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  • Q&A with Australian Health Practitioners

    How is fructose intolerance diagnosed?

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    Joy Anderson

    Dietitian, Nutritionist

    Joy is an Accredited Practising Dietitian and Accredited Nutritionist, as well as an International Board Certified Lactation Consultant (IBCLC). She has a special interest in … View Profile

    There are two ways to diagnose fructose intolerance. One is to reduce the amount of foods that are known to be high in excess fructose and see if the symptoms go away, then eat them again to see if symptoms return. The other is to have a breath test. In the breath test, the person is given a standard dose of fructose to consume and the breath is measured a little later for gases produced by the bowel flora when the bacteria metabolise the unabsorbed fructose. The gases diffuse from the bowel into the body and are exhaled by the lungs. The more of these gases in the breath, the less of the fructose was absorbed.

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    Jaci Barrett is an accredited practising dietitian and one of the leading Monash University researchers involved in the development of the Low FODMAP Diet for … View Profile

    Just to confirm you are asking about fructose malabsorption rather than heriditary fructose intolerance. These are separate. Heriditary fructose intolerance is diagnosed at birth. It is a life-threatening condition. Fructose malabsorption is the poor absorption of fructose that can lead to changes in motility and gas production in the bowel contributing to symptoms of irritable bowel syndrome. Fructose malabsorption is not an abnormality; 33% of healthy people malabsorb fructose without any trouble. The condition is irritable bowel syndrome and when individuals with IBS malabsorb fructose (and other poorly absorbed fermentable carbohydrates), symptoms occur.
    You need a diagnosis of IBS or another functional gut disorder first through your GP, gastroenterologist or specialist dietitian. Then, your dietitian can refer you for appropriate and individualised breath tests for a variety of potential culprits like fructose, or they can start you on a diet reduced in all potential poorly absorbed carbohydrates and you can assess triggers through an elimination and rechallenge process. Just remember, fructose intolerance/malabsorption is not the condition. Rather it is an indicator of what causes your IBS symptoms

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