Fructose Malabsorption and FODMAP sensitivities

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By Justine Thomas

If you’ve ever suffered with gut problems or know someone who has you may have heard of fructose malabsorption or FODMAPS and wondered what exactly is this much talked about issue.

Fructose malabsorption and FODMAP sensitivities are probably the most common cause of bowel symptoms including abdominal pain, wind, bloating, constipation, diarrhoea, nausea or all of the above!

Fructose malabsorption occurs when fructose – a natural sugar found in fruit, honey and table sugar is not absorbed into the body through the small intestine. Instead it continues its journey along the digestive tract to the colon where it is used as food by the bacteria that live there. This fermentation of fructose produces wind and leads to a range of gut symptoms, the type and severity of which varies from person to person. FODMAPS can do the same thing. FODMAP is an acronym that refers to a group of sugars and carbohydrates that, if like fructose, are not absorbed by the small intestine, can wreak havoc in those that are susceptible to gut problems. Technically, FODMAPS are Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols. In short, foods that contain indigestible and malabsorbed sugars and carbohydrates like apples, stone fruit, honey, lactose, wheat, onion and avocado to name a few.

Fructose malabsorption can be diagnosed using a hydrogen and/or methane breath test, which your doctor can refer you for. Lactose intolerance can be diagnosed the same way. For the other FODMAPS however, there is no testing other than avoidance to determine symptom response followed by challenge. If you have been diagnosed with fructose malabsorption, lactose intolerance or suspect a FODMAP issue may be the cause of your symptoms, it is important to seek the advice of a dietitian who specialises in this area.  There is a lot of confusing and conflicting information on-line, which if followed, often leaves little to eat, unnecessary food avoidance and the possibility of overlooking other medical causes of symptoms which should be ruled out.

A dietitian can advise on a strict low FODMAP diet to treat symptoms for up to 4-6 weeks followed by a systematic re-introduction of each FODMAP type to determine actual triggers and tolerance level, so that a long term healthy eating plan can be tailor made to meet your gut and nutritional needs. Fortunately, as the demand for fructose friendly and low FODMAP foods increases, a great range of suitable foods is becoming more widely available at supermarkets and specialty shops.

For more info on fructose friendly food options go to www.fructosefriendlystore.com.au

Justine Thomas, BSc. Grad Dip Diet. APD, is a dietitian specialising in coeliac disease, irritable bowel syndrome, gastrointestinal symptoms and food intolerances.

As published in Peninsula Kids – Winter 2017

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