Background: Fructose malabsorption is characterize d by the inability to absorb fructose ef ciently. As a consequenc e fructose reaches the colon where it is broken down by bacteria to short fatty acids, CO 2 , H 2 , CH4 and lactic acid. Bloating, cramps, osmotic diarrhea and other symptoms of irritable bowel syndrome are the consequenc e and can be seen in about 50% of fructose malabsorbers. Recently it was found that fructose malabsorptio n was associated with early signs of depressiv e disorders. Therefore, it was investigate d whether fructose malabsorptio n is associated with abnormal tryptopha n metabolism . Methods: Fifty adults (16 men, 34 women) with gastrointestina l discomfort were analyzed by measuring breath hydrogen concentration s after an oral dose of 50 g fructose after an overnight fast. They were classi ed as normals or fructose malabsorber s according to their breath H2 concentrations . All patients lled out a Beck depressio n inventory questionnaire . Blood samples were taken for plasma tryptophan and kynurenin e measurements . Results: Fructose malabsorption (breath DH 2 production > 20 ppm) was detected in 35 of 50 individuals (70%). Subjects with fructose malabsorptio n showed signi cantly lower plasma tryptopha n concentration s and signi cantly higher scores in the Beck depressio n inventory compared to those with normal fructose absorption . Conclusions: Fructose malabsorption is associated with lower tryptophan levels that may play a role in the developmen t of depressiv e disorders. High intestinal fructose concentratio n seems to interfere with L-tryptopha n metabolism , and it may reduce availabilit y of tryptopha n for the biosynthesi s of serotonin (5-hydroxytryptamine) . Fructose malabsorption should be considered in patients with symptoms of depression and disturbance s of tryptophan metabolism.
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