Fructose intolerance includes hereditary fructose intolerance and fructose malabsorption. Hereditary fructose intolerance results in an inability to digest fructose, while fructose malabsorption refers to deficient intestinal cells. Symptoms include abdominal pain, vomiting, and diarrhea. Treatment involves eliminating fructose from the diet and reintroducing it in small portions.
The term fructose intolerance is used to refer to both hereditary fructose intolerance and fructose malabsorption. Hereditary fructose intolerance results in an inability of the body to digest fructose, because the proper liver enzymes are unable to break down the sugar in fruit. Fructose malabsorption was previously incorrectly referred to as fructose intolerance, but it is not the same condition. Fructose malabsorption refers to a condition in which the intestinal cells needed to absorb fructose are deficient.
Hereditary fructose intolerance occurs when the activity of the enzyme fructose-1-phosphate aldolase is deficient. Because it can’t be digested properly, fructose builds up in the liver, kidneys, and small intestine. People suffering from this condition may experience abdominal pain, vomiting, nausea, excessive sweating, and hypoglycemia when fructose is ingested. Fructose is a sugar found in fruit and those with an intolerance will also have trouble digesting plain white sugar, brown sugar and sorbitol.
Although eliminating foods sweetened with fructose or other sugars prevents symptoms in most older children and adults, this condition can be life-threatening for infants and the elderly. If left undiagnosed, sufferers may suffer liver or kidney damage. Because many baby foods contain fructose, it’s especially important to look out for signs and symptoms in infants.
Fructose mishandling differs from hereditary fructose intolerance in that those with the condition do not have problems with the intolerance, but rather the problem is with the absorption phase which is supposed to occur in the gut. Unabsorbed fructose builds up in the intestines when the intestinal cells responsible for absorption fail. Instead, the bacteria in the lower intestine must metabolize fructose which produces hydrogen and/or methane gas. This causes gas, bloating, and diarrhea that can last from several hours to several days.
Another symptom of fructose malabsorption occurs a few days after ingesting fructose. Fructose accumulated in the lower intestine can bind to tryptophan, also preventing its absorption. Tryptophan is an amino acid that produces melotonin and serotonin. Melotonin helps regulate sleep and serotonin is associated with mood. A lack of these neurotransmitters can cause sleep problems, difficulty concentrating, fatigue, irritability, anxiety and depression.
To treat malabsorption, fructose must first be completely eliminated from the diet. Then, after about a month, small portions of fructose-containing foods can be reintroduced into the diet. Each person will have a different reaction to the amount of fructose ingested, so it is necessary to evaluate how much fructose can be allowed in the diet before symptoms return.
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