Dietary fructans exacerbate symptoms in some, but not all, adults with irritable bowel syndrome.
Dr Bruno Pedro Chumpitazi and colleagues of Houston, Texas sought to determine whether fructans worsen symptoms in children with irritable bowel syndrome and whether clinical and psychosocial factors, and/or gas production, can identify those who are fructan sensitive.
The doctor's performed a double-blind placebo-controlled cross-over trial of 23 children with irritable bowel syndrome, based on pediatric Rome III criteria, from September 2014 through December 2016.
At baseline, participants completed 1-week pain and stool diaries and a 3-day food record and psychosocial factors were measured.
Subjects were randomly assigned to groups that were provided meals for 72 hours containing either fructans or maltodextrin.
Following a washout period of 10 days or more, the subjects received the meal they were not given during the first study period.
Fructan sensitivity was defined as an increase of 30% or more in abdominal pain frequency following fructan ingestion
Clinical Gastroenterology and Hepathology
Gastrointestinal symptoms and breath hydrogen and methane production were captured during each meal period.
Fructans sensitivity was defined as an increase of 30% or more in abdominal pain frequency following fructan ingestion.
The team discovered subjects had more mean episodes of abdominal pain/day during the fructan-containing diet vs the maltodextrin-containing diet, along with more severe bloating and flatulence.
Hydrogen production was greater while subjects were on the fructans-containing diet than the maltodextrin-containing diet.
The team found that 18 subjects had more frequent abdominal pain while on the fructan-containing diet and 12 qualified as fructans sensitive.
The researchers found no difference between fructans-sensitive and fructans-insensitive subjects in baseline abdominal pain or bowel movement characteristics, dietary intake, psychosocial parameters, irritable bowel syndrome subtype, or gas production.
Dr Chumpitazi's team comments, "In a randomized controlled trial of children with irritable bowel syndrome, we found fructans to exacerbate several symptoms."
"However, fructan sensitivity cannot be identified based on baseline gastrointestinal symptoms, dietary intake, psychosocial factors, or gas production."