Abstract
Intolerance to carbohydrates is relatively common in childhood, but still poorly recognized and managed. Over recent years it has come to the forefront because of progresses in our knowledge on the mechanisms and treatment of these conditions. Children with intolerance to carbohydrates often present with unexplained signs and symptoms. Here, we examine the most up-to-date research on these intolerances, discuss controversies relating to the diagnostic approach, including the role of molecular analysis, and provide new insights into modern management in the pediatric age, including the most recent evidence for correct dietary treatment.
Highlights
Adverse food reactions (AFR) represent a relevant problem in daily clinical practice, but are poorly recognized and managed
Fructose is a six–carbon monosaccharide molecule naturally present in a great variety of daily foods, such as fruits, vegetables, and honey [56]. It is produced through enzymatic processing of corn as high fructose corn syrup (HFCS), which is increasingly used in the food industry as a cheaper, tasteless, readily available sweetener in many products, such as sodas, candies, and artificial fruit juices [57]
A second mechanism has been postulated: fructose with other solutes is absorbed by a paracellular transport system, based on the opening of tight junctions induced by glucose absorption [58]
Summary
Adverse food reactions (AFR) represent a relevant problem in daily clinical practice, but are poorly recognized and managed. They are common in industrialized countries, where, depending on data collection methods and definitions, they affect up to 20% of the general population [1]. The prevalence increases significantly in patients with irritable bowel syndrome (IBS). It has been described that up to. 80% of IBS patients believe that their symptoms are diet-related, of which three quarters are possibly related to intolerance to carbohydrates [2,3]. According to the main pathophysiologic mechanism, AFRs are commonly classified into different groups (Figure 1) [4,5,6,7,8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
