Fructose malabsorption: causes, diagnosis and treatment

Area of Science:

• Gastroenterology
• Human Physiology
• Nutritional Science

Background:

• Fructose malabsorption (FM) is implicated in the etiology of irritable bowel syndrome (IBS), infantile colic, and potentially cancer propagation.
• IBS presents with symptoms like stomach pain, cramps, and bloating, categorized into IBS with constipation (IBS-C) and IBS with diarrhea (IBS-D).
• FM is a proposed cause for IBS-D and other gastrointestinal disorders, though its biochemical basis and relationship with small intestinal bacterial overgrowth require further elucidation.

Purpose of the Study:

• To provide a comprehensive overview of fructose malabsorption (FM).
• To explore the role of FM in the development of diseases such as IBS and infantile colic.
• To discuss the relationship between fructose absorption, dietary factors, and cancer progression.

Main Methods:

• This review synthesizes current knowledge on fructose absorption biochemistry.
• It examines the diagnostic challenges and indirect methods used for FM diagnosis.
• It evaluates existing and potential treatments for FM, including dietary modifications and enzymatic therapies.

Main Results:

• The diagnosis of FM is often challenging, relying on indirect measures that may lead to false positives.
• Dietary factors, particularly the quantity of excess free fructose consumed, significantly influence FM.
• Current treatments involve low fermentable oligo-, di-, monosaccharides and polyols (FODMAP) diets and enzymatic treatments like xylose isomerase.

Conclusions:

• Accurate diagnosis and effective treatment of FM remain significant challenges.
• Further research is essential to improve diagnostic accuracy and therapeutic strategies for FM.
• Understanding the intricate relationship between fructose absorption and various health conditions is critical for patient management.