Bloated? What could be to blame ?
I see lots of patients complaining of stomach ache, bloating, feeling tired, and some have bowel problems ranging from constipation to severe diarrhoea. If we look at our heritage, our food's evolution has raced ahead of our own development, and this has affected our ability to digest our food. Also, wider imports of tropical fruit and vegetables from far flung continents means we are at times eating foods outside our own culture.
An example of this is mango, a wonderful juicy fruit which can be used raw or cooked, and also dried. It has gradually become more and more widely used, and is seen on many menus now. The problem is it is high in fructose, and some individuals have difficulty digesting this type of sugar.
We are naturally designed to better digest glucose. Our bodies do not have the dedicated means of absorption for fructose that glucose has, so this digestive difficulty means some fructose remains undigested in the large intestine, where it ferments. This fermentation leads to the production of gas, bloating and for some people diarrhoea.
Professor Whorwell from the University of Manchester says 'our bodies are not terribly good at digesting fructose, especially in the quantities we eat these days, with year-round access as well'.
Fructose malabsorption can go hand in hand with IBS, Crohn's disease and IBD (inflammatory Bowel Disease), and 'approximately one third of IBS sufferers will have fructose intolerance' (quoted Julie Thompson, Specialist Gastroenterology Dietitian.)
Fructose malabsorption can also be linked to depression or low mood, as fructose has been associated with blocking the production of serotonin! It's interesting to note that children's behaviour has been affected by fructose intake. Fructose is used to sweeten many foods, and marketing and manufacture has made these very appealing and available to children, and behaviour changes have matched this increase.
Some fruit and vegetables are better tolerated than others, so random exclusion is not a good idea. Exclusion should be properly managed in order to prevent further malabsorption and malnutrition.
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