Fructose intolerance in children

Fructose intolerance in children

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All metabolic reactions in the body are genetically encoded, and they need special proteins called enzymes. If there is an error in the metabolism, some of these reactions do not occur properly and the precursor compounds of the reaction accumulate and are generally toxic, while the later ones are not synthesized correctly.

A child can be diagnosed with Fructose intolerance. Within this denomination we can find two disorders. We tell you which ones.

The fructose intolerance in children it can occur in two cases:

- A problem in the gut: It is caused by a deficiency of the specific intestinal transporter for fructose GLUT5, present in the brush border of intestinal cells or enterocytes. This entity is misnamed Fructose Intolerance, but It should be called Fructose Malabsorption. It is very frequent (it is estimated that it affects 30% of the population). Symptoms after fructose ingestion are reduced to gastrointestinal disturbances (similar to lactose intolerance), due to the fermentation of fructose in the colon: nausea, diarrhea, meteorism or gas, etc ... Sometimes intolerance (called intolerance secondary) is due to an intestinal disease, which damages the brush border of the intestinal mucosa, for example after gastroenteritis, due to bacterial overgrowth, celiac disease, and could recover after the improvement of the underlying disease.

- An enzyme problem: Due to a deficiency of aldolase B, which is the hepatic enzyme that metabolizes fructose. This is really Hereditary Fructose Intolerance (IHF). It is a genetic alteration, which is inherited in a recessive autonomic way (the patient must have 2 mutated genes to have the disease, generally he inherits one from the father and the other from the mother who are carriers without symptoms). In this entity the symptoms appear when the infant begins to consume common sugar, fructose or sorbitol, for example when introducing fruits, sugary porridge or vegetables. The child develops severe hypoglycemia, abdominal pain, irritability, drowsiness, vomiting, lack of appetite, poor weight gain. You can develop severe liver and kidney disease. It is rare but if it is not treated it can have serious consequences. However, early diagnosis and treatment avoid the consequences of the defect and allow a good quality of life for affected children.

The diagnosis in both cases is different, since hereditary fructose intolerance requires enzymatic and / or genetic studies, while fructose malabsorption is generally diagnosed by the hydrogen breath test.

This test is performed after a minimum fast of 8 hours (you can drink water), a sample of the patient's exhaled air is taken in a small device that contains a sensor for hydrogen. This would be the baseline value. The patient is then given a fructose solution, or a combination of fructose and sorbitol (which would be more sensitive). In the next 2-3 hours, samples of expired hydrogen are collected, which will give us the diagnosis of malabsorption. It is also recorded if the patient has symptoms such as abdominal pain or diarrhea.

1. Treatment in the Hereditary fructose intolerance Consists of the strict elimination of fructose from the diet, since the consequences of the transgression can be serious. Such treatment must be maintained for life. The diet of children with IHF will be based on the elimination of fructose, that is, of sugar, fruit, honey, vegetables and products derived from them. Treat as quickly as possible to avoid liver and neurological damage.

2. Fructose malabsorption is treated with a low diet (not strict elimination) in fructose, depending on the tolerance of each patient. The degree of fructose restriction is thus different in both disorders. The fruits that produce the greatest intolerance are apple, pear, plum, cherry, peach and apricot. Chocolates, pastries, commercial juices, syrups, candies and gum also usually contain fructose and / or sorbitol.

In any case, the diet will be individualized, and will be adjusted to the real needs of each patient and their tolerance, aiming to improve symptoms, with the least possible dietary restriction.

You can read more articles similar to Fructose intolerance in children, in the category of Allergies and intolerances on site.

Video: Hereditary Fructose Intolerance HFI ll Cause,Symptoms u0026 treatment (December 2022).