Zusammenfassung
Die Fructosemalabsorption repräsentiert eine weit verbreitete Stoffwechselstörung, welche durch eine Überlastung des enteralen fructose-spezifischen GLUT5-Transporters charakterisiert ist. Ins Colon übertretende nicht resorbierte Fructose wird durch Darmbakterien zu kurzkettigen Fettsäuren, Kohlendioxid, Wasserstoff und Methan metabolisiert. Als Folge kommt es zu einem Reizdarmsyndrom. Abzugrenzen ist die Fructosemalabsorption von Lebensmittelallergien, der Lactosemaldigestion, der Histaminintoleranz sowie der selten auftretenden hereditären Fructoseintoleranz. Nach der Diagnosestellung mittels des H2-Fructose-Atemtests steht die konsequente diätetische Therapie der Betroffenen durch einen geschulten Ökotrophologen, u. a. mittels einer fructose-reduzierten Kost, im Mittelpunkt der therapeutischen Interventionen.
Abstract
Fructose malabsorption or dietary fructose intolerance represent a widespread metabolic disorder caused by an overload of the enteral fructose-specific GLUT5 transporter. Fructose that reaches the colon is metabolized by colonic bacteria to short chain fatty acids and the gases carbon dioxide, hydrogen and methane which lead to irritable bowel syndrome. Fructose malabsorption is not to be confused with food allergies, lactose maldigestion, histamine intolerance and hereditary fructose intolerance. Medical tests require a fructose-based hydrogen breath test for a clinical diagnosis. Depending on the individual threshold for fructose, an appropriate fructose-reduced diet should be initiated by a trained ecotrophologist.
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Dr. med. Florian-Walter Velten
Klinik für Dermatologie, Venerologie und Allergologie
Medizinische Fakultät Mannheim gGmbH der Ruprecht-Karls Universität Heidelberg
Theodor-Kutzer Ufer 1 - 3
68167 Mannheim
Email: florian.velten@haut.ma.uni-heidelberg.de