Symptomatic fructose malabsorption in irritable bowel syndrome: A prospective study

Area of Science:

• Gastroenterology
• Human Physiology
• Dietary Science

Background:

• Fructose consumption can exacerbate symptoms in irritable bowel syndrome (IBS) patients.
• Understanding fructose malabsorption prevalence is crucial for managing IBS symptoms.

Purpose of the Study:

• To determine the prevalence of symptomatic fructose malabsorption in IBS patients.
• To assess if patient characteristics can predict fructose malabsorption.

Main Methods:

• Prospective study of 90 Rome III IBS patients, excluding small intestinal bacterial overgrowth.
• Fructose malabsorption assessed via a 5-hour breath test after a 25g fructose load, monitoring symptoms.
• Diagnosis of malabsorption based on >20ppm increase in exhaled hydrogen or methane.

Main Results:

• Fructose malabsorption detected in 22% of IBS patients (20/90).
• Only 35% of those with abnormal tests reported symptoms, indicating fructose intolerance.
• Younger and male IBS patients showed a higher risk for malabsorption.
• 18 patients had symptoms despite normal fructose absorption, suggesting other triggers.

Conclusions:

• Symptomatic fructose malabsorption affects 22% of IBS patients.
• An additional 28% of IBS patients showed intolerance without malabsorption.
• Patient characteristics were not strong predictors of fructose malabsorption.