BACKGROUND: The carbohydrate substitutes fructose, sorbitol and xylitol are gaining more and more importance in the production of dietary food. But they can provoke gastrointestinal side-effects. In a randomized double blind study the rate of malabsorption of these sugars was compared and the concomitant symptoms were recorded. SUBJECTS AND METHODS: 25 healthy controls received 25 g of each sugar within 3 consecutive days. The intestinal absorption was determined by H2-exhalation tests and the clinical symptoms were recorded. RESULTS: The rate of malabsorption was 84% for sorbitol, 36% for fructose and 12% for xylitol (p < 0.01 for sorbitol versus fructose and xylitol). 57% of the participants with pathological H2-test after sorbitol and 56% after fructose reported symptoms, while all of the 3 malabsorbers of xylitol were symptomatic. CONCLUSIONS: There is an advantage to administering xylitol and fructose with regard to the intestinal absorption and concomitant symptoms as compared with sorbitol. H2-exhalation tests appear to be a reliable diagnostic tool to detect carbohydrate malabsorption and should find broader application in patients suffering from non-specific abdominal complaints.
RCT Entities:
BACKGROUND: The carbohydrate substitutes fructose, sorbitol and xylitol are gaining more and more importance in the production of dietary food. But they can provoke gastrointestinal side-effects. In a randomized double blind study the rate of malabsorption of these sugars was compared and the concomitant symptoms were recorded. SUBJECTS AND METHODS: 25 healthy controls received 25 g of each sugar within 3 consecutive days. The intestinal absorption was determined by H2-exhalation tests and the clinical symptoms were recorded. RESULTS: The rate of malabsorption was 84% for sorbitol, 36% for fructose and 12% for xylitol (p < 0.01 for sorbitol versus fructose and xylitol). 57% of the participants with pathological H2-test after sorbitol and 56% after fructose reported symptoms, while all of the 3 malabsorbers of xylitol were symptomatic. CONCLUSIONS: There is an advantage to administering xylitol and fructose with regard to the intestinal absorption and concomitant symptoms as compared with sorbitol. H2-exhalation tests appear to be a reliable diagnostic tool to detect carbohydrate malabsorption and should find broader application in patients suffering from non-specific abdominal complaints.
Authors: Martin Raithel; Michael Weidenhiller; Alexander Fritz-Karl Hagel; Urban Hetterich; Markus Friedrich Neurath; Peter Christopher Konturek Journal: Dtsch Arztebl Int Date: 2013-11-15 Impact factor: 5.594
Authors: Heinz F Hammer; Mark R Fox; Jutta Keller; Silvia Salvatore; Guido Basilisco; Johann Hammer; Loris Lopetuso; Marc Benninga; Osvaldo Borrelli; Dan Dumitrascu; Bruno Hauser; Laszlo Herszenyi; Radislav Nakov; Daniel Pohl; Nikhil Thapar; Marc Sonyi Journal: United European Gastroenterol J Date: 2021-08-25 Impact factor: 4.623