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Sugar malabsorption in functional bowel disease: clinical implications

F Fernández-Bañares1, M Esteve-Pardo, R de Leon

  • 1Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.

The American Journal of Gastroenterology
|December 1, 1993
PubMed
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Sugar malabsorption, particularly of lactose and fructose, is linked to abdominal distress in functional bowel disease patients. Dietary restriction of offending sugars improved symptoms in 40% of those studied.

Area of Science:

  • Gastroenterology
  • Digestive Health
  • Clinical Nutrition

Background:

  • Functional bowel disease (FBD) affects a significant portion of the population, often presenting with unexplained gastrointestinal symptoms.
  • Carbohydrate malabsorption is frequently suspected in patients with FBD, but its direct link to symptom development requires further investigation.

Purpose of the Study:

  • To investigate the relationship between sugar malabsorption and the development of clinical symptoms in patients diagnosed with functional bowel disease.
  • To assess the impact of dietary interventions on symptom severity in FBD patients with identified sugar malabsorption.

Main Methods:

  • Twenty-five FBD outpatients and 12 healthy controls underwent breath-hydrogen testing after oral sugar loads (lactose, fructose, sorbitol, sucrose).

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  • Symptom severity was recorded post-challenge, and the effect of a sugar-restricted diet versus a low-fat diet was evaluated.
  • Main Results:

    • High prevalence of sugar malabsorption (over 90%) was observed in both FBD patients and controls.
    • FBD patients reported significantly higher symptom scores after lactose and fructose/sorbitol malabsorption compared to controls and sucrose malabsorption.
    • Hydrogen production capacity was elevated in FBD patients, and symptom improvement occurred in 40% of patients on a sugar-restricted diet.

    Conclusions:

    • Sugar malabsorption, particularly of lactose and fructose, is associated with increased symptom severity in a subset of functional bowel disease patients.
    • Dietary restriction of identified offending sugars can lead to clinical improvement in some individuals with FBD.