A beginners guide to fructose malabsorption

This is a beginners guide to fructose malabsorption and a proof that that the most overrated proverb of all times is ‘an apple a day keeps the doctor away’. Fructose malabsorption is a gastrointestinal condition that causes digestive disorder and abdominal pain. I’ve been suffering from fructose malabsorption the past years. In this article I would like to give you a quick overview about fructose malabsorption and scientifically-proven diet suggestions that can help improve your symptoms.


Fructose is a simple carbohydrate, or simple sugar, found in many fruit and veggies. Sometimes it’s also referred to as ‘fruit sugar’. It is used in food manufacturing to sweeten many processed foods and beverages. Fructose can be found as free fructose, bonded to glucose (also a simple sugar) or as part of a fructan. Fructan is a polymer of fructose molecules and for example in onions or garlic.

Fructose Malabsorption

If you suffer from fructose malabsorption your ability to absorb fructose is impaired. When a healthy person eats fructose, it travels to the small intestine where it is absorbed with the help of a specific protein called GLUT-5. If this protein either is not there or has become inactive, the fructose reaches the large intestine, where it is promptly fermented by colonic bacteria to acids and gases (mostly hydrogen, but also methane and carbon dioxide).

This all causes gastrointestinal symptoms and the increase of intestinal bacteria, which transform the fructose. It’s important to know that it’s malabsorption not intolerance. Fructose Malabsorption should not be confused with a serious genetic disorder called hereditary fructose intolerance, which can be life threatening. Hereditary fructose intolerance is diagnosed in early childhood and rather rare. So, fructose malabsorption is rather uncomfortable, but definitely not life threatening.

Symptoms and Diagnosis

Symptoms of fructose malabsorption are caused by extra water and gas in the large intestine. Symptoms include abdominal pain and gas, bloating, nausea, acid reflux, diarrhea, and constipation. But also headache and migraine, acne and depression are often linked to fructose malabsorption.

Fructose malabsorption can be diagnosed using a hydrogen breath test. Most of the gas produced by bacteria in the large intestine moves into the bloodstream and then into the lungs. The hydrogen breath test then measures the amount of hydrogen in our breath.

Treatment and Diet

If you are diagnosed with fructose malabsorption you will start with a zero fructose diet for a few weeks. Your physician in charge will help you with a diet plan. This will give your stomach some time to heal and the good bacteria time to thrive. After a few weeks you will start to let small amounts of fructose back into your diet. Then the main aim is to determine how much fructose your body is able to absorb without causing uncomfortable digestive issues. Fruit and veggies with a 1:1 glucose fructose ratio are usually better to digest than others. For example apricots, blueberries or grapefruit have a similar glucose fructose ratio and work well. But each person and stomach is unique. What works for you might be too much for someone else. Take your time and keep on testing! 

In my experience

Use dextrose powder or grain sugar to sweeten your food or to bake
Eat ripe bananas
From time to time, eliminate all fructose from your diet for a week to give your stomach time to rest
I’ve got a pinterest board with fructosefriendly fruit & veggies that work for my stomach
Try rice syrup instead of honey and maple syrup
If you are consuming fructose, it’s better to do it on a full stomach or with high protein meals
Ditch chewing gum with sorbitol

If you are a fructose malabsorption suffer I would love to hear from your experience. What fruit and veggies work for you, what are your favourite recipes and of course how do you deal with eating away?! I have loads of recipes which might work for you too! Also join my Facebook page or follow me on Instagram. I would love to hear about your experience and bring a few malabsorption sufferers together.