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Fructose intolerance: an under-recognized problem.

Abstract

OBJECTIVES

Although the role of lactose intolerance in the pathogenesis of abdominal symptoms is well known, the role of fructose intolerance is unclear. Our aims were 1) to examine the prevalence of fructose intolerance in patients with unexplained abdominal symptoms, and 2) to explore whether fructose concentration influences fructose breath test.

METHODS

Over 2 yr, patients with unexplained symptoms answered questionnaires and underwent fructose breath tests. Patients received 50 g fructose in 150 ml water (33% solution). Breath samples were collected for hydrogen and methane. In a second study, breath test was performed after giving either 10%, 20%, or 33% fructose solution. Data were analyzed retrospectively.

RESULTS

A total of 183 patients (50 male, 133 female) had breath tests, of whom 134 (73%) were positive. Among these, 119 (89%) had elevated H(2), and 15 (11%) had elevated CH(4) or both gases. Questionnaires showed that flatus (83%), pain (80%), bloating (78%), belching (70%), and altered bowel habit (65%) were the most common symptoms. Breath test reproduced symptoms in 101 patients (75%). In the second study, 14/36 (39%) tested positive with a 10% solution, 23/33 (70%) with a 20% solution, and 16/20 (80%) with a 33% solution (10% versus 20% or 33%, p < 0.01).

CONCLUSIONS

Fructose intolerance may cause unexplained GI symptoms. The higher yield of positive tests in our initial study may be due to referral bias or testing conditions; lower test dose produced a lower yield. Nonetheless, recognition and treatment of fructose intolerance may help many patients.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.

    , , ,

    Source

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Breath Tests
    Female
    Fructose
    Fructose Intolerance
    Gastrointestinal Diseases
    Humans
    Male
    Middle Aged
    Osmolar Concentration
    Prevalence
    Retrospective Studies
    Surveys and Questionnaires

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    12818280

    Citation

    Choi, Young K., et al. "Fructose Intolerance: an Under-recognized Problem." The American Journal of Gastroenterology, vol. 98, no. 6, 2003, pp. 1348-53.
    Choi YK, Johlin FC, Summers RW, et al. Fructose intolerance: an under-recognized problem. Am J Gastroenterol. 2003;98(6):1348-53.
    Choi, Y. K., Johlin, F. C., Summers, R. W., Jackson, M., & Rao, S. S. (2003). Fructose intolerance: an under-recognized problem. The American Journal of Gastroenterology, 98(6), pp. 1348-53.
    Choi YK, et al. Fructose Intolerance: an Under-recognized Problem. Am J Gastroenterol. 2003;98(6):1348-53. PubMed PMID: 12818280.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Fructose intolerance: an under-recognized problem. AU - Choi,Young K, AU - Johlin,Fredrick C,Jr AU - Summers,Robert W, AU - Jackson,Michelle, AU - Rao,Satish S C, PY - 2003/6/24/pubmed PY - 2003/8/6/medline PY - 2003/6/24/entrez SP - 1348 EP - 53 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 98 IS - 6 N2 - OBJECTIVES: Although the role of lactose intolerance in the pathogenesis of abdominal symptoms is well known, the role of fructose intolerance is unclear. Our aims were 1) to examine the prevalence of fructose intolerance in patients with unexplained abdominal symptoms, and 2) to explore whether fructose concentration influences fructose breath test. METHODS: Over 2 yr, patients with unexplained symptoms answered questionnaires and underwent fructose breath tests. Patients received 50 g fructose in 150 ml water (33% solution). Breath samples were collected for hydrogen and methane. In a second study, breath test was performed after giving either 10%, 20%, or 33% fructose solution. Data were analyzed retrospectively. RESULTS: A total of 183 patients (50 male, 133 female) had breath tests, of whom 134 (73%) were positive. Among these, 119 (89%) had elevated H(2), and 15 (11%) had elevated CH(4) or both gases. Questionnaires showed that flatus (83%), pain (80%), bloating (78%), belching (70%), and altered bowel habit (65%) were the most common symptoms. Breath test reproduced symptoms in 101 patients (75%). In the second study, 14/36 (39%) tested positive with a 10% solution, 23/33 (70%) with a 20% solution, and 16/20 (80%) with a 33% solution (10% versus 20% or 33%, p < 0.01). CONCLUSIONS: Fructose intolerance may cause unexplained GI symptoms. The higher yield of positive tests in our initial study may be due to referral bias or testing conditions; lower test dose produced a lower yield. Nonetheless, recognition and treatment of fructose intolerance may help many patients. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/12818280/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=12818280 DB - PRIME DP - Unbound Medicine ER -