Fructose malabsorption and celiac disease

[faithberry]

If you've all been down this road before, just let me know!

According to Jan Modric, possible causes of fructose malabsorption are:

Inherited or acquired abnormality of fructose transporting protein GLUT-5 (other family members are often affected)
Overuse of High Fructose Corn Syrup (HFCS) or fruit juices in children (toddler’s diarrhea)
Small intestinal bacterial overgrowth (SIBO)
Celiac disease
Chemotherapy or radiation (damage of small intestinal mucosa)
Dumping syndrome (rapid stomach emptying).

http://www.healthhype.com/fructose-mala ... nosis.html

Celiac disease popped out for me. Most of us don't have celiac disease, but most of us have non-celiac gluten sensitivity. Do you think it's the gluten that might have cause this damage in us and that we might have/or had sub-clinical damage to the villi that caused the fructose malabsorption? The fructose malabsorption occurs in the enterocytes, not sure if that's the same as the villi.

Faith

[tex]

The fructose malabsorption occurs in the enterocytes, not sure if that's the same as the villi.

The enterocytes are the mucosal cells from which the villi protrude. The boundaries between the enterocytes are the "tight junctions", referred to in the description of the leaky gut syndrome. Here's a representation of what they look like:

http://www.solvo.hu/Solvo%20Solutions/i ... ocyte1.jpg

Along with your quote listing the causes of fructose intolerance, it appears to me that fructose intolerance is a natural result of small intestinal enteritis, (from any cause). As inflammation/damage to the villi progresses, first lactase production is virtually terminated, and as the damage progressively increases, production of the other sugar-splitting enzymes is sequentially curtailed. Some people with MC only have to worry about lactase deficiency, while others, at the other extreme, (myself included), can handle only the most minimal amounts of just about any type of sugar, while reacting.

Tex

[faithberry]

Thanks Tex,

What a cute diagram! Thanks. Now I won't confuse villi and enterocytes.

So do you think for us the damage occurs to the small intestine due to the undiagnosed gluten sensitivity (or it could be casein, which is said causes as much damage as gluten)? I suppose it could be the same with yeast, soy, and egg protein.

The lactose problem began a few years before the MC. I haven't been able to eat fruit and many vegetables since soon after I came down with MC, so this is certainly not new by any means. I thought it was the starch in vegies, but it could have just been the higher levels of fructose in the starchy vegetables. It has all gotten worse in the last two years, in particular when I started eating millet and brown rice again. The brown rice contains fructans which are counter-indicated in fructose intolerance. Do you think this means I have a problem with polysaccharides too (like in SCD) or maybe just the fructans in the brown rice. I don't recall my c-reactive protein ever being elevated until now! What a mess. I guess I never gave myself time to heal in the first place, because I no longer had D, so I thought the MC was under control. I had no clue that my small intestine could be so damaged.

I guess this wouldn't show up on a biopsy for celiac and damaged villi. It seems they can do a biopsy to assess fructose intolerance, but it's not commonly done.

So what I'm wondering about now is whether I need to avoid white rice too if I might have a problem with polysaccharides...Oh gosh, then I wouldn't have anything to eat except meat. I'm not sure how to figure that out since I don't get obvious symptoms from eating the white rice, whereas when I was eating the brown rice I was getting burning.

Thanks for any input you have! I can't help feeling like a do-do.How could I so mindlessly keep harming myself with food???????

[tex]

Do you think this means I have a problem with polysaccharides too (like in SCD)

Sure, because there are two types of polysaccharides - starches, and non-starch polysaccharides, (NSP), (which includes various forms of what we call dietary fiber, including cellulose, pectins, glucans, gums, mucilages, inulin, and chitin). Clearly, some/most of the NSPs are a problem for most of us.

The NSP in wheat, corn, and rice, are mainly insoluble and therefore tend to have a laxative effect, while those in oats, barley, rye, and beans, are mainly soluble, and are claimed to have a cholesterol lowering effect. (Of course, wheat, rye, barley, and oats are off limits for most of us, and beans are highly suspect for many of us. In most vegetables, the proportion of soluble to insoluble NSP is roughly equal, but it tends to vary in fruits.

If you happen to have a deficiency of pancreatic amylase, (or one of the other forms of amylase enzyme), then you would not be able to properly digest starches, also. Pancreatic insufficiency seems to go along with MC, for some people.

Don't feel like the Lone Ranger. We all feed ourselves the wrong foods, until we finally get it all figured out.

Tex

[adelie]

Hi Faith,

I also react to brown rice but seem to be able to tolerate some white rice. It took quite a while to figure that one out. In fact, there were a few times in the past year when I ate something with brown rice syrup as the primary sweetener and ended up spending a couple of days with massive D and vomiting. The last couple of times it got me, I was in a rush and bought something I'd eaten many times before but didn't check the label. Sure enough, the ingredient list changed.

Karen

[Gloria]

The last couple of times it got me, I was in a rush and bought something I'd eaten many times before but didn't check the label. Sure enough, the ingredient list changed.

Oh, yeah, that gets us most everytime. Why do manufacturers take a perfectly good product and change it???

Gloria