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Open Access 01-12-2024 | Fructose Malabsorption | Research

Fructose malabsorption and fructan malabsorption are associated in patients with irritable bowel syndrome

Authors: Twan Sia, Riki O. Tanaka, Albert Mousad, Aditya P. Narayan, Kristen Si, Leeon Bacchus, Hind Ouerghi, Aashka Patel, Arnav Patel, Evan Cunningham, Taylor Epstein, Jerry Fu, Stanley Liu, Raisa Khuda, Paige McDonald, Shibani Mallik, Joanna McNulty, Michelle Pan, John Leung

Published in: BMC Gastroenterology | Issue 1/2024

Abstract

Background

Food malabsorption and intolerance is implicated in gastrointestinal symptoms among patients with irritable bowel syndrome (IBS). Key triggers include fructose and fructan. Prior studies examined fructose and fructan malabsorption separately in IBS patients. None have concurrently assessed both within the same patient group. We aimed to investigate the association between fructose and fructan malabsorption in the same patients with IBS using hydrogen breath testing (HBT).

Methods

We retrospectively identified patients with IBS who underwent fructose and fructan HBTs and abstracted their results from the electronic medical record. Fructose and fructan HBTs were performed by administering a 25 g fructose solution or 10 g fructan solution, followed by breath hydrogen readings every 30 min for 3 h. Patients were positive for fructose or fructan malabsorption if breath hydrogen levels exceeded 20 ppm.

Results

Of 186 IBS patients, 71 (38.2%) were positive for fructose malabsorption and 91 (48.9%) were positive for fructan malabsorption. Of these patients, 42 (22.6%) were positive for fructose malabsorption and fructan malabsorption. Positive fructose HBT readings were significantly associated with positive fructan HBT readings (p = 0.0283). Patients positive for fructose malabsorption or fructan malabsorption had 1.951 times higher odds of testing positive for the other carbohydrate.

Conclusions

Our results reveal a clinically significant association between fructose malabsorption and fructan malabsorption in patients with IBS. Fructan malabsorption should be assessed in patients with fructose malabsorption, and vice versa. Further studies are required to identify the mechanisms underlying our findings.

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Title: Fructose malabsorption and fructan malabsorption are associated in patients with irritable bowel syndrome
Authors: Twan Sia
Riki O. Tanaka
Albert Mousad
Aditya P. Narayan
Kristen Si
Leeon Bacchus
Hind Ouerghi
Aashka Patel
Arnav Patel
Evan Cunningham
Taylor Epstein
Jerry Fu
Stanley Liu
Raisa Khuda
Paige McDonald
Shibani Mallik
Joanna McNulty
Michelle Pan
John Leung
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Fructose Malabsorption
Irritable Bowel Syndrome
Published in: BMC Gastroenterology / Issue 1/2024
Electronic ISSN: 1471-230X
DOI: https://doi.org/10.1186/s12876-024-03230-x

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