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Sophia asked...

I have been diagnosed with IBS.

I have been diagnosed as having IBS, but my symptoms seem identical to fructose malabsorption. How can I lose weight and reduce fructose intake since fruits and a lot of vegetables seem to be off limits for me?

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The answer

Fructose malabsorption used to be called fructose intolerance, is a digestive disorder in which your gut is not efficient at absorbing fructose into the body. This results in high levels of fructose in the gut, and this in turn can cause symptoms very similar to the bloating, abdominal pain and change in bowel habit seen in irritable bowel syndrome. This often means that the two conditions are confused, although interestingly on testing the proportion of IBS sufferers found to have fructose malabsorption is no higher than the proportion in the general population.

There has been great interest in a new diet, called the ‘FODMAPS’ diet, for the management of symptoms of IBS. Many of the foods excluded in the FODMAPS diet are high in fructose.
Researchers in Australia have developed helpful guidelines for reducing fructose in your diet while still having a healthy balanced diet (http://sacfs.asn.au/download/SueShepherd_sarticle.pdf).
For instance, fruit and vegetables which appear to have a favourable ratio of glucose to fructose, and are therefore less likely to cause problems, include :

  • Stone fruit: apricot, nectarine, peach, plum (although these contain sorbitol so are worth avoiding if you want to follow the FODMAPS diet)
  • Berry fruit: blueberry, blackberry, cranberry, raspberry, strawberry
  • Citrus fruit: kumquat, grapefruit, lemon, lime, mandarin, orange
  • Other fruits: ripe banana, kiwi fruit, passion fruit, pineapple, rhubarb
  • Breads etc: gluten free bread and pasta, any rice products (including rice noodles), porridge, cornflakes

Foods to try and avoid include onion, garlic, beetroot, leek, wheat, rye, brussel sprouts, cabbage, Jerusalem artichokes, cherries, apples, nectarines, peaches and pears.

Answered by Dr Sarah Jarvis.


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