title: Fructose malabsorption is not uncommon among patients with irritable bowel syndrome in India: a case-control study.
abstract: BACKGROUND
  Fructose malabsorption (FM) is reported in 38 % to 75 % patients with irritable bowel syndrome (IBS). Most of these studies, however, had limitations due to use of variable dose of fructose, small sample size, and lack of control population. Moreover, there is no study on this issue from India. Hence, in this prospective study, we evaluated the frequency of FM on an adequately powered sample of patients with IBS and healthy controls (HC) from India.
  
  
  METHODS
  Ninety-seven patients with IBS (diagnosed using Rome III criteria) and 41 healthy controls were evaluated for FM by fructose hydrogen breath test (FHBT) using 25 g fructose. Persistent rise (at least two readings) in breath hydrogen 20 parts per million (PPM) above basal was considered diagnostic of FM.
  
  
  RESULTS
  Patients and controls were comparable in age (37 years [21-66] vs. 33 years [15-56]; p = 0.1) and gender (76/97 [78.4 %] vs. 29/41 [70.7 %] male; p = 0.3). Of 70 patients reporting data on Bristol's stool forms, 10 (14 %), 43 (61 %), and 17 (25 %) had constipation, diarrhea predominant and unclassified IBS (Asian classification), respectively. Patients with IBS more often had FM than controls on FHBT (14/97 [14.4 %] vs. 1/41 [2.4 %]; p = 0.04). Patients with FM more often had diarrhea-predominant IBS than those without FM (10/11 [91 %] vs. 33/59 [56 %]; p = 0.02).
  
  
  CONCLUSIONS
  Though FM was not very common among Indian patients with IBS, it was higher among them than controls. Patients with FM more often had diarrhea-predominant IBS.
authors: Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India.
authors: Atul
authors: A
authors: Sharma
authors: Deepakshi
authors: D
authors: Srivastava
authors: Abhai
authors: A
authors: Verma
authors: Asha
authors: A
authors: Misra
authors: Uday C
authors: UC
authors: Ghoshal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests / Q000379:methods; D016022:Case-Control Studies; D005260:Female; D005632:Fructose / Q000378:metabolism*; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D007194:India / Q000453:epidemiology; D007408:Intestinal Absorption; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism*; D008286:Malabsorption Syndromes / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005632:Fructose; D006859:Hydrogen