Therapy

The therapy of intestinal fructose intolerance starts with a significant reduction of fructose intake. For a period of two weeks, the patient should switch to a well digestible whole food diet. In this way, a reduction of the symptoms is achieved.

In the following four weeks, the dietary regimen is extended to include higher-protein and higher-fat products. In addition, the personal fructose threshold and the tolerance of certain types of fruit are determined. Subsequently, a continuous, individually tailored dietary change is recommended.

Fruit should be eaten in small portions and certain varieties (raisins, prunes and grapes) should be avoided. Foods with a high sorbitol or fructose content should be avoided, while sufficient consumption of vegetables should be ensured. Only strict avoidance of fructose can counteract long-term damage in the case of hereditary fructose intolerance.

This is especially true for the development of liver cirrhosis. Fructosemia usually does not require treatment. In the most common form of fructose intolerance, the intestinal malabsorption disorder, an enzyme preparation can help.

It contains the so-called xylose isomerase, whose function is based on the conversion of fructose into glucose and vice versa from glucose into fructose. As long as both sugar molecules are not present in equal amounts, the enzyme tries to achieve an equilibrium. However, since glucose is absorbed from the intestine into the blood much faster than fructose, this state is not reached.

The xylose isomerase therefore continues to convert fructose. The enzyme is available from various manufacturers in the form of capsules. One capsule is taken twice a day immediately before meals.

Since a change in diet promises greater therapeutic success, medication should only be taken in exceptional cases. The false colonization of the intestine can be reduced with antibiotics. However, there is still no scientific proof of the effectiveness of such a treatment.

The simple sugar fructose occurs in its natural form mainly in fruit and honey. All foods that are partly made of fruit therefore also contain fructose. Some types of fruit have a higher sugar content than others.

These include in particular apples, grapes, pears, pineapples and mangoes. Dried fruits also have a high fructose content. Besides these “obvious” occurrences of fructose, it is hidden in many industrially produced products.

Here, fructose is used to sweeten pastries and sweets and is added to beverages such as soft drinks.Finished products such as dressings, sauces, instant soups and ready-to-eat pizzas often contain a considerable amount of sugar. In addition to avoiding or reducing the consumption of fructose-containing foods, sugar substitutes should also be avoided in the case of a diagnosed fructose intolerance. Products containing, for example, sorbitol, maltitol or xylitol have an inhibitory effect on fructose absorption in the intestine.

This results in an increase in symptoms. Despite avoiding certain foods, there is a wide range of healthy products with low fructose content. In general, the daily fructose requirement is about 2 grams.

Food tables help to put together a healthy and varied diet. They provide information about the fructose content of foods. Particular attention should be paid to the consumption of sufficient quantities of vegetables.

Zucchini, avocado, green leafy vegetables, mushrooms and potatoes are particularly low in fructose. Onions, legumes and leeks, on the other hand, have a flatulent effect and should not be eaten at the beginning of a change of diet. Whole grain products without added fructose can be included in the diet in small quantities.

Gluten-free cereals such as buckwheat, millet, rice, corn and quinoa serve as satiating side dishes. Animal products such as eggs, meat and fish contain only very small amounts of fructose. This also applies to various types of nuts, almonds and coconuts.

Oil seeds, which include pumpkin seeds, sunflower seeds and linseed, have a high fat content and a low fructose content. Dietary fiber, which aids digestion in a healthy person, should be taken with caution in cases of intestinal fructose intolerance. They cause an increase in the symptoms.

The consumption of dairy products should be kept to a minimum. If fructose intolerance is already present, there is an increased risk of a disturbed lactose absorption in the intestine. If fructose is tolerated in small amounts, fruit varieties with low sugar content can also be consumed. Papaya, mandarins and apricots as well as rhubarb are particularly suitable for this purpose. The simultaneous consumption of foods containing fructose and glucose, for example in the form of dextrose, improves the transport of fructose via the intestinal wall into the blood.