title: Fructose-sorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders.
abstract: OBJECTIVE
  To evaluate gastrointestinal (GI) symptoms and breath hydrogen responses to oral fructose-sorbitol (F-S) and glucose challenges in eating disorder (ED) patients.
  
  
  METHODS
  GI symptoms and hydrogen breath concentration were monitored in 26 female ED inpatients for 3 h, following ingestion of 50 g glucose on one day, and 25 g fructose/5 g sorbitol on the next day, after an overnight fast on each occasion. Responses to F-S were compared to those of 20 asymptomatic healthy females.
  
  
  RESULTS
  F-S provoked GI symptoms in 15 ED patients and one healthy control (P<0.05 ED vs control). Only one ED patient displayed symptom provocation to glucose (P<0.01 vs F-S response). A greater symptom response was observed in ED patients with a body mass index (BMI)<or=17.5 kg/m2 compared to those with a BMI>17.5 kg/m2 (P<0.01). There were no differences in psychological scores, prevalence of functional GI disorders or breath hydrogen responses between patients with and without an F-S response.
  
  
  CONCLUSIONS
  F-S, but not glucose, provokes GI symptoms in ED patients, predominantly those with low BMI. These findings are important in the dietary management of ED patients.
authors.affiliation: Department of Obstetrics and Gastroenterology, Royal North Shore Hospital, University of Sydney, Sydney 2065, Australia.
authors.forename: Noel
authors.initials: N
authors.lastname: Friesen
authors.forename: Ross D
authors.initials: RD
authors.lastname: Hansen
authors.forename: Suzanne F
authors.initials: SF
authors.lastname: Abraham
authors.forename: John E
authors.initials: JE
authors.lastname: Kellow
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001315:Australia; D001944:Breath Tests; D001068:Feeding and Eating Disorders / Q000178:diet therapy / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D005414:Flatulence / Q000139:chemically induced; D005632:Fructose / Q000009:adverse effects* / Q000494:pharmacology; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D007408:Intestinal Absorption / Q000187:drug effects; D009325:Nausea / Q000139:chemically induced; D012680:Sensitivity and Specificity; D013012:Sorbitol / Q000009:adverse effects* / Q000494:pharmacology; D013549:Sweetening Agents / Q000009:adverse effects* / Q000494:pharmacology; D055815:Young Adult
chemical_list: D013549:Sweetening Agents; D005632:Fructose; D013012:Sorbitol; D006859:Hydrogen