**I want to make it clear, that I am NOT a medical professional! My knowledge of Fructose Malabsorption comes from many years with this condition - and knowledge gleaned from other FructMals I have networked with around the world, as well as the medical advice we have gotten from our various medical professionals, which we have compared and shared.**
What is the difference between Fructose Malabsorption Disorder (FructMal), Dietary Fructose Intolerance, and Hereditary Fructose Intolerance?
Well, there are three names on that list, but only two ailments! FructMal and Dietary Fructose Intolerance are actually the same thing. However, the term Dietary Fructose Intolerance is in the process of being abandoned. Technically, our condition is not an "intolerance" in the medical sense of the word. Also, the term is too similar to the other term on the list "HEREDITARY Fructose Intolerance, and that is the source of too much confusion. FructMal is a dietary problem. In other words, the digestive system is malfunctioning, and as a result, sufferers cannot absorb fructose (though if absorption can be induced, we "tolerate" it just fine). Symptoms are the result of unabsorbed fructose lingering in the intestine, and as this fructose is passed through the body the symptoms go as well. Hereditary Fructose Intolerance , as the name suggests, is genetic. HFI sufferers cannot metabolize fructose at all - they even have to avoid sucrose just because is contains fructose molecules. Consumption of fructose can cause cumulative damage to the liver. It is important to know with accuracy which ailment you have if fructose is a problem for you. See a doctor.
Spencer from Manhattan, NY, USA asks:
I'm curious where you heard that probiotics can be bad for FM? I have a couple doctors that believe differently (I think) and although
your statement makes sense, I'm just curious what it's origins are.
thanks in advance!
Most of the advice coming out of Australia and Europe regarding
fructmal suggests staying away from probiotics and prebiotics, as they
just make things worse. That said, there IS research going on as we
speak into tracking how specific bacterial strains affect fructmal and
to what degree and in what dosages. Some of this research is looking
promising, but at the moment not really usable for the general public.
Probiotics are a bit of a fad right now, and they are being embraced by
many for a wide variety of things. The problem is, what bacterial
strain are you taking? In what dosage? How often? How is it
interacting with your existing intestinal colonies? At the moment,
buying yogurt or getting probiotic supplements is a bit like walking
into a strangers medicine cabinet and grabbing a handful of
multi-coloured pills and assuming they'll be good for you because
they're medicine. Just a little too "russian-roulette".
Now, if like me, your fructmal is medium to mild in severity and
you giving these things a try is not going to result in debilitating or
crippling symptoms - perhaps you want to try something in co-operation
with your GI doctor. Just don't go at it pell-mell, eh? Do some
research into specific strains and what they do (don't just pick a
bacteria at random). Talk to your GI doctor about conservative
dosages. Keep a journal religiously and touch base with your doctor
about how things are going. You need to be absolutely on track with
your eating habits - you don't want to have a reaction and not know
whether it was the bacteria or your dinner that made you sick! No
cheating on the foodplan!
If you are a severe case and have strong reactions, I wouldn't mess
around with anything iffy. Wait until hard data is in from the
research front and there are particular strains in particular doses
that are proven to help.
D.O. from California asks:
Are Corn Starch, Corn Syrup, and Potatoes alright for Fructose Malabsorption?
Corn starch/corn syrup.......corn tolerance seems
to vary by individual. Corn has both fructose and dextrose. As
mentioned on the Diet page of the site, dextrose aids in the absorbtion
of fructose...in small amounts. Different varieties of corn and
different individuals equals different tolerance. Eliminate fresh
corn, corn flour and corn meal for about a month, then reintroduce it
and see how you feel. I don't know of anyone having a problem with
Corn *Starch*. The starch of the corn itself does not seem to have any
The syrup? Well, the media has been talking a lot about HFCS or
High Fructose Corn Syrup. Obviously that is BAD! LOL!! As to regular
corn syrup... again it depends on the brand and your personal
tolerance. However, corn syrup is what is called a "high load"
product...in other words, it's a concentrated form of the sweetness naturally found in corn.
Use it in small amounts with caution until you determine your personal tolerance.
Potatoes...... I have NO issues with potatoes
personally. However, there are other FructMals who have issues with
all but the ones with the thin, red skin. I know I sound like a broken
record, but you have to go off them for about a month, then start
reintroducing. Treat each kind of potato separately. First, say,
start eating russets for a few days and see what happens. If you're
okay, try the ones with the thin yellow skins, etc.
