brown rice cakes. For 2 days her comfort level was better but then we gave her some beef on recommendation of a dietician (who is not very familiar with IBS or FM) because she said Rosie needs more protein to help gain weight and satifsy her apetite as she is hungry all the time. Well that was a mistake. That set Rosie up with terrible cramping and gas for the last 3 days. It is heartwrenching as she can't verbalize to us and she is sobbing in pain. We are back at trying to stabilize her with just the safe basic soluble as recommended on the website. I appreciate your advice so much as right now we have no one else to speak to who has much knowledge of IBS/FM. Rosie has always had intestinal pain/trapped gas even on the IBS diet but the fructose malabsortpion could be another layer that needs to be peeled back for her. We ahven't given her apples or pears for a few years. I also have done trials of taking fruit juices out but never really saw a big difference. We don't know what to feed her now. She is so sick of the chicken, etcc... that she spits alot of it out. What are foods that you have found OK for you having both IBS/FM? I tried some Kiwi fruit and plain oranges as they are on the safe list for FM but wondering if these are too high in fiber. What fruits/vegies have you found OK. I should also mention that Rosie is lactose intolerant. She also has had complete GI workup: endoscopy, colonscopy, barium enema, CT enterography, Upper GI barium swallow, motility tests, US, Biliary scan and hydrogen breath test to check for SIBO which she was negative for. Tests revealed fast gastric emptying along with delayed small intestinal transit. Also reflux which we feel is under control.
Thank you so much for any more tips you could give us.
Sincerely,
Teresa
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