Mo1638 Intolerance and Hypersensitivity During and After an Inulin (Fructan) Breath Test. A Study in Irritable Bowel Syndrome and Healthy Controls

Gutierrez, Xaira J. Rivera; Galvez-Rios, Shareni; Amieva-Balmori, Mercedes; Sosa, Olivia Rascon; Liceaga, Hector Alonso Taboada; Gómez-Castaños, Paulo César; Reyes-Huerta, Job; Sanchez-Maza, Yolopsi de Jesús; Troche, José M. Remes

doi:10.1016/s0016-5085(16)32509-4

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“…Test duration of 2 h 24% in patients with abdominal symptoms (n = 341) Enko et al, 2016 [ 40 ] Fructan breath tests Fructan (10 g inulin dissolved in 100 cc water) Hydrogen Rise of ≥ 20 ppm over baseline hydrogen. Test duration of 3 h 19% in IBS patients (n = 21), 5% in healthy patients Gutierrez et al, 2016 [ 41 ] Fructan (10 g fructan dissolved in 100 cc water) Hydrogen and methane Rise of ≥ 20 ppm over baseline hydrogen; or ≥ 15 ppm over baseline methane. Test duration of 3 h 64% in IBS patients (n = 102) Leelasinjaroen et al, 2017 [ 42 ] Fructan (10 g fructan dissolved in 100 cc water) Hydrogen and methane Rise of ≥ 20 ppm over baseline hydrogen; or ≥ 15 ppm over baseline methane.…”

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confidence: 99%

Fructose malabsorption and fructan malabsorption are associated in patients with irritable bowel syndrome

Sia,

Tanaka,

Mousad

et al. 2024

BMC Gastroenterol

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Background Food malabsorption and intolerance is implicated in gastrointestinal symptoms among patients with irritable bowel syndrome (IBS). Key triggers include fructose and fructan. Prior studies examined fructose and fructan malabsorption separately in IBS patients. None have concurrently assessed both within the same patient group. We aimed to investigate the association between fructose and fructan malabsorption in the same patients with IBS using hydrogen breath testing (HBT). Methods We retrospectively identified patients with IBS who underwent fructose and fructan HBTs and abstracted their results from the electronic medical record. Fructose and fructan HBTs were performed by administering a 25 g fructose solution or 10 g fructan solution, followed by breath hydrogen readings every 30 min for 3 h. Patients were positive for fructose or fructan malabsorption if breath hydrogen levels exceeded 20 ppm. Results Of 186 IBS patients, 71 (38.2%) were positive for fructose malabsorption and 91 (48.9%) were positive for fructan malabsorption. Of these patients, 42 (22.6%) were positive for fructose malabsorption and fructan malabsorption. Positive fructose HBT readings were significantly associated with positive fructan HBT readings (p = 0.0283). Patients positive for fructose malabsorption or fructan malabsorption had 1.951 times higher odds of testing positive for the other carbohydrate. Conclusions Our results reveal a clinically significant association between fructose malabsorption and fructan malabsorption in patients with IBS. Fructan malabsorption should be assessed in patients with fructose malabsorption, and vice versa. Further studies are required to identify the mechanisms underlying our findings.

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