Fructose-sorbitol malabsorption and symptom provocation in irritable bowel syndrome: Relationship to enteric hypersensitivity and dysmotility

P. R. Evans, C. Piesse, Young-Tae Bak, J. E. Kellow

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: Fructose-sorbitol (F-S) mixtures can provoke symptoms in irritable bowel syndrome (IBS) patients, and a proportion of lBS patients also have enteric hypersensitivity to distension. We hypothesized, therefore, that sugar malabsorption and fermentation to produce hydrogen gas may provoke symptoms to a greater extent in lBS patients hypersensitive to distension than in those patients without such hypersensitivity. Our aims were therefore to compare, in IBS patients, symptoms and breath hydrogen responses after F- S, on the basis of jejunal sensitivity and jejunal motor function. Methods: Fifteen female IBS patients (44 ± 15 years) underwent, on separate occasions, 3-h breath hydrogen analyses after ingesting 10 g lactulose and 25 g fructose with 5 g sorbitol. Jejunal sensitivity and motor function were determined by balloon distension and 24-h manometry studies, respectively. Cumulative symptom scores and breath hydrogen production were analysed on the basis of the presence or absence of jejunal hypersensitivity and dysmotility. Results: Four and seven patients had jejunal hypersensitivity for initial perception and pain, respectively. Eleven, nine, and nine patients had jejunal dysmotility for fasting phase 3, phase 2, and fed motor activity, respectively. Of the patients with symptom provocation after F-S (n = 8 within 3 h, n = 12 within 12 h) or with F-S malabsorption (n = 10), the relative proportion did not differ on the basis of the presence or absence of jejunal hypersensitivity or of motor dysfunction. Symptom scores and hydrogen production also were not different in these subgroups. Conclusions: Although carbohydrate malabsorption can provoke symptoms in some IBS patients, there is no consistent association between such a phenomenon and the presence of either jejunal hypersensitivity or dysmotility.

Original languageEnglish
Pages (from-to)1158-1163
Number of pages6
JournalScandinavian Journal of Gastroenterology
Volume33
Issue number11
Publication statusPublished - 1998 Dec 22
Externally publishedYes

Fingerprint

Sorbitol
Irritable Bowel Syndrome
Fructose
Hypersensitivity
Hydrogen
Lactulose
Pain Perception
Manometry
Fermentation
Fasting
Motor Activity
Gases
Carbohydrates

Keywords

  • Fructose-sorbitol
  • Irritable bowel syndrome
  • Jejunal motility
  • Symptoms
  • Visceral hyperalgesia

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Fructose-sorbitol malabsorption and symptom provocation in irritable bowel syndrome : Relationship to enteric hypersensitivity and dysmotility. / Evans, P. R.; Piesse, C.; Bak, Young-Tae; Kellow, J. E.

In: Scandinavian Journal of Gastroenterology, Vol. 33, No. 11, 22.12.1998, p. 1158-1163.

Research output: Contribution to journalArticle

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