Fructose and Fructans and FODMAPS

One of the best treatments for Irritable Bowel Syndrome, or the symptoms of IBS is the low FODMAP diet, where you restrict the amount of those Carbohydrates that ferment in the gut, causing pain, cramping, bloating or changes in bowel habits. For some of us the symptoms are unbearable, for others the flying rush to the toilet every day makes going out impossible but what is the diet about.

For the purpose of this post I am focussing on the Fructans and Fructose which are two of the groups of foods restricted in a low FODMAP diet.

Around 1 in 3 people are affected by Fructose malabsorption, but for most of us the symptoms are mild. During digestion we have fructose "carriers" in the small intestine which take the fructose to where it can be digested, but if our small intestine is a little more sensitive than normal, the fructose builds up in the large intestine and the fermentation process causes excessive symptoms. Avoid this by:-

- reducing processed and highly refined foods - reducing stress - keeping the balance of gut bacteria in check by eating a good healthy diet with lots of vegetables. With the help of an Accredited Practising Dietitian, eliminating fructose from your diet for a period of time to assess the effect of the change can be the first step to finding out whether you have an intolerance to Fructose. Foods high in Fructose include:- - pears and apples - pear and apple juice - honey - many processed foods containing high levels of fructose

If you have a Fructose intolerance you may also experience an intolerance to Fructans as they are digested in a similar fashion as Fructan molecules are made up of Fructose units.

Fructans include:-

- Wheat including pasta, bread, couscous - Onions and shallots - Garlic - Barley - Brussels Sprouts, cabbage - Inulin If you see some foods here that you feel cause digestive issues, you are advised to speak to a Dietitian who specialises in Bowel Health and the low FODMAPS diet to discuss your best options. Your Dietitian can assess you and direct you to an appropriate diet, which may be a low FODMAPS diet, an elimination diet or a different approach for best results. References Fedewa, A., & Rao, S. S. (2014). Dietary Fructose intolerance, fructan intolerance and FODMAPS. Current Gastroenterology, 16(1), 370.