Sorbitol & Fructose

Watermelon
A close-up of watermelon. (Image: yasson7/iStock/Getty Images)

Many people suffering from irritable bowel syndrome, or IBS, or with gastrointestinal issues, including bloating, constipation, diarrhea, flatulence and abdominal pain, believe that some foods may trigger their symptoms. However, pinpointing the exact foods that are responsible for causing your symptoms can be quite difficult when you are not sure what compounds you tolerate. Fructose and sorbitol are two types of sugars that occur naturally in many foods. Some people have trouble absorbing them properly, resulting in many common gastrointestinal problems.

Fructose

If you have fructose malabsorption, avoid foods that contain more fructose than glucose including watermelon, apples, pears, mangoes and cherries, as well as asparagus, artichoke and tomato paste. Consuming large amounts of fructose at once, even though the amount does not exceed the amount of glucose, can also cause problems. As such, avoid fruit juices, dried fruits or eating too many servings of fruits at once. High-fructose corn syrup, agave syrup and honey are also problematic with fructose malabsorption. Avoid these sweeteners and check the labels of your foods and beverages to ensure they do not contain high-fructose sweeteners.

Sorbitol

Sorbitol is mainly found in fruits, such as apples, pears, nectarines, plums, apricots and blackberries. Avoid these fruits. Smaller amounts are also found in avocados, cherries and lychees, which most people with fructose malabsorption can generally tolerate in small quantities. Check the ingredient list of your foods to ensure they are free of sorbitol, isomalt, xylitol or mannitol. Foods likely to include these ingredients are sugar-free ice creams, sugar-free chocolate and sugar-free chewing gums and mints. These ingredients can all contribute to your gastrointestinal symptoms.

Elimination Diet

To determine whether fructose and sorbitol are responsible for your gastrointestinal problems, try an elimination diet, which involves completely eliminating all potentially problematic foods from your diet for at least two weeks, but ideally up to 4 to 6 weeks. If fructose and sorbitol are problematic, you should experience relief within a few weeks. After the elimination phase, you can try reintroducing some sorbitol or fructose into your diet to determine your tolerance and confirm what foods are causing your problems. A dietitian can assist you with your elimination diet and can help you determine your trigger foods.

Low-Fructose and Sorbitol-Free Foods

If you need to eliminate foods with excess fructose and stay away from sorbitol, opt for fruits like oranges, kiwifruits, banana, blueberry, grapes and honeydew melon. Vegetables like red bell peppers, cucumber, lettuce, carrot, Swiss chards, zucchini and turnip are usually well-tolerated. Choose sweeteners that contain equal amounts of glucose and fructose, such as regular sugar or maple syrup, but keep the servings small to prevent problems.

Special Considerations

Many people suffering from fructose and sorbitol malabsorption often have trouble digesting other short-chain fermentable carbohydrates such as lactose, fructans, galactans and mannitol. These sugars are found in dairy products, onions, broccoli, wheat, rye, legumes, mushrooms, cauliflower and sweet potatoes. Consult a registered dietitian to determine what foods could be problematic in your diet.

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