Dr. Satish Rao is an expert on fructose and its effect on our bodies.
"Part of the reason it's more common now than before is we are now taking more fructose products than we ever did."
Dietary Fructose Intorerance is a relatively new diagnosis in the field of food sciences.
If you are an IBS patient and you just can't get a handle on your symptoms, you may need to be tested. As you'll see, the condition is so new, and so specific, that your doctor may not even know about it.
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Lauren Bairas is one of Dr. Rao's patients.
"I had no idea how sick I was. I did not realize you were not supposed to have vertigo all day every day."
Lauren is talking about her dramatic improvement when Dr.Rao diagnosed her with Dietary Fructose Intolerance. She lives in Las Vegas, so we talked with her via Skype. Lauren had a feeding tube because it seemed like everything she ate made her sick.
Paula Mitchell is a research scientist from Alabama who ended up here in Augusta when doctors at Birmingham's Kirkland Clinic gave up.
"They had done all the tests and basically said, 'Everything's normal, we have to cut you loose."
But everything wasn't normal. The symptoms she'd experienced for years had begun to impact her quality of life.
"Bloating, disention, cramping, that sort of thing... constant."
Her physician shared research that led her to Dr. Rao, head of the Gastroenterology/Hepatology Department at Georgia Health Sciences University.
"I think the number of fructose cases being diagnosed now is less than 10%. Our diets have become enriched with fructose but our absorptive capacity is still limited."
About 2/3 of the fructose Americans consume comes from fruit drinks and carbonated beverages, but as HFCS has become a common ingredient in so many foods, you may have increased your intake of fructose, evn if you don't drink sodas. Hot dog relish has HFCS, salad dressings, chocolate syrup. HFCS is the top ingredient in pancake syrup... HFCS is even in hot dog buns.
The problem for DFI patients is that the body can't absorb fructose, can't break it down... and according to Rao that causes painful physical symptoms.
"Gas, bloating, pain, diarrhea, or IBS, as it's often called."
Right now, there's just one way to treat DFI: removing fructose from the diet. No dobut, that's a challenge for Paula.
"It's just gonna involve a major dietary and lifestyle change."
Which means avoiding all of this stuff- anything with HFCS- but it's much more complicated that that. Imagine not being able to eat what you always considered healthy foods: fruits, like these apples and pineapples, most vegetables, including these carrots, onions- all off limits.
At first, shopping for food was devastating for Lauren.
"I would go to the grocery store at 4:00 in the morning just so people wouldn't see me cry. At first it was tricky. Once I got the hang of it though, my life has been immensely, immensly better."
So much better that she made this artwork for Dr. Rao: the digestive tract, with a heart in the place where her feeding tube used to be.
"Many gastroenterologists don't know about it," Rao says, "let alone general internists, let alone family physicians, and certainly I can't expect the lay public to know about it."
Rao says they key is recognition of the problem and diagnostic testing.
For Paula, the week spent in specialized testing at GHSU made all the difference.
"That's what they're able to do here that they're not able to do at a lot of places. It was a very simple test, you just sit there and breathe into a bag every 30 minutes."
Dr. Rao says it's important to get the word out.
"There is just a dearth of information, people don't know about the existence of this problem, so the number of patients diagnosed in the next decade will go ten fold, easily."
Paula says she's optimistic about her diagnosis.
"I'm happy to have a diagnosis and know that there's something I can do about it."
These are the two books I use as guidelines for following a fructose-free lifestyle. Everyone is different, though, and you have to test foods to see how you react. There are discrepancies in books (and lists from different websides) which is a bit frustrating, too!
“Fructose Malabsorption: The Survival Guide,” by Debra & Bob Ledford
“Living With Dietary Fructose Intolerance,” by Judy Smith
Dr. Rao and his colleagues stumbled on the fructose connection through a study with diabetes and bacterial overgrowth. They ended up applying a test for diabetics to a group of IBS patients.
The small intestine is unable to break down sugars, so they progress to the large intestine which has to work to break it down into short-chain fatty acids, carbon dioxide and hydrogen which are not absorbed by the intestine. This combination creates bloating, pain, diarrhea or constipation, gas. The problem goes beyond this because other nutrients are often lost including calcium and iron and can lead to diseases like anemia and osteoporosis.
After a year of following his test group, about 60 % were compliant with the diet, 40% were not.
"And they were still suffering with the symptoms, and they knew! It's interesting, but one of the messages that came through that study for us is that it is hard to change people's eating habits."
The most effection treatment today is the Exclusion Diet, but Dr. Rao is working with other researchers to come up with an enzyme for patients to take,from a naturally occuring amino acid.
"In our preliminary studies, when given before intake of fructose, it substantially decreases or eliminates the symptoms."
Fructose malabsorption has been linked to:
Following a fructose free diet means the following foods will need to be avoided:
•Fruit and fruit juices
•Meat products cured in sugar or breaded
•Corn syrup & HFCS
•Table sugar (beet and cane)
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