What is Fructose Intolerance and How to Manage it?

Have you ever experienced bloating, abdominal pain, or diarrhoea? It might be due to fructose intolerance. Like glucose, fructose is also a type of sugar. It also occurs naturally in some healthy food such as honey, fruits, and vegetables.

What is Fructose Intolerance?

For our body to use fructose, the liver has to convert and absorb it. But the medical condition when our body is unable to digest it is called fructose intolerance. A person having fructose intolerance may experience symptoms like diarrhoea, bloating, gas, etc.

People with more severe form of fructose intolerance known as hereditary fructose intolerance would develop symptoms in infancy. Without treatment, they may develop life-threatening complications like kidney and liver failure.

What are the Types of Fructose Intolerance?

Fructose intolerance may be of three types: fructose malabsorption, essential fructosuria and hereditary fructose intolerance.

Fructose Malabsorption

Fructose Malabsorption is a common disorder in the western hemisphere. If you have this condition, your body cannot digest fructose . Thus, the fructose passes onto the large intestine and causes problems like gas and bloating.

Several factors, including genetics, lifestyle, and fructose consumption, play a part in causing fructose malabsorption.

Essential Fructosuria

Essential fructosuria is the most harmless type of the three. It is so negligible that you might not even have any symptoms or be aware that you have it.

Hepatic fructokinase is a liver enzyme that can break fructose for your body to absorb. Lack of this enzyme causes this condition. Hence, it is also sometimes called hepatic fructokinase deficiency.

You can also develop it due to genetics, but only if you get both parents’ genes. If you get it from a single parent, you will be a carrier.

Hereditary fructose intolerance

It is the most harmful type of fructose intolerance and can be fatal. Lack of or inactivity of a liver enzyme called fructose-1-phosphate aldolase causes hereditary fructose intolerance. The symptoms are usually developed at infancy when fructose becomes a part of the diet.

When the liver is unable to digest fructose, it gets accumulated. The accumulation can lead to liver and kidney problems.

What are the Symptoms of Fructose Intolerance?

Symptoms depend on the type. Essential fructosuria does not develop any symptoms nor requires treatment. But the other two types can show the following signs:

Symptoms of Fructose Malabsorption

Primary symptoms of fructose malabsorption include:

• Bloating
• Diarrhea
• Gas
• Nausea

Symptoms of Hereditary Fructose Intolerance

Usually, the symptoms of hereditary fructose intolerance develop during infancy. Some common symptoms are:

• Physical development delays
• Jaundice
• Hyperventilation
• Dislike of sweets
• Vomiting
• Liver or kidney failure

When to See a Doctor for Fructose Intolerance?

If you have fructose malabsorption symptoms, you can reduce the amount of fructose in your diet to see the results. But if the symptoms do not improve, it is best to see a doctor.

When it comes to hereditary fructose intolerance, immediate medical help is essential. Usually, the symptoms develop at infancy. Hence, if your child shows any signs mentioned above,  constantly falls ill and exhibits growth delays , seek medical help. Let your doctor know about any family history.

Since hereditary fructose intolerance is life-threatening, it is best to take professional help. You can reach out to or contact the nearest branch of Apollo Hospitals.

Request an appointment at Apollo Hospitals

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How do Doctors Diagnose Fructose Intolerance?

The diagnosis again depends on the type of fructose intolerance. If you face malabsorption symptoms, your doctor may perform a breath test or suggest an elimination diet.

The breath test helps to detect hydrogen levels. The high presence of hydrogen is an indicator that you might have difficulty digesting fructose. The elimination diet is when your doctor will ask you to avoid any fructose containing  food to monitor the results.

If your baby is suffering from hereditary fructose intolerance symptoms, your doctor may perform a liver biopsy or feeding test.

Liver biopsy can confirm the lack of or inactivity of the fructose-1-phosphate aldolase enzyme that causes the condition. On the other hand, for the feeding test, the doctor will deliver a fructose-rich diet to your baby using an intravenous needle to monitor how the body reacts. 

There’s also an option of a DNA test. It is safer than the traditional methods and can help diagnose fructose intolerance.

How to Treat Fructose Intolerance?

The best and only treatment for fructose intolerance is reducing the amount of fructose in your diet. The reduction depends on the type and how much fructose your body can tolerate.

If you have fructose malabsorption, reduce the amount and track your diet. The symptoms will usually go within five or six weeks. Once the symptoms fade, you can start by taking a small amount of fructose and track how much your body can digest.

The only solution for hereditary fructose intolerance is a fructose-free diet. Avoid consuming any  fructose. This might require avoiding numerous foods and drinks.

Thus, you cannot treat fructose intolerance; instead, you have to manage it.

How to Manage Fructose Intolerance?

To manage fructose intolerance, you will first have to keep a diary log to track your fructose intake. The next step is to avoid fructose. This means avoiding the following fructose-rich foods:

• Fruits
• Fruit juices
• Candies and gums
• Alcohol
• Molasses
• Honey
• Sorghum
• Soda
• Sorbitol
• FODMAP foods  (fermentable oligo-, di-, monosaccharides, and polyols)

It will also help if you check the nutritional information of all packaged foods and drinks. If the nutritional list contains fructose or even high sugar, it is best to avoid it.

Reducing or altogether avoiding, in case of hereditary fructose intolerance, are the only ways to manage fructose intolerance.

Conclusion

While you can easily manage fructose malabsorption, it can be challenging to manage hereditary fructose intolerance. Hence, it is best to seek medical help. You can take help from dieticians and nutritionists to create a fructose-free diet. You can contact the nearest Apollo Hospitals branch for help. Apollo Hospitals is home to some of the best doctors worldwide who can provide you with complete assistance to eliminate fructose intolerance symptoms and lead a normal  life.

Frequently Asked Questions (FAQs)

Are there any complications of fructose intolerance?

While essential fructosuria and fructose malabsorption do not have any significant complications, hereditary fructose intolerance can be fatal. Fructose gets accumulated in the liver and kidney in hereditary fructose intolerance. If not managed, the fructose level can increase, leading to seizures, coma, and even death due to liver and kidney failurs.

Who is at most risk of having fructose intolerance?

You are at risk of fructose malabsorption if you have any of the following medical conditions:

• Irritable Bowel Syndrome (IBS)
• Crohn’s disease
• Colitis
• Celiac disease

For hereditary fructose intolerance, genetics is a risk factor, and infants are at the most risk.

What causes fructose intolerance?

Fructose malabsorption can be due to:

• Gut issues
• Imbalance of bacteria in the gut
• Inflammation
• High-intake of refined foods

Hereditary fructose intolerance results from mutations in the ALDOB gene that helps make  the aldolase enzyme.

What are the other names for hereditary fructose intolerance?

Some other names of hereditary fructose intolerance include:

• Fructose-1-phosphate aldolase deficiency
• ALDOB deficiency
• Aldolase B deficiency
• Fructosemia
• Fructose aldolase b deficiency

How many people are affected by fructose intolerance?

Fructose malabsorption is a common disorder affecting around 40% of the western hemisphere population or 1 in 3 people worldwide.

Hereditary fructose intolerance is a rare genetic disorder affecting 1 in every 20,000 to 30,000 people.