Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 14, 2009; 15(42): 5295-5299
Published online Nov 14, 2009. doi: 10.3748/wjg.15.5295
Fructose-sorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders
Noel Friesen, Ross D Hansen, Suzanne F Abraham, John E Kellow
Noel Friesen, Suzanne F Abraham, Department of Obstetrics and Gynaecology, Royal North Shore Hospital, University of Sydney, Sydney 2065, Australia
Ross D Hansen, John E Kellow, Department of Gastroenterology, Royal North Shore Hospital, University of Sydney, Sydney 2065, Australia
Author contributions: Friesen N performed data collection and contributed to data analysis and writing of the paper; Hansen RD contributed to experimental design, data collection and analysis, and writing of the paper; Abraham SF and Kellow JE designed the research and contributed to data analysis and writing of the paper.
Correspondence to: Dr. John E Kellow, Department of Gastroenterology, Royal North Shore Hospital, St. Leonards, Sydney 2065, Australia. johnk@med.usyd.edu.au
Telephone: +61-2-99267355 Fax: +61-2-94363719
Received: May 8, 2009
Revised: October 2, 2009
Accepted: October 9, 2009
Published online: November 14, 2009
Abstract

AIM: To evaluate gastrointestinal (GI) symptoms and breath hydrogen responses to oral fructose-sorbitol (F-S) and glucose challenges in eating disorder (ED) patients.

METHODS: GI symptoms and hydrogen breath concentration were monitored in 26 female ED inpatients for 3 h, following ingestion of 50 g glucose on one day, and 25 g fructose/5 g sorbitol on the next day, after an overnight fast on each occasion. Responses to F-S were compared to those of 20 asymptomatic healthy females.

RESULTS: F-S provoked GI symptoms in 15 ED patients and one healthy control (P < 0.05 ED vs control). Only one ED patient displayed symptom provocation to glucose (P < 0.01 vs F-S response). A greater symptom response was observed in ED patients with a body mass index (BMI) ≤ 17.5 kg/m2 compared to those with a BMI > 17.5 kg/m2 (P < 0.01). There were no differences in psychological scores, prevalence of functional GI disorders or breath hydrogen responses between patients with and without an F-S response.

CONCLUSION: F-S, but not glucose, provokes GI symptoms in ED patients, predominantly those with low BMI. These findings are important in the dietary management of ED patients.

Keywords: Fructose; Sorbitol; Malabsorption syndromes; Functional gastrointestinal disorders; Eating disorders; Underweight