Disclaimer: I’m not a nutritionist / dietician and by no means qualified to give you health advice, but I’m writing this blog post based on my personal experience.
Discovering and being diagnosed with Fructose Malabsorption
For as long as I can remember, I have suffered from tummy aches, constipation, extreme gassiness and bloating. I thought it was normal, didn’t think much of it and tried to just suck it up and live with it.
Having had a lot of exposure to people with lactose intolerance and gluten intolerance from social media, I started to question whether I was gluten intolerant. I didn’t suspect lactose intolerance, as I’ve gone by weeks without drinking milk and still had the same symptoms. I tried to cut out gluten from my diet but not much changed. Shortly after I had a conversation with my cousin who was diagnosed with fructose intolerance a while back, and decided to consult my GP to have proper diagnosis.
Getting tested for Fructose Malabsorption
The test for fructose malabsorption is called a ‘hydrogen test’, which can be done through a doctor’s referral. The cost of the hydrogen test was quite expensive but luckily for me, it is now $50 with medicare rebate. I booked my test at a local endoscopy centre that specialises in testing for fructose malabsorption and lactose intolerance. On the day of making the appointment, they will give you a dietary guideline for week before the test as well as a stricter guideline for the day before the test.
Essentially the day before you have to stick to a diet of protein (no skin), with no seasoning (salt AND pepper), and no herbs or spices. On the day of testing, you cannot brush your teeth plus you will need to fast until your appointment. You will then be given a plastic cup full of fructose concoction to ingest in 5 minutes. I’m not going to lie, but it is the grossest concoction you will taste in your life. Further, if you suffer from fructose malabsorption, chances are you’d probably start suffering from your usual tummy problems. You will then have your breath measured via a breathalyser over 3-4 hours where they will measure your breath hydrogen and symptoms. They will then analyse your results and a full report is sent to your GP.
Yes, I was clinically diagnosed with fructose malabsorption. The advice I received from the GP was the usual concept of eating everything in moderation. Applying this principle meant that I didn’t have to go off and avoid every amount of fructose, as that’s impractical, but to understand that what I eat throughout the day will build up my fructose consumption. Eating too much food with fructose would lead to the bloating, upset tummy, gassiness and constipation. With that advice in hand, I went home to research on fruit and vegetables and the amount of fructose it contains.
Unfortunately, for fructose malabsorption sufferers, there is no indicative list of trigger foods one should avoid, as one person’s trigger foods might not necessarily have an affect on you. For example, I have an intolerance to broccoli, however to a girl who also suffers from fructose malabsorption might not be strongly affect with broccoli. Having said that, there are some food that are definitely trigger foods that would be best avoided such as apples, pears, onions, garlic, watermelon, and mangoes.
What to do if you love certain trigger foods?
Fructose malabsorption is VERY hard to manage when eating out, as garlic and onions are found in a lot of dishes at a cafe/restaurant menu. That is not to say that you cannot have your favourite dish anymore, you just have to plan ahead.
1. If you know that you’re visiting a cafe and eating a dish that contains your trigger foods, make a plan to ensure that the other meals you are having for the rest of the day are low in fructose meals. This will ensure that your fructose consumption is low, and you’re less likely to suffer later in the day or the next morning.
2. The alternative method would be to visit the cafe / restaurant with a friend and ask if they mind sharing the dish with you. Chances are, your friends will help be more than happy to help you eat it, unless they too have an intolerance to the fructose. If they don’t have the intolerance, take a few bites and let your friend eat the rest.
I’m eating out at a restaurant/cafe. How do I navigate around the menu?
At the start of your fructose malabsorption journey, you will find it difficult, however things will get easier once you know what your trigger foods are. Once you know your trigger foods, you will know what dishes to avoid or eat less of.
When you’re at a cafe/restaurant, always read the menu carefully. If the menu lists only the key ingredients, ask the staff if your trigger foods are added. If they say they aren’t sure, ask them to check with the chef, and tell them that you have an intolerance. The moment you tell them that, they will be sure to check for you. They will quite often tell you and offer you an alternative dish, or tell you they can leave it out. When your dish is saucy, or soupy, you should always check whether garlic or onion is added, as most of the times it does contain it.
Another thing to look out for is dishes labeled as “Low FODMAP”, as I have found some of my trigger foods in “Low FODMAP” dishes.
If you’re eating out at a cafe, and the menu is full of your trigger foods, the best idea is to order ‘bread and eggs’, and pile on the side dishes.
If you’re eating out at a fine dining restaurant, I would say – suck it up and deal with it, coz YOLO and you’re there for the experience. However, sometimes if I don’t want to feel bloated the next day, I would list fructose intolerance in my dietary requirements, because it’s a real bi*ch to cook for someone with fructose intolerance and the dishes are very bland.