Many people (including me) have had bad experiences with mashed
potatoes, fries, etc in restaurants. That's usually due to onions, or
other problem stuff being added as seasoning. Often, "steak fries" are
breaded with wheat flour...so BIG PROBLEM!
What is the best link you know of for a reliable diet? Some say do not eat asparagus, as yourself, and some say it is fine to eat. There seem to be many contradictions. Also, some say wheat is fine. This is extremely confusing.
The "disconnect" which seems to be occurring with a lot of diet advice is that many authorities do not seem to be making the connection between fructose and FRUCTANS. Every diet agrees on the fructose part of it, of course, staying away from fruit and fruit products as well as anything listing fructose or fructose syrup as an ingredient. Fructans are chains of fructose molecules that terminate in a glucose
molecule. THEY are the nasties in many veggies and wheat, spelt, kamut
and brown rice (not white rice). I
can speak as one who was RELIGIOUSLY off all fruit for 15 years -
and I did not get relief from the gastrointestinal symptoms and the
overpowering depression until I got rid of the wheat family, the onion
family, and the major problem veggies. Researcher Sue Sheppard has a very reliable diet out. This diet is posted at the Fructose Malabsorption Support Site at Yahoo Groups:
If you are on this diet for awhile, do you have to worry about vitamin deficiency?
Any person who is on any kind of restrictive food plan, fructmal, lactose intolerant, vegetarian, etc, must be aware that nutrition must not suffer. I can't speak for everyone, but I've found that my diet has become MORE varied since giving up wheat, because I have discovered amaranth, buckwheat, millet, and other grains. Did you know that amaranth is the only known plant in the world that provides a complete protein, just like meat? Vitamin C is a big concern for me, because other than fruit the biggest source is green leafy veg - which I don't really like! LOL!! I take vitamin C tablets (sourced from seaweed rather than fruit). A big concern for many FructMals is fibre. Most FructMals can eat oats and rye. These are good sources of fibre as are raw carrots and celery. Remember to check the ingredients if you use a fibre supplement. Inulin or FOS is a common ingredient and anything prebiotic (like inulin) should be avoided (as well as anything probiotic).
Is it possible to have FructMal in combination with other gastrointestinal problems?
Absolutely, yes! Not only possible, but quite common. If eliminating fructose helps, but does not eliminate your symptoms, keep looking!
What is Glucodin?
Glucodin is a brand name of glucose/dextrose tablets. They are marketed as an "energy" tablet (which, being sugar, they are). As they are a tablet, many FructMals find them a convenient form of glucose/dextrose to carry around. If you cannot obtain glucose/dextrose as a tablet in your area, the powder is widely available (sometimes called Corn Sugar). For an explanation of why a FructMal would carry glucose/dextrose, check out the Fructose Malabsorption Diet page of the website.
What are FODMAPS?
Fermentable Oligo-, Di-
and Mono-saccharides And Polyols
Fermentable Oligo-, Di-
and Mono-saccharides And Polyols
FODMAPS stands for "Fermentable Oligo-, Di- and Mono-saccharides And Polyols". Woo! Yah, that's a mouthful! Basically, there are a lot of people out there who are having problems with similar gastrointestinal problems (cramps, bloating, diarrhea, etc). Interestingly, though the specifics of the ailments may vary, there is an identifiable "family" of foods that initiate these problems in all cases. These foods are the FODMAPS. Fructose for example, is a mono-saccharide. Lactose is a Di-saccharide. Sorbitol is a Polyol. All these foods (or perhaps ingredients would be a better term?) can cause GI problems in many people.
Rather than the traditional approach of only eliminating select foods based on a person's specific diagnosed condition (be it Fructose Malabsorbtion, Lactose Intolerance, etc), the FODMAPS approach is to eliminate ALL the members of this category of problematic foods.... in essence, casting the net wider, to be on the safe side. Many people feel this is the only way to give the body of a sufferer a truly restorative "rest". For more information on this approach, visit the Research page and click on the link for Clinical Ramifications of Malabsorption of Fructose andOther Short-chain Carbohydrates.
Contact the website with your questions and comments on Fructose Malabsorption or the site itself!
Thanks to Nick G. of Australia, for the compliments on the site!
Thanks to M.R. and D.O. for their questions and interest!
Thanks to Spencer from Manhattan for his compliments!