title: Colonic bacterial activity determines the symptoms in people with fructose-malabsorption.
abstract: OBJECTIVE
  This study was performed to find a parameter to discriminate symptomatic from asymptomatic subjects with fructose-malabsorption.
  
  
  METHODS
  Thirty-four subjects (12 m, 22 f; average age, 28.6 years; range 16-60) were investigated after an overnight fast. After intake of 25 g fructose, H2-tests were carried out. Endexspiratory breath samples were taken before the ingestion of the tested sugar and at 30 minute intervals over a 2 hour period. Hydrogen determination was performed immediately after sampling. Results were considered pathological if there was a rise in hydrogen over 20 ppm and a twofold increase from the initial value. Aerobic and anaerobic cultures from stool bacteria were set and incubated with 0.5 g fructose.
  
  
  RESULTS
  Among 34 healthy controls, 13 malabsorbers (38%) were detected. Out of these malabsorbers, 6 (46%) reported gastrointestinal concomitant symptoms. Symptomatic and asymptomatic subjects with fructose-malabsorption showed a comparable increase in hydrogen levels. The disappearance rate of fructose in the stool cultures was significantly elevated in the symptomatic group compared with the asymptomatic, but only in the anaerobic culture.
  
  
  CONCLUSIONS
  This activity of colonic bacteria, significantly discriminating symptomatic subjects with fructose-malabsorption from asymptomatic, enhances the importance of fructose-malabsorption in the differential diagnosis of people with non-specific abdominal complaints. Antibiotic therapy in severe cases should be considered a therapeutical approach. Moreover these results may support the role of nutritional carbohydrates in the pathogenesis of colonic diseases.
authors.affiliation: II. Medizinische Klinik, Technische Universität München.
authors.forename: P
authors.initials: P
authors.lastname: Born
authors.forename: J
authors.initials: J
authors.lastname: Zech
authors.forename: H
authors.initials: H
authors.lastname: Lehn
authors.forename: M
authors.initials: M
authors.lastname: Classen
authors.forename: R
authors.initials: R
authors.lastname: Lorenz
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000994:Antitrichomonal Agents / Q000494:pharmacology; D001420:Bacteria, Aerobic / Q000187:drug effects / Q000378:metabolism*; D001421:Bacteria, Anaerobic / Q000187:drug effects / Q000378:metabolism*; D001944:Breath Tests; D003106:Colon / Q000382:microbiology*; D003937:Diagnosis, Differential; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D005260:Female; D005632:Fructose / Q000032:analysis / Q000378:metabolism*; D015318:Fructose Metabolism, Inborn Errors / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D008297:Male; D008795:Metronidazole / Q000494:pharmacology; D011112:Polymyxin B / Q000494:pharmacology; D014640:Vancomycin / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D000994:Antitrichomonal Agents; D008795:Metronidazole; D005632:Fructose; D014640:Vancomycin; D006859:Hydrogen; D011112:Polymyxin B