Tuesday, 19 March 2013

A fruity issue

Fruit is mother natures candy, delicious, sweet and full of good for you nutrients, so it's a bitter pill to swallow if you find out that you can't eat it.

Can't eat fruit? Why wouldn't you be able to?

Well if you have IBS symptoms then there's a chance you may have fructose malabsorption, this is a digestive disorder where your small intestine can't absorb as much fructose as an average person. In not absorbing the fructose it leaves it to pass undigested into the large intestine where it is metabolized by colonic bacteria into short chain fatty acids, producing hydrogen, carbon dioxide and methane gases, causing bloating, gas and commonly diarrhoea or urgently.

So how do you know if you have fructose malabsorption?
Well firstly you'll have these symptoms when you eat fruit, but you might be getting these symptoms on and off all the time so it might be hard to isolate.  Even if you know it's happening with fruit this is also a common symptom with small intestine overgrowths such as candida.  The only conclusive test is a hydrogen breath test using fructose, but you can always just eliminate fruit from your diet for a couple of weeks and seeing if your symptoms improve.

What can you do it if you have it?
Well unfortunately there is no known cure if you have genuine malabsorption other than to avoid fructose. If your symptoms are due to small intestine bacterial overgrowth including candida, you can treat this with antimicrobials, probiotics and a low sugar diet to rebalance your gut flora at which point you should be able to tolerate fructose again.

Apples and pears are the highest in fructose content so most likely to cause symptoms in those with fructose malabsorption, however berries, citrus and ripe bananas are the lowest so may be tolerated. I generally limit my fruit intake to berries, lemons, limes and the odd grapefruit and find that I tolerate these pretty well.

Fructose and fructans are both part of the group of carbohydrates called FODMAPs (Fermentable Oligo-, Di- and Mono-saccharides and Polyols). Therefore if you have an issue with fructose you may also benefit from trying a diet excluding all the FODMAP foods including wheat, pulses, lactose and certain vegetables.

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