After well over a year of suffering from the embarrassing, distressing and uncomfortable symptoms of IBS, I  finally visited my Doctor.  She asked questions, took blood samples and finally despatched me and a box of Colofac pills back home to ‘see how things go’ before returning to her in a month.  She explained that IBS is not a disease but rather a diagnosis by exclusion of other bowel-related pathologies.  It was only when I mentioned to my sister, who is also a Doctor, that I noticed that, after eating my mid morning snack at work – an apple – my symptoms arose quickly and forcefully. “Hmmm”, she considered, “I suppose it could be fructose malabsorption….”.   My printer was soon rolling off all the papers I could find on the subject.  Without getting too technical, I will be writing a short series of posts on this condition.

Fructose malabsorption causes symptoms that mirror those of IBS -

• abdominal cramps/pain
•  wind/flatulence
•  loose stools and/or constipation
• very growly, unhappy stomach

When you are at work, this is NOT ideal!

The ability of individuals to absorb fructose varies.  Fructose malabsorption should not be confused with fructose intolerance.
Fructose intolerance is a rare, inherited condition whereby the individual lacks the protein necessary to metabolise fructose.
Fructose malabsorption is a dietary problem where there is a deficiency of the fructose transporter GLUT5, resulting in fructose not being properly absorbed, passing into the larger intestine in an increased concentration, leading to rapid fermentation and an increase in liquid, triggering IBS-type symptoms.  Malabsorption of fructose and lactose may be detected by a hydrogen  breath test.  M Ledochowski et al  found that those with fructose malabsorption also had a tendency towards folic acid deficiency and some researchers have also found a decreased amount of tryptophan, a pre-cursor to serotonin.  Serotonin is the happiness chemical so less seratonin is less happiness!

Gastroenterologist, Prof. P R Gibson and Dietician, Susan Shepherd have observed that malabsorption of dietary fructose triggers symptoms in IBS sufferers and that removal of fructose from the diet could lead to symptom relief.  However, it should be noted that not all people who have fructose malabsorption have IBS.

To describe the group of  ‘offenders’, Gibson and Shepherd coined the acronym FODMAP – Fermentable Oligo-,Di- and Monosaccharides and Polyols.  These are made up of fructose, lactose, fructans and galactans and polyols such as sorbitol, mannitol, xylitol and maltitol (a few of these names I recognise as being present in some brands of chewing gum – always wondered why my stomach played up when I chewed gum!).  Not every person will react to every FODMAP type.  Their effects if you are a sufferer?

• poorly absorbed in your small intestine
• poorly absorbed FODMAPs exert a laxative effect by increasing liquid in the gut therefore moving bowel contents swiftly through and out of your body, not allowing nutrients to be fully extracted and used by the body
• rapid fermentation leading to unpleasant gas, bloating and pain

FODMAPs don’t actually cause your symptoms – they simply trigger them in susceptible people.  The Western diet today is, generally, high in FODMAPs, although people in Finland eat far fewer than, say, those in the US where a lot of corn syrup (high in fructose) is used in the food manufacture process.  Fructose is also cheaper than sucrose  – knew money would come into it somewhere

I believe there are many people out there who don’t even know about this condition and yet they may have it and there are steps that can be taken to ease symptoms.  Yes please!

Who are the offenders?

• fructose/sucrose – e.g apples, pears, mangoes / sugar  – avoid or limit the load
• fructans – e.g. wheat-based products, onions, leeks, asparagus, artichokes, chicory root-based coffee substitutes – avoid
• lactose – e.g. cow/goat/sheep’s milk, ice cream, custard, evaporated and condensed milk, yoghurt, soft cheeses – restrict
• galactans – e.g. chickpeas, lentils, red kidney beans, baked beans – avoid
• polyols – e.g. apples, apricots, cherries, plums, prunes, avocado, cauliflower, mushrooms, snow peas, sweeteners ending in -ol – avoid

Just to complicate things, glucose is the friend of the fructose malabsorber as it actually helps our system to better absorb the fructose, so foods that have a more or less equal balance of fructose and glucose are less likely to cause problems.  Gibson and Shepherd recommend that a strict trial of the low FODMAP diet is recommended for the first 6 – 8 weeks.

Before writing Part 2, here are a some food offenders you will probably already be familiar with as being, let’s say, reactive!

