Fructose Malabsorption and/ or Dietary Fructose Intolerance

UPDATE on December 12, 2011: Thank you for reading about our experience with FM. I have begun a seperate blog that focuses specifically on FM and has more up-to-date information. You can read more about FM at:
Life with Fructose Malabsorption

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Some time ago I mentioned that Rebecca has reoccurring stomach pains. We did eventually see the pediatrician. Actually we never had an appointment, she just asked how Rebecca was doing and in our brief conversation she came up with the idea to have her tested for Fructose Intolerance. She mentioned that she had a patient that was recently diagnosed with this and although uncommon it could be a possibility and worth testing. I think she based this idea on the combinations of two comments I made. I said when we put Rebecca on a high fiber diet her stomach hurt much more. That doesn't really tell you much, but the other thing I told her was the time we noticed she got much worse was when we discovered she had been binging on candy (she had a large coffee tin full of candy when we came back home from the Ronald McDonald House which it's contents disappeared in a rather short period of time). Well we can be thankful our pediatrician was on the ball and knows us well enough to think outside the box for it saved us putting her through a round of tests and we found the answer. Rebecca is now considered Fructose Intolerant.

I will admit that if she hadn't suggested this test I probably would never have followed through on seeing the doctors. I sometimes get the feeling I must be making my kids sick for it seems everytime I turn around something is wrong with one or more of them and we're always at the doctors. It seems all we talk about in our house is medical conditions and then you start to wonder if you're just completely wacko or something, and maybe that's rubbing off on the rest of the family, or maybe I'm brainwashing my kids into thinking every little thing is worth complaining about or more serious then it really is. I ignored Rebecca because she didn't complain too drastically (she never does complain so I should have known better), she appears healthy, is growing well, active etc. So I figured she'd outgrow the problem if I just ignored it. I'm thankful an answer came quickly for otherwise she'd have suffered with stomach issues for a long time since she's not very good at complaining (she should have gotten a few lessons from Marietta and then I would have done something long ago just to keep her quiet :)

So the doctor told us Rebecca is Fructose Intolerant, but after doing some research I'd have to say that she's actually has Fructose Malabsorption (also called by some Dietary Fructose Intolerance). We have a new pediatrician and she said she had never dealt with anyone with Fructose Intolerance, and our normal pediatrician (who is on maternity leave) said she had one case. So this is something more rare again, although in reading it seems it's not really as rare as believed, that many of us suffer from it, we just don't realize it. Anyways, so our doctor classified it as Fructose Intolerance, likely because of lack of knowing the difference and also because this is how it would commonly be referred to to the average person. True Fructose Intolerance (known as HFI - Hereditary Fructose Intolerance) is actually a much more serious disorder where the body does not have the proper enzyme to break down fructose, thus it can cause liver and kidney problems, as well as be fatal. Fructose Malabsoprtion (FM) although not always pleasant it is not life-threatening and is easily manage by diet. FM is an inability for your small intestines to break down fructose. In HFI you must adhere to a very strict diet whereas with FM you can learn to adjust your diet according to what you can tolerate.

So once again we're doing the diet thing in our house. We've done the gestational diabetes diet, the low-protein diet, we're now doing the gluten-free diet, along with milk, soy and rice free (Matthew), so why not add low-Fructose too. We see a dietician next week, which I look forward to as the internet gives a ton of information but is almost making me more confused. At least I had a chance to research before I go so I can ask questions when I get there. It seem that we have to avoid foods that have a higher amount of fructose then glucose in them. For some reason glucose helps breakdown fructose so if the glucose level is higher it will assist the fructose in breaking down and therefore the intestines will not have so much trouble ... so now we have to learn what foods have higher fructose levels then glucose. And if you think that fructose is just in fruit ... think again. Although most common in fruit is is also found in your regular table sugar, honey, corn syrup (a bit one). There is also some mention of fructan which is chains of fructose molecules in foods, such as wheat, onions, asparagus. The bigger challenge is that fructose is not on food labels like protein is, or always in the ingredients list.

We do know that Rebecca's intolerance is not too extreme as she had gone this long without having severe side effects. So she will be able to tolerate basic intake of fructose, but will likely have to tone down on the sweets and fruits. We'll take some time to learn the diet and see how she feels once more careful and then we can start challenging her to see how much she can tolerate. With the sweet tooth Rebecca has this could be an interesting challenge, but hopefully she can feel the results of abiding by the restrictions and that will make it easier. Regardless the effect of not abiding by the diet is not too serious and hopefully enough to put her back in line when needed.

So that's my medical lesson for today!