Tummy troubles tend to be common in kids, but when the situation becomes chronic and abdominal cramps become part of your life, it is important to investigate a bit more. Consult your doctor to have some testing done to rule out any serious medical conditions, such as inflammatory bowel diseases and celiac disease. If these serious conditions are ruled out, look into food sensitivities and intolerances to certain nutrients found in foods, such as fructose.
Fructose Malabsorption vs. Dietary Fructose Intolerance
Fructose intolerance is most often called fructose malabsorption to better distinguish it from another condition called dietary fructose intolerance. Dietary fructose intolerance is a rare condition that requires a strict avoidance of fructose. Follow your doctor and registered dietitian advice if you are diagnosed with dietary fructose intolerance. Regular fructose intolerance, or fructose malabsorption, corresponds to an inability to fully absorb fructose. This condition can appear at any ages and is associated with many distressing gastrointestinal symptoms.
Symptoms
If a child is intolerant to fructose because she cannot absorb it properly, the fructose that stays unabsorbed in her gut will get fermented. This fermentation process can produce a large volume of gas, which creates abdominal distension, or bloating, as well as abdominal discomfort, pain and cramping. You may also notice changes in the gut motility of your child, such as diarrhea, constipation, or alternating diarrhea and constipation. These symptoms are not specific to fructose intolerance and this is why it is important to get tested to establish the source of these gastrointestinal symptoms, especially in kids.
Testing
Fructose malabsorption is diagnosed with a hydrogen or methane breath test. This test may be difficult to perform in toddlers and very young children because it requires the patient to blow in a bag at regular intervals after drinking a fructose-containing solution. This fructose breath test should be done after doing a baseline test with a sugar called lactulose to determine whether your child produces more hydrogen or methane as a result of malabsorbing fructose. If your child's results indicate high levels of fructose in the two- to three-hour period after ingesting fructose, your child will be diagnosed with fructose intolerance.
Diet
Being diagnosed with fructose intolerance can allow your child to lessen and eventually completely eliminate her abdominal cramps by avoiding high-fructose foods. The main foods to avoid with fructose malabsorption include honey, agave syrup, high-fructose corn syrup and foods sweetened with these sugars. Apples, pears, watermelon, mangoes and cherries as well as fruit juices and dried fruits should also be avoided. You can use regular sugar and maple syrup to safely sweeten your child's food without causing abdominal cramping. Fruits like bananas, cantaloupe, blueberries, oranges and strawberries are better tolerated and can be included in your child's diet, but keep the servings small and spread them throughout the day to prevent any gastrointestinal problems.
References
- "Journal of Hepatology & Gastroenterology"; Evidence-Based Dietary Management of Functional Gastrointestinal Symptoms: The FODMAP Approach; Peter R. Gibson; October 2009
- "The Low FODMAP Diet -- Reducing Poorly Absorbed Sugars to Control Gastrointestinal Symptoms"; Eastern Health Clinical School -- Monash University; 2011
- Shepherd Works: Hydrogen Breath Testing
- "IBS -- Free at Last!: A Revolutionary, New Step-by-Step Method for Those Who Have Tried Everything. Control IBS Symptoms by Limiting FODMAPS Carbohydrates in Your Diet"; Patsy Catsos; 2009
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