Fructose Intolerance in Children with Functional Abdominal Pain

Author: American College of Gastroenterology
Published: 2010/10/18 - Updated: 2023/06/20
Peer-Reviewed: Yes
Topic: Food Allergies - Publications List

Page Content: Synopsis Introduction Main

Synopsis: With fructose in foods ranging from apples to packaged foods and widespread use of high fructose corn syrup it is difficult to avoid.

• Fructose intolerance is seems to be more prevalent in teenage girls with chronic abdominal pain.

• Over half of patients who are fructose intolerant and are able to maintain a low fructose diet will notice an immediate improvement in their symptoms.

Defining Fructose Intolerance

Fructose Intolerance: Fructose is a natural sugar that's found in fruit, some veggies, and honey. In people with fructose malabsorption - also known as ALDOB deficiency, Aldolase B deficiency, Fructose aldolase B deficiency, Fructose intolerance, Fructose-1,6-biphosphate aldolase deficiency, Fructose-1-phosphate aldolase deficiency, and Fructosemia - the cells of the intestine cannot absorb fructose normally, leading to bloating, diarrhea or constipation, flatulence, and stomach pain. Similarity in symptoms means that patients with fructose malabsorption often fit the profile of those with irritable bowel syndrome. Fructose malabsorption is not to be confused with hereditary fructose intolerance, a potentially fatal condition in which the liver enzymes that break up fructose are deficient. Fructose malabsorption is thought to affect approximately 40 percent of individuals in the Western hemisphere; its cause is unknown.

Introduction

Fructose intolerance, or fructose malabsorption, is common in children with recurrent or functional abdominal pain, but the condition can be effectively managed with a low fructose diet, according to the results of a new study unveiled today at the American College of Gastroenterology's (ACG) 75th Annual Scientific meeting in San Antonio, Texas.

Main Item

The study, "Fructose Intolerance/Malabsorption and Recurrent Abdominal Pain in Children," investigated a total of 245 patients with unexplained chronic abdominal pain alone or associated with constipation, gas or bloating and/or diarrhea 150 of them female (62.1 percent) - who ranged in age from 2 to 18 years old, with a median age of 11.

Fructose intolerance is typically diagnosed by exclusion, according to researchers Daniel Lustig, M.D. and Bisher Abdullah, M.D., pediatric gastroenterologists with the Mary Bridge Children's Hospital and Health Center in Tacoma, WA, who explained that once other GI conditions like Crohn's disease and ulcerative colitis are ruled out, a hydrogen breath test is given to the patient. If the patient's breath hydrogen exceeds 20 points above baseline, then the patient is likely fructose intolerant.

Breath hydrogen test (BHT) for fructose was performed in all patients in the study and it was positive for fructose intolerance in 132 of 245 patients (53.9 percent).

A total of 113 of 245 (46.1 percent) of patients had a negative BHT for fructose intolerance.

All of the 132 patients with a positive BHT for fructose had a nutritional consult with a registered dietitian and were placed on a low fructose diet.

Using a standard pain scale for children, 88 of the 132 patients (67.7 percent) reported resolution of symptoms on a low fructose diet.

"With fructose in so many foods, ranging from apples to packaged foods with the wide spread use of high fructose corn syrup, it is difficult to avoid, so the challenge is finding those foods with low fructose and still maintain a healthy nutritional balance that patients will adhere to," said Dr. Lustig, "especially teenagers."

He said fructose intolerance is seems to be more prevalent in teenage girls with chronic abdominal pain. In his practice, Dr. Lustig said he typically sees three or four teenage girls a week with either a new diagnosis of fructose intolerance or for follow-up.

"But the good news is that over half of patients who are fructose intolerant and are able to maintain a low fructose diet will notice an immediate improvement in their symptoms," concluded Dr. Lustig.

Attribution/Source(s):
This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its significant relevance to the disability community. Originally authored by American College of Gastroenterology, and published on 2010/10/18 (Edit Update: 2023/06/20), the content may have been edited for style, clarity, or brevity. For further details or clarifications, American College of Gastroenterology can be contacted at gi.org. NOTE: Disabled World does not provide any warranties or endorsements related to this article.