Fructose malabsorption

Fructose Malabsorption: Understanding Impaired Fructose Absorption

Fructose malabsorption, previously known as dietary fructose intolerance (DFI), is a gastrointestinal condition characterized by the inability to properly absorb fructose in the small intestine. This article provides an overview of fructose malabsorption, including its symptoms, diagnosis, management, and differentiation from hereditary fructose intolerance.

Introduction

The molecular structure of fructose, a simple sugar that can be malabsorbed in some individuals.

Fructose malabsorption is a digestive disorder where the small intestine's enterocytes lack the fructose carriers necessary for the efficient absorption of this sugar. As a result, fructose accumulates in the intestine, which can lead to various symptoms.

Pathophysiology

The condition arises from the insufficient presence or function of GLUT5, a fructose transporter protein in the enterocytes of the small intestine. Without adequate fructose transport, the sugar is not absorbed into the bloodstream and instead remains in the gut.

Symptoms

Symptoms of fructose malabsorption may include:

• Abdominal pain and bloating
• Diarrhea or constipation
• Flatulence
• Nausea

Historical Identification

Intolerance to fructose was first reported in 1956, enhancing the understanding of dietary contributions to gastrointestinal disorders.

Diagnosis

Diagnosis of fructose malabsorption is often made using a hydrogen breath test, which measures hydrogen levels in the breath after ingestion of fructose. Elevated hydrogen levels suggest malabsorption.

Management

Management strategies include:

• Dietary modifications to limit fructose intake
• Use of a low FODMAP diet, which restricts certain sugars including fructose
• Nutritional counseling to maintain balanced nutrition while avoiding fructose

Distinction from Hereditary Fructose Intolerance

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Hereditary fructose intolerance involves a deficiency in liver enzymes, unlike fructose malabsorption.

Fructose malabsorption should not be confused with hereditary fructose intolerance (HFI), a more severe condition where the liver lacks enzymes to metabolize fructose. HFI can lead to serious health complications and requires strict avoidance of fructose, Sucrose, and Sorbitol.

Conclusion

Fructose malabsorption is a condition with dietary management as the mainstay of treatment. Understanding the difference between fructose malabsorption and hereditary fructose intolerance is crucial for appropriate diagnosis and care.

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