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Dietitian, Nutritionist
Everyone has a limited capacity to absorb fructose (a sugar found in many plant foods). If you eat excess fructose, some will not be absorbed but will travel through the digestive tract to the lower bowel. There bacteria of the bowel flora will metabolise it and produce gases and fatty acids. This is a normal process and the same as what happens to ‘dietary fibre’. Fructose is just one of a number of poorly-absorbed, small carbohydrates that act as dietary fibre or ‘prebiotics’. These are collectively known as FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols). Fructose in the monosaccharide in this name. Some people have bloating, diarrhoea (or constipation) and abdominal pain (IBS) from eating too many of these small carbohydrates. However, they are actually healthy for us, so it is best not to avoid them more than necessary to control symptoms.
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Dietitian
As Joy stated fructose malabsorption is normal. The symptoms that occur due to malabsorption of fructose and other FODMAPs are due to altered gut flora and/or hypersensitivity to distension of the bowel, such is the case in Irritable bowel syndrome (IBS). We need to change the way we think about fructose malabsorption - IBS is the condition, and when dietary sugars such as fructose are poorly absorbed they will contribute to symptoms.
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Dietitian, Nutritionist, Sports Dietitian
Great answers from both Joy and Jaci above here. To add, people with fructose malabsorption generally have a lack of fructose transporters compared to those who do not suffer from this condition.
These transporters are located in the small intestine (the site of most of our absorption) and transport the sugars glucose and fructose into our body. Our bodies have two transporters that enable us to absorb sugars from the carbohydrates we eat (glucose transporter and fructose transporter). It is generally the fructose transporter which is lacking.
The glucose transporter is able to carry some fructose molecules across but only when equal amounts of glucose are present. Some foods contain a greater percentage of fructose compared to glucose and this can cause symptoms such as IBS.
It is best to seek the expert advice from an Accredited Practising Dietitian (APD) to help you to understand fructose malabsorption and how you can tailor your diet to relieve your IBS but keep it nutritionally adequate. You can find one at www.daa.asn.au
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