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Stomach Pain & Apples

Jul 5, 2011 | By Ashley Jacob
Stomach Pain & Apples
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The common adage, "An apple a day keeps the doctor away," may not be true for everyone, especially if you have specific food intolerances that cause you to have stomach pain and other gastrointestinal issues when you eat apples. Although apples are a healthy and natural food, some sensitive individuals may not tolerate their high fructose, sorbitol or salicylate content. These compounds are found in many other foods besides apples. Your doctor and registered dietitian can help you identify the problematic compounds that cause your pain so you can eliminate other potentially problematic foods from your diet.

Excess Fructose Content

If your stomach hurts after eating an apple, you could have fructose malabsorption, a condition characterized by a difficulty to properly absorb fructose. The most common symptoms include abdominal pain, cramping, bloating, diarrhea and constipation. Some fruits, such as apples, cherries, watermelon, pears and mangoes, contain more fructose than glucose and can cause gastrointestinal problems for people dealing with fructose malabsorption. For example, a large apple contains 13.2 g of fructose and 5.4 g of glucose. Fruits with more glucose than fructose, such as kiwi, oranges and cantaloupe, are usually better tolerated because glucose helps with the absorption of fructose.

Polyol Content

Sorbitol malabsorption is another disorder that could be responsible for your gastrointestinal symptoms after eating apples. Sorbitol is a type of polyol, or sugar alcohol, found not only in apples, but also in pears, peaches, apricots, nectarines and avocado. It is not uncommon for people to have problems absorbing or tolerating more than one compound, and fructose and sorbitol malabsorption are often seen together. Moreover, sorbitol impairs the proper absorption of fructose, which explains why eating a fruit that is high both in fructose and sorbitol can exacerbate your stomach pain.

Fructose and Sorbitol Malabsorption

Both fructose and sorbitol malabsorption can be diagnosed with a hydrogen breath test that is very similar to the test done to diagnose lactose intolerance. To start the test, you will take either a high-fructose or high-sorbitol drink that you will have to consume within five minutes. Every 20 to 30 minutes for a total of two to three hours, a sample of your breath will be taken and analyzed to check the amount of hydrogen it contains. If your breath has high hydrogen levels, which indicates that you have not absorbed the given sugar and that it is being fermented in your intestines, you will be diagnosed with either fructose or sorbitol malabsorption. If you have either of these conditions, consult a registered dietitian to get a list of foods to eliminate, in addition to apples, from your diet to stay pain-free.

Natural Food Chemicals

If your hydrogen breath tests show that you do not have fructose nor sorbitol malabsorption, you may be reacting to the natural food chemicals found in apples. Salicylate is one of the natural food chemicals found in apples. Most people do not react to salicylates, but sensitive people can have gastrointestinal symptoms when eating high-salicylate foods. Salicylates are mostly found in the peel of the apple, so try peeling your apples to see if you tolerate them better. It would be wise to consult with a healthcare professional with experience in the field of food intolerances to help you find what compound in apples or other foods is causing your stomach pain.

References

Article reviewed by MER Last updated on: Jul 5, 2011

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