Fructose malabsorption is a condition in which you are not able to absorb fructose, a sugar found in fruits and various sweeteners. Unabsorbed fructose is fermented in your intestines and result in bloating, abdominal pain, flatulence, diarrhea and constipation as well as fatigue. The only way to manage fructose malabsorption is by restricting sources of fructose in your diet. Probiotics, or friendly bacteria that can improve the quality of your gut flora, are rising in popularity and recommended to improve digestive health. However, caution is required if you wish to use probiotics with fructose malabsorption.
Elimination Phase
After being diagnosed with fructose malabsorption, you should be referred to a qualified registered dietitian to help you get started. An elimination diet comprising only safe foods with a low free fructose content and low fructose load will help you get rid of most of your symptoms. An elimination diet should be followed for at least four weeks before attempting any challenge of consuming potentially problematic foods. During the elimination phase, it is best to stick to the same safe foods and avoid changing other factor that may impact your symptoms. For this reason and to ensure you have clear results, you should not start or stop using supplements, such as probiotics, during this phase. When you start introducing probiotics to your diet, document how it makes you feel.
Bifidobacteria
One of the potential problem with fructose malabsorption is the excess production of gas by the bacteria in the intestinal tract. This is why adding probiotics can sometimes exacerbate your symptoms if you have fructose malabsorption. Bifidobacteria is probably the best choice in terms of probiotics because it doesn't produce gas, unlike other types of bacteria, as shown in a study published in the February 1998 issue of the "Journal of Nutrition." When buying supplements, look for good quality brands that have clinical studies documenting their role in human health.
Watch for Prebiotic
Some probiotic supplements can contain prebiotics. Prebiotics are food for the probiotic and healthy bacteria and help you to maintain a healthy and favorable gut flora. Some of the prebiotics that are most often used include insulin and fructooligosaccharides, which are chains of fructose that may be problematic for people with fructose malabsorption. Carefully check the ingredient list of any supplements, including probiotics, before buying to ensure they do not contain potentially problematic ingredients.
Start Small
Whenever introducing something new to your diet, it is always prudent to start small to test how your body react to it, as recommended by registered dietitian Patsy Catsos, MS, RD, author of the book "IBS--Free At Last!" You can start with a small dose for a week and then slowly work your way up to an amount that is comfortable for you. If you are critically ill or are immunocompromised or take immune-suppressing drugs, talk to your doctor before starting taking probiotics.
References
- MayoClinic.com: Fructose Intolerance
- "Journal of the American Dietetic Association"; Fructose Malabsorption and Symptoms of Irritable Bowel Syndrome: Guidelines for Effective Dietary Management; Susan J. Shepherd and Peter R. Gibson; 2006
- "Journal of Nutrition"; Consumption of Exogenous Bi?dobacteria Does Not Alter Fecal Bi?dobacteria and Breath Hydrogen Excretion in Humans; Mary M. Amann, et al.; February 1998
- IBSFree.net; How do Probiotics Fit In On a FODMAPs Elimination Diet?; April 2011
- IBSFree.net; Probiotics and FODMAPS; February 2009
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