Dietary fructans exacerbate symptoms in some, but not all, adults with irritable bowel syndrome (IBS).
Dr Bruno Pedro Chumpitazi and colleagues determined whether fructans worsen symptoms in children with IBS and whether clinical and psychosocial factors, and/or gas production, can identify those who are fructan sensitive.
The team performed a double-blind placebo-controlled cross-over trial of 23 children with IBS, based on pediatric Rome III criteria, from 2014 through 2016.
At baseline, participants completed 1-week pain and stool diaries and a 3-day food record and psychosocial factors were measured.
The researchers randomly assigned subjects 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.
|78% had more frequent abdominal pain while on the fructan-containing diet|
|Clinical Gastroenterology & Hepatology|
The team captured gastrointestinal symptoms and breath hydrogen and methane production during each meal period.
Fructan sensitivity was defined as an increase of 30% or more in abdominal pain frequency following fructan ingestion.
The research team found that 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 fructan-containing diet than the maltodextrin-containing diet.
The researchers found that 78% had more frequent abdominal pain while on the fructan-containing diet, and 52% qualified as fructan sensitive.
The team found no difference between fructan-sensitive and fructan-insensitive subjects in baseline abdominal pain or bowel movement characteristics, dietary intake, psychosocial parameters, IBS subtype, or gas production.
Dr Chumpitazi's team concludes, "In a randomized controlled trial of children with IBS, 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."