Fructose Intolerance Symptoms

Ricarda Schwarz studied medicine in Würzburg, where she also completed her doctorate. After a wide range of tasks in practical medical training (PJ) in Flensburg, Hamburg and New Zealand, she is now working in neuroradiology and radiology at the Tübingen University Hospital.

More about the experts All content is checked by medical journalists.

The most common symptoms of acquired fructose intolerance include gas and diarrhea. Other digestive problems are also possible. In addition, various health disorders and diseases can occur as a result of or accompanying fructose malabsorption, for example a vitamin deficiency or depression. Here you can find out more about the most important fructose intolerance symptoms - both acquired and congenital!

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. E74

Acquired fructose intolerance: symptoms

Flatulence and diarrhea are the most common symptoms of acquired fructose intolerance. Other symptoms such as abdominal cramps can also occur. Often, a resulting lack of nutrients and concomitant diseases also cause discomfort for those affected.

Guiding symptoms

In the case of acquired fructose intolerance (fructose malabsorption), the body can only absorb fructose to a limited extent or not at all in the small intestine. The fructose reaches the large intestine, where it is broken down by bacteria. This creates hydrogen, carbon dioxide and short-chain fatty acids. The gaseous carbon dioxide can accumulate in the intestines and cause flatulence. The short-chain fatty acids allow water to flow into the inside of the intestine. This causes the stool to liquefy and the affected person gets diarrhea.

These two fructose intolerance symptoms - flatulence and diarrhea - are considered to be the leading symptoms of the disease. Nevertheless, they do not occur in every person affected!

More symptoms

There are also other fructose intolerance symptoms that affect the digestive tract. They resemble the symptoms of irritable bowel syndrome and are therefore often not correctly interpreted. These include:

• Abdominal pain (preferably in the lower abdomen)
• Stomach cramps
• nausea
• Bloating
• loudly audible bowel noises
• sudden urge to defecate
• loose stool
• Mucus build-up on the stool
• Constipation (often after previous diarrhea)

What Affects Fructose Intolerance Symptoms

People with acquired fructose intolerance can usually still tolerate small amounts of fructose. Only when the individual tolerance limit is exceeded do complaints arise. The symptoms mentioned above can vary and are subject to certain influencing factors.

Food composition

Of course, fructose intolerance symptoms occur especially when those affected consume fructose-rich foods (fruit, fruit juices, etc.) - especially if this happens in large quantities. Symptoms are also easier with meals that combine fructose with a low fat and protein content. Conversely, this means: In conjunction with a lot of protein and fat, fructose is often better tolerated.

The combination with grape sugar (glucose) is also beneficial for tolerability. This is also the reason why those affected can often better absorb the fructose in the form of household sugar (sucrose) - half of which consists of fructose and half of grape sugar.

Intestinal flora

Since intestinal bacteria are fundamentally involved in the formation of gas in the case of fructose intolerance, the problems are intensified if an unusual number of or the wrong bacteria colonize the intestine. There are usually many more bacteria in the large intestine than in the small intestine. They are necessary for normal digestion. So naturally intestinal gases develop in the large intestine, which we normally do not perceive as stressful.

If, on the other hand, the bacteria multiply in the small intestine or if there is an incorrect colonization of the small intestine (DDFB), because colon bacteria get into the small intestine, more gases are already formed here. This does not correspond to the normal digestive process and can cause discomfort.

Folic acid and zinc deficiency in fructose intolerance

Symptoms of acquired fructose intolerance can appear not only acutely, but also over the long term. In many people with fructose malabsorption, the unabsorbed fructose builds up in the intestines. In addition, the colonization with intestinal bacteria often changes. These factors influence the intestinal flora and can have a negative effect on the absorption of vitamins and trace elements. The result is often a folic acid and / or zinc deficiency.

Folic acid

The vitamin folic acid is involved in cell formation and regeneration as well as blood formation and is necessary for various metabolic processes. It is found in, for example, green leafy vegetables, nuts, legumes, liver and yeast.

With acquired fructose intolerance, the body sometimes does not absorb enough folic acid from the intestine. A folic acid deficiency develops, which can lead to anemia. This can lead to a lack of oxygen in the body with symptoms such as dizziness, decreased performance, pale skin and headaches.

If pregnant women suffer from a folic acid deficiency, the child's nervous system can develop incorrectly (neural tube defect).

zinc

Symptoms of zinc deficiency are also often observed in people with acquired fructose intolerance. Zinc is one of the most important trace elements and is involved, among other things, in various metabolic processes and the regulation of the immune system.If you are insufficiently supplied, you are therefore more susceptible to infections. In addition, wound healing can be disturbed. Other possible symptoms of zinc deficiency include loss of appetite, hair loss, and diarrhea.

Examples of good zinc suppliers are nuts, eggs, milk, beef and pork.

Concomitant diseases with fructose intolerance

Symptoms in people with fructose malabsorption cannot only be caused by the disease itself or the resulting deficiencies in vitamins and minerals. Sometimes they are also a sign of an accompanying illness. Often, for example, people with lactose intolerance (milk sugar intolerance) also have fructose intolerance. The symptoms of both clinical pictures overlap.

The symptoms of fructose intolerance can also appear or intensify under certain circumstances due to an insufficient supply of certain messenger substances.

Compared to the normal healthy population, people with fructose malabsorption also suffer significantly more often from depression. Presumably this has something to do with a tryptophan deficiency: In the case of fructose intolerance, the body absorbs this protein component (amino acid) more poorly because it is bound by the fructose present in the intestine. Tryptophan is, however, necessary for the formation of the messenger substance serotonin. In depression, the serotonin concentration in the brain is often measurably lower.

A lack of serotonin often leads to a craving for sweets. The sugar actually improves the tryptophan transport to the brain - unless it is fructose if you are intolerant to fructose. This can make fructose intolerance symptoms worse.

Hereditary fructose intolerance: symptoms

In contrast to the mostly harmless symptoms of fructose malabsorption, fructose intake can have serious consequences in hereditary fructose intolerance (congenital fructose intolerance). Even very small amounts of fructose can trigger low blood sugar (hypoglycaemia) in the affected children in addition to nausea and vomiting. This can manifest itself in concentration disorders, headaches, dizziness, sweating and even fainting and seizures.

In addition, hereditary fructose intolerance has chronic symptoms such as loss of appetite and failure to thrive, as well as liver failure and kidney damage. However, if the congenital metabolic disorder is recognized early (in babies) and taken into account in the diet, these serious consequences can be avoided.

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