Fruit : apple, pear, guava, honeydew melon, mango, pawpaw/papaya, watermelon, grapes, cherries, persimmon, lychees, plums, nectarines or more than 1 fruit at a sitting
Fruit juice, juice of tinned fruit, dried fruit, fruit bars: only consume an amount of fruit juice that you would get out of one piece of fruit (not much!)
Sweeteners: honey, corn syrup, fructose, fruit juice concentrate, artificial sweeteners sorbitol, mannitol, isomalt, xylitol
Coconut milk/cream
Pastes and sauces:   tomato paste, chutney, relish, plum sauce, sweet and sour sauce, BBQ sauce
Fortified wines - sherry, port etc
Confectionery – excessive intake
Fizzy drinks – (I love Appletiser but found out that it doesn’t love me!)
Wheat products – white bread, wheat or wheat based pasta/noodles/breakfast cereals/cakes/cookies/crackers
Chicory-based coffee-substitute beverages

The above list of foods has not been quoted verbatim but was derived from an article in August 2007 edition of Practical Gastroenterology

This article was written by Lynne @ Holistic Ways, copyright remains with me
You can find links to all the information that I have summarised above on http://en.wikipedia.org/wiki/Fructose_malabsorption

Today  my bay tree had a major haircut.  While separating the leaves from its severed branches (the larger branches are shredded and used as a mulch on my garden to reduce outbreaks of dandelions and alkanet! ), I got to thinking about how healthy the tree was in its younger days and how, over the last few years, signs of infestation and disease have begun to manifest.  Although it has grown enormously, reaching upwards of 18 feet in height, its base is being invaded by woolly aphids, as well as small red and yellow insects, mould and leaf spot.  Was it, perhaps, so busy reaching for the stars that it lost touch with its own foundations?  Am I perhaps guilty of the same behaviour?  My thoughts were thus occupied as I therapeutically sifted and sorted.

When studying for my Diploma in Aromatherapy & Essential Oil Science with Neal’s Yard Remedies, we were encouraged to learn the Latin botanical names of the essential oils we studied as these become important where there are chemotypes or the oil is extracted from different parts of a plant, resulting in differing chemical structures which may influence safety cautions or useful properties/actions.

For example, confusion exists between Laurus nobilis and Pimenta racemosa, both known as Bay Leaf even though they are from completely different plant families!  Pimenta racemosa is from the West Indian Bay Tree, a member of the Myrtaceae family, whose principal chemical constituents are Eugenol, Myrcene and Methyl eugenol.  Laurus nobilis also known as Laurel, Bay Laurenl, Laurel Leaf, Roman Laurel, True Bay, Bay Leaf or Sweet Bay is a member of the Lauraceae family, whose principal chemical constituents are 1.8 cineole (25 – 55%), Sabinene (10%) alpha and beta pinene, limonene, phellandrene, Linalool (15%), a-terpineol, geraniol, terpinen-4-ol, a-terpinyl acetate (< 10%), methyl eugenol, eugenol and camphor.  According to Robert Tisserand, some laurel leaf oils are thought to contain small amounts of costunolide.

The primary actions of Laurus nobilis in aromatherapy are antibacterial, anticatarrhal, antirheumatic, antispasmodic, digestive, expectorant, mucolytic and neurotonic.  In addition, it has some safety cautions due to the methyl eugenol and eugenol content.  This oil should be avoided in pregnancy, with children, and with hypersensitive, diseased or damaged skin. I do not use more than 1 drop in 15ml.

Use with respect and never take essential oils internally.

A blend for your vapouriser:  Bay Laurel and cardamom

Sources:
Essential Oil Safety, Robert Tisserand, Tony Balacs

Related articles

• The Magic of Bay Laurel (witchofstitches.wordpress.com)

Click pic to buy or join us as a NYR Organic home consultant

I love NYR Organic skincare products because ….

– NYO Organic, Neal’s Yard Remedies is a small, independent, British-owned company

– family run business who are proud to say that family values are at the heart of everything they do

– NYO encourage a more natural and holistic way of caring for yourself

– their products are not tested on animals and DO NOT CONTAIN

parabens – linked to oestrogen over production
synthetic fragrances – may contain chemicals harmful to health
GMO ingredients or nano – not enough is known about their long-term effects
mineral oils, carbomer, acrylates or propylene glycol – derived from petroleum, may block pores
EDTA – not biodegradable
DEA – associated with known carcinogens
BHT- linked to breathing and lung impairment

– you are offered the opportunity to earn an income by becoming a specially trained home consultant

If you love caring for your skin naturally, you’ll love these products – mood boosters!