Abstract
This review intends to act as an overview of fructose malabsorption (FM) and its role in the aetiology of diseases including, but not limited to, irritable bowel syndrome (IBS) and infantile colic and the relationship between fructose absorption and the propagation of some cancers. IBS results in a variety of symptoms including stomach pains, cramps and bloating. Patients can be categorised into two groups, depending on whether the patients’ experiences either constipation (IBS-C) or diarrhoea (IBS-D). FM has been proposed as a potential cause of IBS-D and other diseases, such as infantile colic. However, our knowledge of FM is limited by our understanding of the biochemistry related to the absorption of fructose in the small intestine and FM’s relationship with small intestinal bacterial overgrowth. It is important to consider the dietary effects on FM and most importantly, the quantity of excess free fructose consumed. The diagnosis of FM is difficult and often requires indirect means that may result in false positives. Current treatments of FM include dietary intervention, such as low fermentable oligo-, di-, monosaccharides and polyols diets and enzymatic treatments, such as the use of xylose isomerase. More research is needed to accurately diagnose and effectively treat FM. This review is designed with the goal of providing a detailed outline of the issues regarding the causes, diagnosis and treatment of FM.
Highlights
It is estimated that irritable bowel syndrome (IBS) affects around 11 % of the global population[1]
A study into breath hydrogen of colic-affected patients indicated an increase in breath hydrogen in children, less than 1 year of age, but not in those 2 years or older[35]. These results indicate that GLUT5 is not initially expressed in infants and the resulting Fructose malabsorption (FM) may result in the colic that many infants suffer from
A key problem with the hydrogen breath test (HBT) is the lack of specificity of the test; elevated breath hydrogen can be as a result of a multitude of reasons, including FM, and potentially small intestinal bacterial overgrowth (SIBO) and malabsorption of other carbohydrates, which will need alternative treatments
Summary
A ketonic monosaccharide, is able to be directly absorbed into blood from the GI tract; it is one of three dietary. IP address: 34.204.7.64, on 02 Nov 2021 at 10:32:24, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. The solubility and sweetness of fructose have been exploited by the food industry in artificial sweeteners, with particular popularity around the use of HFCS, a mixture of glucose and fructose in the monosaccharide form in recent years. Fructose can be present as a monosaccharide, most abundantly in the furanose form, or as the disaccharide sucrose, in a one to one molecular ratio with glucose.
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