Fructose malabsorption testing through Sullivan Nicolaides

My experience undergoing Fructose Malabsorption testing

Originally I obtained a referral from my GP for a range of malabsorption tests, as my FODMAP diet and tracking had led me to believe I had sorbitol, mannitol and fructose malabsorption issues. Therefore, as I had a referral already for fructose malabsorption, and I had just learned this was one of the 3 tests used to work out if one has SIBO or not, I decided to start with fructose first.

Preparation

In order to prepare for the fructose malabsorption test, you are required to only eat... for 24 hours beforehand (48 hours if you are constipated), then fast from 6pm the night before the test. They also request you empty your bowels before performing the test (no necessarily an easy feat for someone with bowel issues!) During the preparation, I consumed only boiled white rice and boiled eggs and was very lucky to just happen to need to go to the toilet before heading out to my test appointment, phew! Otherwise it was suggested I use an enema to empty the bowels, something I didn't want to have to do.

Appointment

As I had an appointment booked in, the test commenced at my appointment time. I was taken into the collection room, and given the breath test apparatus to take my baseline breath. I didn't know I had to keep my mouth on the piece until the woman collecting my samples had closed it off with her hand, so thought my initial sample could have been compromised. After this, I consumed the substrate, fructose mixed in water. It was super sweet after days of being on the SIBO bi-phasic diet and not consuming any sugar, not even fruit. It wasn't a lot and easy enough to get down, though I did feel a bit sick after the initial ingestion. Then the first waiting period commenced, 20 mins. I returned to the collection room and blew another sample. This continued for a 3 hour period, and I had to provide breath samples at 20 mins, 40 mins, 60 mins, 90 mins and 120 mins after consumption of the fructose. I started to feel sick after not too long after consuming the fructose, in the upper digestive tract area, but couldn't pin point what was the instigator; having just consumed such a large amount of sugar in one hit, an empty stomach, my stomach/intestine struggling with absorbing the substrate, or something else. I was also feeling bloated by the end, and although there isn't an a huge noticeable difference in the before and after photos, there was one there. And this was from 50g of fructose and nothing else being in my stomach. Imagine consuming a plate full of food, with all sorts of triggers in it and my gut not knowing how to handle it all!

Results

My results came a few days later and I had to book in a GP appointment in order to get them. And drum roll... it came back positive, I have fructose malabsorption. This was a pretty big thing for me, to see on paper that there was a diagnosable issue going on in my digestive system that was being triggered by the food I was eating. The results also showed a high baseline level, suggesting unsatisfactory patient preparation. I knew this wasn't the case as I followed everything to the letter, however wondered if it could have been that I had taken my mouth off of the blowing apparatus before the phlebotomist was ready. The GP had very uninspiring advice for me, to stop eating fructose, or to go to the gut clinic in Sydney to see the team of Gastroenterologists for specialist advice. Instead I wanted to do my own further investigation to see if SIBO was in fact my issue, a condition the GP said she didn't believe in, however was willing to give me a referral for Lactulose and Glucose testing all the same, as I was paying for it.

I left feeling unsupported, with new information that it was up to me to look into further, and so I reached out to The Biome Clinic in Mullumbimby and knew this was the next step in my journey as I put the 'western medical system' behind me.