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Effect of Nonabsorbed Amounts of a Fructose–Sorbitol Mixture on Small Intestinal Transit in Healthy Volunteers

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Although malabsorption of small amounts of fructose–sorbitol mixtures occurs frequently in healthy humans, insights into their effects on gastrointestinal motility are poor. The present study addresses the hypothesis that malabsorption of a fructose–sorbitol challenge changes the small intestinal transit rate. Eleven healthy volunteers participated in a double-blind crossover investigation. In random order, the subjects ingested 30 g glucose or a mixture of 25 g fructose and 5 g sorbitol as 10% solutions. As a radiolabeled marker, 99mTc-diethylenetriaminepentaacetic acid was added to each test solution. Breath hydrogen and methane concentrations and gastrointestinal progress of the radiolabeled marker were followed for the next 6-hr period. Malabsorption of small amounts of the fructose–sorbitol mixture was evident in all subjects. The area under the gastric radioactivity–time curve after ingestion of glucose did not differ from that after ingestion of the fructose–sorbitol mixture (P = 0.7897). However, the mouth-to-cecum transit of the radiolabeled marker was faster (P = 0.0033) and the percentage content of the marker in colon was higher after ingestion of the fructose–sorbitol mixture than after ingestion of glucose (P = 0.0128). In healthy humans, malabsorption of small amounts of a fructose–sorbitol mixture accelerates small bowel transit.

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  1. 1.

    Rumessen JJ: Fructose and related food carbohydrates. Sources, intake, absorption, and clinical implications. Scand J Gastroenterol 27:819–828, 1992

  2. 2.

    Rumessen JJ, Gudmand-Hoyer E: Absorption capacity of fructose in healthy adults. Comparison with sucrose and its constituent monosaccharides. Gut 27:1161–1168, 1986

  3. 3.

    Ravry MJ: Dietetic food diarrhea. JAMA 244:270, 1980

  4. 4.

    Hyams JS: Sorbitol intolerance: an unappreciated cause of functional gastrointestinal complaints. Gastroenterology 84:30–33, 1983

  5. 5.

    Rumessen JJ, Gudmand-Hoyer E: Malabsorption of fructose—sorbitol mixtures. Interactions causing abdominal distress. Scand J Gastroenterol 22:431–436, 1987

  6. 6.

    Corazza GR, Strocchi A, Rossi R, Sirola D, Gasbarrini G: Sorbitol malabsorption in normal volunteers and in patients with coeliac disease. Gut 29:44–48, 1988

  7. 7.

    Rumessen JJ, Gudmand-Hoyer E: Functional bowel disease: malabsorption and abdominal distress after ingestion of fructose, sorbitol and fructose–sorbitol mixtures. Gastroenterology 95:694–700, 1988

  8. 8.

    Ravich WJ, Bayless TM, Thomas M: Fructose: incomplete intestinal absorption in humans. Gastroenterology 84:26–29, 1983

  9. 9.

    Rumessen JJ, Hamberg O, Gudmand-Hoyer E: Interval sampling of end-expiratory hydrogen (H2) concentrations to quantify carbohydrate malabsorption by means of lactulose standards. Gut 31:37–42, 1990

  10. 10.

    Rumessen JJ, Nordgaard-Andersen I, Gudmand-Hoyer E: Carbohydrate malabsorption: quantification by methane and hydrogen breath tests. Scand J Gastroenterol 29:826–832, 1994

  11. 11.

    Rumessen JJ, Kokholm G, Gudmand-Hoyer E. Methodological aspects of breath hydrogen (H2) analysis. Evaluation of a H2 monitor and interpretation of the breath H2 test. Scand J Clin Lab Invest 47:555–560, 1987

  12. 12.

    Madsen JL, Larsen NE, Hilsted J, Worning H: Scintigraphic determination of gastrointestinal transit times. A comparison with breath hydrogen and radiologic methods. Scand J Gastroenterol 26:1263–1271, 1991

  13. 13.

    Rumessen JJ, Gudmand-Hoyer E: Fructans of chicory: intestinal transport and fermentation of different chain lengths and relation to fructose and sorbitol malabsorption. Am J Clin Nutr 68:357–364, 1998

  14. 14.

    Evans PR, Piesse C, Bak YT, Kellow JE: Fructose—sorbitol malabsorption and symptom provocation in irritable bowel syndrome: relationship to enteric hypersensitivity and dysmotility. Scand J Gastroenterol 33:1158–1163, 1998

  15. 15.

    Jouet P, Sabate JM, Coffin B, Bouhnik Y, Lemann M, Jian R, Rambaud JC, Flourie B: Sugar intolerance: origin and mechanisms of symptoms? Dig Dis Sci 47:886–893, 2002

  16. 16.

    Vonk RJ, Priebe MG, Koetse HA, Stellaard F, Lenoir-Wijnkoop I, Antoine JM, Zhong Y, Huang CY: Lactose intolerance: analysis of underlying factors. Eur J Clin Invest 33:70–75, 2003

  17. 17.

    Ropert A, Cherbut C, Roze C, Le Quellec A, Holst JJ, Fu-Cheng X, Bruley des Varannes S, Galmiche JP: Colonic fermentation and proximal gastric tone in humans. Gastroenterology 111:289–296, 1996

  18. 18.

    Jain NK, Boivin M, Zinsmeister AR, Brown ML, Malagelada JR, DiMagno EP: Effect of ileal perfusion of carbohydrates and amylase inhibitor on gastrointestinal hormones and emptying. Gastroenterology 96(2, Pt 1):377–387, 1989

  19. 19.

    Rumessen JJ, Hamberg O, Gudmand-Hoyer E: Influence of orocaecal transit time on hydrogen excretion after carbohydrate malabsorption. Gut 30:811–814, 1989

  20. 20.

    Fukumoto S, Tatewaki M, Yamada T, Fujimiya M, Mantyh C, Voss M, Eubanks S, Harris M, Pappas TN, Takahashi T: Short-chain fatty acids stimulate colonic transit via intraluminal 5-HT release in rats. Am J Physiol Regul Integr Comp Physiol 284:R1269–R1276, 2003

  21. 21.

    Villako K, Maaroos H: Clinical picture of hypolactasia and lactose intolerance. Scand J Gastroenterol 29 (Suppl 202):36–54, 1994

  22. 22.

    Larson M, Schulze K: Appearance of peristaltic reflex in isolated guinea pig ileum in response to boluses of air, water, oil, and cellulose. Dig Dis Sci 47:2644–2650, 2002

  23. 23.

    Ladas S, Papanikos J, Arapakis G: Lactose malabsorption in Greek adults: correlation of small bowel transit time with the severity of lactose intolerance. Gut 23:968–973, 1982

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Author information

Correspondence to Jan L. Madsen MD, DMSc.

Additional information

This work was supported by grants from The Danish Hospital Foundation for Medical Research, The Region of Copenhagen, The Faeroe Islands, and Greenland.

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Madsen, J.L., Linnet, J. & Rumessen, J.J. Effect of Nonabsorbed Amounts of a Fructose–Sorbitol Mixture on Small Intestinal Transit in Healthy Volunteers. Dig Dis Sci 51, 147–153 (2006). https://doi.org/10.1007/s10620-006-3100-8

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Key Words

  • carbohydrate malabsorption
  • fructose
  • sorbitol
  • hydrogen and methane breath tests
  • scintigraphy
  • small intestinal transit