Fructose- and Sorbitol-reduced Diet Improves Mood and Gastrointestinal Disturbances in Fructose Malabsorbers

Ledochowski, Maximilian; Widner, Bernhard; Bair, Henry; Probst, Tamara; Fuchs, Dietmar

doi:10.1080/003655200451162

Cited by 85 publications

(20 citation statements)

References 21 publications

(24 reference statements)

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“…The result was believed to be associated with increased fermentation of carbohydrates [40]. In support of this study, fructose elimination diet was found to improve symptoms of depression as well as gastrointestinal symptoms [41]. Likewise, probiotics could also alleviate the depression-like behaviors in adult mice [42].…”

Section: Discussionsupporting

confidence: 57%

Methylglyoxal Induces Systemic Symptoms of Irritable Bowel Syndrome

et al. 2014

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Patients with irritable bowel syndrome (IBS) show a wide range of symptoms including diarrhea, abdominal pain, changes in bowel habits, nausea, vomiting, headache, anxiety, depression and cognitive impairment. Methylglyoxal has been proved to be a potential toxic metabolite produced by intestinal bacteria. The present study was aimed at investigating the correlation between methylglyoxal and irritable bowel syndrome. Rats were treated with an enema infusion of methylglyoxal. Fecal water content, visceral sensitivity, behavioral tests and serum 5-hydroxytryptamine (5-HT) were assessed after methylglyoxal exposure. Our data showed that fecal water content was significantly higher than controls after methylglyoxal exposure except that of 30 mM group. Threshold volumes on balloon distension decreased in the treatment groups. All exposed rats showed obvious head scratching and grooming behavior and a decrease in sucrose preference. The serum 5-HT values were increased in 30, 60, 90 mM groups and decreased in 150 mM group. Our findings suggested that methylglyoxal could induce diarrhea, visceral hypersensitivity, headache as well as depression-like behaviors in rats, and might be the key role in triggering systemic symptoms of IBS.

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Section: Discussionsupporting

confidence: 57%

Methylglyoxal Induces Systemic Symptoms of Irritable Bowel Syndrome

et al. 2014

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“…Although these results are promising, the latter two studies do not characterize the fructose content of the diet, either before or after instruction. In one of the few articles to report baseline dietary fructose intake, Ledochowski et al (2000) showed that fructose malabsorption was defined by an increase of 20 ppm of hydrogen over baseline following provision of a 50 g fructose load. Based on a dietary questionnaire, the mean daily total fructose intake of malabsorbing subjects was 20 g prior to the intervention and 5 g after dietary instruction to reduce both fructose and sorbitol intake.…”

Section: Resultsmentioning

confidence: 99%

Fructose Malabsorption and Intolerance: Effects of Fructose with and without Simultaneous Glucose Ingestion

Latulippe

Skoog²

2011

Critical Reviews in Food Science and Nutrition

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Concern exists that increasing fructose consumption, particularly in the form of high-fructose corn syrup, is resulting in increasing rates of fructose intolerance and aggravation of clinical symptoms in individuals with irritable bowel syndrome. Most clinical trials designed to test this hypothesis have used pure fructose, a form not commonly found in the food supply, often in quantities and concentrations that exceed typical fructose intake levels. In addition, the amount of fructose provided in tests for malabsorption, which is thought to be a key cause of intolerance, often exceeds the normal physiological absorption capacity for this sugar. To help health professionals accurately identify and treat this condition, this article reviews clinical data related to understanding fructose malabsorption and intolerance (i.e., malabsorption that manifests with symptoms) relative to usual fructose and other carbohydrate intake. Because simultaneous consumption of glucose attenuates fructose malabsorption, information on the fructose and glucose content of foods, beverages, and ingredients representing a variety of food categories is provided.

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“…The symptoms of fructose malabsorption (which may affect approx. 30% of the European population) for instance are characterized by the inability to absorb fructose in the small intestine leading to bloating, cramps, osmotic diarrhea and other symptoms of irritable bowel syndrome which can be seen in about 50% of fructose malabsorbers [2]. Low serum tryptophan and signs of folic acid and/or zinc deficiency can also be linked with the inability to absorb fructose efficiently [3].…”

Section: Introductionmentioning

confidence: 99%

The importance of methane breath testing: a review

Costello¹,

Ledochowski²,

Ratcliffe³

2013

J. Breath Res.

161

132

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Sugar malabsorption in the bowel can lead to bloating, cramps, diarrhea and other symptoms of irritable bowel syndrome as well as affecting absorption of other nutrients. The hydrogen breath test is now a well established noninvasive test for assessing malabsorption of sugars in the small intestine. However, there are patients who can suffer from the same spectrum of malabsorption issues but who produce little or no hydrogen, instead producing relatively large amounts of methane. These patients will avoid detection with the traditional breath test for malabsorption based on hydrogen detection. Likewise the hydrogen breath test is an established method for small intestinal bacterial overgrowth (SIBO) diagnoses. Therefore, a number of false negatives would be expected for patients who solely produce methane. Usually patients produce either hydrogen or methane, and only rarely there are significant co-producers, as typically the methane is produced at the expense of hydrogen by microbial conversion of carbon dioxide. Various studies show that methanogens occur in about a third of all adult humans; therefore, there is significant potential for malabsorbers to remain undiagnosed if a simple hydrogen breath test is used. As an example, the hydrogen-based lactose malabsorption test is considered to result in about 5-15% false negatives mainly due to methane production. Until recently methane measurements were more in the domain of research laboratories, unlike hydrogen analyses which can now be undertaken at a relatively low cost mainly due to the invention of reliable electrochemical hydrogen sensors. More recently, simpler lower cost instrumentation has become commercially available which can directly measure both hydrogen and methane simultaneously on human breath. This makes more widespread clinical testing a realistic possibility. The production of small amounts of hydrogen and/or methane does not normally produce symptoms, whereas the production of higher levels can lead to a wide range of symptoms ranging from functional disorders of the bowel to low level depression. It is possible that excess methane levels may have more health consequences than excess hydrogen levels. This review describes the health consequences of methane production in humans and animals including a summary of the state of the art in detection methods. In conclusion, the combined measurement of hydrogen and methane should offer considerable improvement in the diagnosis of malabsorption syndromes and SIBO when compared with a single hydrogen breath test.

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Fructose- and Sorbitol-reduced Diet Improves Mood and Gastrointestinal Disturbances in Fructose Malabsorbers

Cited by 85 publications

References 21 publications

Methylglyoxal Induces Systemic Symptoms of Irritable Bowel Syndrome

Methylglyoxal Induces Systemic Symptoms of Irritable Bowel Syndrome

Fructose Malabsorption and Intolerance: Effects of Fructose with and without Simultaneous Glucose Ingestion

The importance of methane breath testing: a review

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