About 10 years ago I was diagnosed by a gastroenterologist as having Fructose Malabsorption.  Before that, due to lack of knowledge and care by doctors that I had seen, I thought I had Coeliac disease. I assumed this for several reasons. One was that I was so sick, gravely so, 10 years ago. I have had lifelong problems however and I am now 49 years old. My sister was also gravely ill and had a blood test for Coeliac disease. Her test came up positive but mine came up negative but our symptoms were very similar. Because I was so sick I immediately gave up eating anything with gluten in it. I started to get better straight away and was able to improve but levelled out after 6 months and did not progress any further in health or energy. I was recommended to a G.I. and was given a hydrogen breath test.

Basically Fructose Malabsorption is a condition where fructose, a simple sugar molecule, is not absorbed properly in the small intestine. It moves through to the large intestine where bacteria munch away on it. When the bacteria digest fructose it produces the symptoms of malabsorption. The degree of malabsorption can vary from individual to individual. Some people are very sensitive.

It is good to have an understanding about these sugars to understand the condition. To explain it very simply in layman's terms sucrose (table sugar) is a double sugar molecule. 1  fructose molecule and 1 glucose molecule combine to form sucrose. People with fructmal can eat sucrose because the glucose facilitates the absorption of fructose. But the foods that have to be avoided is where the fructose to glucose ratio is higher. However, in some foods that may be borderline increasing the intake of glucose helps facilitate the absorption of fructose thus lessen the symptoms of malabsorption.

I've noticed quite a bit published on the net but some of it regarding fructose malabsorption is confusing and not accurate according to what my specialist and dietitian has told me. So therefore I urge anyone with the condition or knows of someone with it, not to rely on everything one reads on the net, which is a good place to glean information about things, but rely on the knowledge of these specialists especially those who can assure that they indeed do know about it.

I went to a dietitian at a local hospital before I saw one that was able to give me the right information. She admitted she didn't know about fructose malabsorption. As a result, based on her advice, I began a terrible entirely sugar(sucrose)-free diet because this dietitian had fructose malabsorption and fructose intolerance (HFI) confused. Fructose intolerance is a different condition. And I wouldn't want to suffer with that and my sympathy goes out to people who do! I was just so relieved to discover that indeed I could eat sugar and foods with a fructose/glucose ratio suitable for my diet and health.
                                                   
I found a dietitian who gave me a suitable diet. As fructose, and not gluten, was not the problem my dietitian told me that I could eat rye bread as long as it was wheat-free. Wheat contains fructans that are chains of fructose molecules strung together and foods with fructans, wheat and onions particularly, need to be avoided. It was good to be able to eat a grain bread again because I had developed a thin skin condition where I would scratch and bruise easily. So the inclusion of rye in my diet was a big improvement. 

I know that there are diets for fructmal that include wheat but I can recommend the world-leading researcher, Dr Sue Shepherd and her finding to the no-wheat diet. There's a link at the left for info.

There are other very basic foods that have to be avoided. The ones that come immediately to mind are: apples, pears, dried fruit, honey, green beans, asparagus, and other fruits and vegetables. It is important to stick with eating ‘safe foods’.

This is what happens to me when I ingest too much fructose:

Soreness, 

Bloating, 

Gas

Acute fatigue

Anxiety through ‘small bowel hurry’.

Depression

If I do have too much fructose I will eat 'safe' foods, increase glucose intake and drink lots of water. I also get excessive fatigue. I will have to sleep and rest, currently more than what I usually now do. I will have fm all my life, so I have to stay on this special diet.

There's certain things I miss eating but there are alternatives. For example, no more apples but I eat some citrus fruits. Naturally my staples are rice and corn. And if I think I could be eating a food that potentially could contain an excess of fructose I spoon some glucose powder. For instance I might go to a Chinese restaurant. I will always ask what they thicken their sauces with. If they can assure me it is with potato flour then it's fine. I might eat a spoonful or so of powdered glucose from a container I brought with me, just in case of any high fructose contaminant in the food. This works ok for me. 

I cannot eat much take away food except for hot chips (no chicken salt), fresh salads with some grilled or fried chicken, fish etc., or a stuffed baked potato, usually with cheese, sour cream and coleslaw. There's also BBQ chicken but without the skin, which might have a wheated coating, and no stuffing. I can also eat sushi as long as the rice isn't sweetened with high fructose corn syrup but in Australia corn syrup is not commonly used. But that's about it. The up-side is that my diet is pretty healthy. I have to plan my outings and pre-enquire about food if going to a restaurant. Most people these days seem to know about Coeliac disease. Sometimes to save any confusion and a long-winded explanation I just order a gluten-free meal. A gf meal means completely wheat-free to me so it just simplifies things. But whatever I do I make sure that what I eat is not going to make me sick. It is just not worth it.

One of the bigger problems I had once was when I was in a hospital having an operation and the kitchen staff thought I was being food fussy instead of believing that my malabsorption condition was real. That is just ignorance and I would advise anyone if you or your relative/friend has the condition that you always pre inform the people in the place you are going and tell them you will be very sick if your dietary instructions are not followed.

If there is anything you think I might be able to help you with you may contact me. But I'm not an expert, I can only relate my situation. 

Please note that inquiries will be replied to as soon as possible. I apologise for any delay in response.