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Fructose-Breath-Testing
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CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2007;5:959–963bility of the Normal Human Small Intestine to Absorb Fructose:
valuation by Breath Testing
ATISH S. C. RAO, ASHOK ATTALURI, LESLIE ANDERSON, and PHYLLIS STUMBOepartment of Internal Medicine and Clinical Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa
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packground Aims: Fructose consumption is increas-
ng, and its malabsorption causes common gastrointestinal
ymptoms. Because its absorption capacity is poorly under-
tood, there is no standard method of assessing fructose
bsorption. We performed a dose-response study of fruc-
ose absorption in healthy subjects to develop a breath test
o distinguish normal from abnormal fructose absorption
apacity. Methods: In a double-blind study, 20 healthy
ubjects received 10% solutions of 15, 25, and 50 g of fruc-
ose and 33% solution of 50-g fructose on 4 separate days at
eekly intervals. Breath samples were assessed for hydro-
en (H2) and methane (CH4) during a period of 5 hours,
nd symptoms were recorded. Results: No subject tested
ositive with 15 g. Two (10%) tested positive with 25 g
ructose but were asymptomatic. Sixteen (80%) tested pos-
tive with 50 g (10% solution), and 11 (55%) had symptoms.
reath H2 was elevated in 13 (65%), CH4 in 1 (5%), and both
n 2 (10%). Twelve (60%) tested positive with 50 g (33%
olution), and 9 (45%) experienced symptoms. The area
nder the curve for H2 and CH4 was higher (P .01) with
0 g compared with lower doses. There were no gender
ifferences. Conclusions: Healthy subjects have the ca-
acity to absorb up to 25 g fructose, whereas many exhibit
alabsorption and intolerance with 50 g fructose. Hence,
e recommend 25 g as the dose for testing subjects with
uspected fructose malabsorption. Breath samples mea-
ured for H2 and CH4 concentration at 3
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