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Fructose intolerance : Origin, Symptoms, Diagnosis and Treatment

Does your gut rebel after ingesting fruit and fruit juices? A fructose intolerance could be behind it. We reveal what you should pay attention to.

Origin: Fructose intolerance

Small transport proteins, which are located in the intestine, get into the blood via the nutrients from the interior of the intestine. In addition to glucose (grape sugar), a certain amount of fructose is transported into the body. Everyone can only tolerate a certain amount of fructose, most people can actually only absorb a small amount of fructose without suffering from symptoms such as stomach pain, diarrhea, nausea or the like.

If it is an intestinal fructose intolerance, also known as fructose malabsorption, the transporter can process no or less fructose from food than in a healthy person. The sugar is only absorbed to a limited extent by the cells in the lining of the small intestine and travels straight on to the large intestine, where it is broken down by bacteria into organic acids, hydrogen and carbon dioxide. The result: the affected person has a restricted intake of fructose. The sugar is not well tolerated and symptoms are triggered by the absorption of the sugar.

As an important addition: A fructose intolerance is not to be equated with a food allergy. The intake of the sugar does not lead to the typical symptoms of a food allergy. There is no swelling in the mucous membrane in the mouth and nose and throat, and the tongue does not swell either.

Despite a lot of research, the exact causes of fructose intolerance are not yet known. There are only a few guesses. This includes, for example, that fructose can be found as an ingredient in more and more foods, which means that people eat more fructose than they used to.

Symptoms: intolerance

If you suffer from fructose malabsorption, you may experience pain after the bacteria break down the sugar. At the same time , gases and sometimes foul-smelling fatty acids are produced , and digestion is also disturbed. Which symptoms and, above all, how severe they occur varies from person to person. The following symptoms should be noted with this intolerance:

Diagnosis: fructose intolerance

It takes years for most people affected to get a diagnosis. They go from doctor to doctor and suffer from the symptoms. There are many causes that can account for the symptoms that occur. For example, there may be a disease in the intestines, lactose intolerance or irritable bowel syndrome, which can cause the respective symptoms. In most cases, an incorrect diet also speaks for a suddenly occurring intolerance. In particular, flatulent foods should be avoided at first if there is a suspicion. Whole grain products, types of cabbage, legumes or onions are just a few examples of such flatulent foods.

If such symptoms occur, specific attention must be paid to which foods the problems occur after. A visit to a nutritionist should always be considered. Among other things, an H2 breath test is carried out so that the latter can diagnose the possible trigger. A small amount of fructose is drunk with water on an empty stomach, then you blow into the breathing apparatus for about three hours. This measures the hydrogen content in the breathing air, if a set value is exceeded and symptoms appear, then there is a lot to be said for fructose intolerance.

Treatment of fructose intolerance

Once the doctor has diagnosed fructose intolerance, the next step is to talk to a nutritionist. The nutritionist will work with you to draw up a nutrition plan and tell you which foods you should avoid or only eat in small portions. In most cases, you do not have to completely eliminate fructose from your diet, because fructose provides the body with important nutrients. The only exception is if you have hereditary fructose intolerance. This is a hereditary disorder of the fructose metabolism, which already occurs in infancy. On the one hand, an intake of fructose causes gastrointestinal problems and, on the other hand, the fructose accumulates in the liver, which can lead to life-threatening symptoms of poisoning.

During a nutritional consultation, we will also talk to you about your eating habits and specifically change your diet. Therapy usually begins with a two- to four-week phase in which you only eat foods without fructose. In a diary you then record your food of the day and your well-being. The primary goal is to improve symptoms.

After the first few weeks, the next phase begins. Food containing fructose will find a place on your menu again. Of course, these are initially foods that contain relatively little fructose so that your body can get used to the fructose again. Your advisor tries to find out with you how well you tolerate certain foods and which ones cause you problems. You keep all of that in a diary. It is also checked whether you are consuming all the important nutrients with your current diet or whether you are missing nutrients.

Best of all, in future you will no longer have to desperately look for foods that you can tolerate. You should only pay attention to your diet and the signs of your body in order to be able to live healthy and without complaints. There are no bans on intolerance, you eat what your body can tolerate. The transport system in the intestine often recovers so well that those affected can even eat fructose-containing foods such as apples from time to time without any symptoms.

Diet for fructose intolerance

How to eat properly if you have fructose intolerance:

  • Sugar-free candies, chewing gum and diabetic products contain natural and healthy sugar substitutes such as stevia, xylitol and sorbitol. Try to avoid them as much as possible in order to maintain an intact and healthy digestion, because the substances impede the absorption of fructose from the intestine.
  • Be careful with foods containing fructose. Mangoes, grapes, pears, dried fruit, apples, honey, fruit and vegetable juices and concentrated pear juice contain a particularly large amount of fructose. Conventional household sugar consists partly of fructose and partly of glucose. Sweets, soft drinks, canned vegetables and light products contain a lot of sugar because sweeteners are often added to them. Before you eat it, look at the list of ingredients before you dare to try the sugar!
  • As a rule, types of fruit such as bananas, berries and apricots are considered to be well tolerated because they either have little fructose or roughly the same amount of fructose and glucose. Glucose facilitates the absorption of fructose in the intestine. Otherwise, dextrose can also be added to the fruit to achieve a relative balance of glucose and fructose.
  • Save your intestinal transporter some work and don’t just eat fruit pure. Consume it in the form of a dessert with dairy products. In this way, the fructose is absorbed more slowly through the fat and protein.
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Crystal Waston MD

Crystal Waston has a degree in Cross Media Production and Publishing. At vital.de she gives everyday tips and deals with topics related to women's health, sport, and nutrition.

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