Glass of orange juice as an example of a food that may cause fructose intolerance symptoms

Common Fructose Intolerance Symptoms

Medically reviewed on Sept 20, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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Most people would say fruits are an important part of a balanced diet, but this isn’t always true. In particular, people with fructose intolerance are unable to consume fruits and other fructose-containing foods because doing so leads to acute and chronic digestive upset.

If you’re looking to find the cause of persistent digestive discomfort, you may want to discuss fructose intolerance with a healthcare provider.

Here, we’ll define what fructose intolerance is, take a look at common fructose intolerance symptoms, and explore approaches to management and treatment.

What Is Fructose Intolerance?

Fructose intolerance is a condition that impairs a person’s ability to comfortably digest [1]:

  • Fructose
  • Fructans
  • FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols)

You can find each of these constituents in many naturally derived fruits and vegetables. [1] You may also encounter them in processed foods like high fructose corn syrup which is used liberally in commercial food products.

Because it’s seldom discussed, researchers believe fructose intolerance often gets mistaken for other common digestive conditions. In fact, one study predicted that as many as ⅓ of people diagnosed with irritable bowel syndrome (IBS) have misdiagnosed fructose intolerance. [1]

If you experience digestive discomfort after eating fruit, it may be worth learning about the two different types of fructose intolerance: dietary and hereditary.

Dietary Fructose Intolerance

Dietary fructose intolerance, also called fructose malabsorption, is the most common instance of fructose intolerance. It results when an individual’s intestines are unable to absorb fruit sugars normally. [2]

Dietary fructose intolerance typically presents with symptoms like:

  • Flatulence
  • Bloating or abdominal swelling
  • Abdominal pain
  • Diarrhea and digestive disturbances

Because these are also symptoms associated with better-known illnesses, like irritable bowel syndrome (IBS), many cases of fructose intolerance go under-reported. [2]

Fortunately, dietary fructose intolerance rarely leads to severe health consequences. [2] By modifying diet in cooperation with a healthcare provider, people with this type of fructose intolerance can usually lead full, healthy lives. [2]

Hereditary Fructose Intolerance

Hereditary fructose intolerance is more serious, resulting from a gene mutation.3 People with this type of fructose intolerance are born without the ability to produce the enzyme needed to break down sugars in fruit (aldolase B enzyme).3 Or, the enzymes they do possess don’t function properly.

Hereditary fructose intolerance is rare. It affects only 1 in every 20,000 or 30,000 people.3 Usually, hereditary fructose intolerance makes itself known in infancy or childhood when a baby has a negative response to eating fruit. [3]

Considered a severe condition, untreated hereditary fructose intolerance can result in [3]:

  • Hypoglycemia (low blood sugar)
  • Nausea and vomiting
  • Abdominal pain
  • Inability to gain weight
  • Impaired development
  • Liver or kidney damage
  • Organ failure [2]
  • Seizures [2]

In severe cases, untreated hereditary fructose intolerance can result in fatal consequences. If an infant has an adverse reaction to eating fruit or fructose-containing products, it’s crucial that a healthcare provider examine them immediately.

Diagnosing Fructose Intolerance

There are several methods healthcare providers use to diagnose intestinal fructose intolerance [2]:

  • Fructose breath tests – These tests evaluate the amount of methane and hydrogen in a person’s breath after they ingest a fructose-containing solution. If they are intolerant, they may need to follow a [low-fructose diet](https://www.everlywell.com/blog/metabolism/low-fructose-diet) to minimize symptoms.
  • Elimination diets – If a person’s symptoms aren’t urgent or severe, healthcare providers may recommend trying an elimination diet to detect possible triggers. But [how does an elimination diet work](https://www.everlywell.com/blog/food-sensitivity/how-to-do-an-elimination-diet/)? In this meal plan or diet, certain foods and ingredients are completely removed and then reintroduced to assess symptoms and detect any [food sensitivity](https://www.everlywell.com/blog/food-sensitivity/food-sensitivity-explained/). If a fructose-containing food is removed and reintegrated to yield negative symptoms, that person may have fructose malabsorption.

Fructose Intolerance: Management And Treatment

The most effective starting place for managing fructose intolerance is familiarizing yourself with foods that contain fructose so that you can easily avoid them. Some foods with the highest amounts of fructose include [2]:

  • Fresh, sugary fruits, like grapes, apples, and ripe bananas
  • Dried fruit or fruits canned in syrup
  • Certain vegetables, like broccoli, onions, and red peppers
  • Wheat, like wheat bread, pasta, and pastries
  • Certain sweeteners, like honey and high-fructose corn syrup
  • Certain highly processed sweets
  • Sodas sweetened with fructose

Sometimes, a healthcare provider may also recommend a Low FODMAP diet. [4] This diet helps reduce your exposure to short-chain carbohydrates (high FODMAP foods) responsible for much of fruits’ sugars. [4]

If you’ve been diagnosed with fructose intolerance, eliminating fruits and fructose-containing foods may help reduce symptoms. However, in some cases, a healthcare provider may give you the green light to consume certain low-fructose fruits in moderation.

If that’s the case for you, you may be able to enjoy the following fruits occasionally, in limited amounts [2]:

  • Citrus fruits like lemons, limes, and oranges
  • Pineapple
  • Certain melons, like cantaloupe
  • Certain berries, like strawberries
  • Avocados

Finally, it’s important to find alternative ways of obtaining the nutrients you’d normally obtain through fruit and vegetables. A multivitamin that offers essential vitamins and minerals can be an excellent tool for finding nutritional balance.

Digestive Wellness With Everlywell

Many people struggle with digestive discomfort, but discerning the root cause isn’t always clear. With Everlywell, you can screen for everything from a food sensitivity to celiac disease affordably, conveniently, and with complete privacy protection. Find out more of what you can discover about your health by checking in with Everlywell today.

Shop Food Sensitivity Tests Today!

Low Fructose Diet: Recommended Foods

IBS Flare Up: Treatment and Prevention

High FODMAP Foods: What to Know

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References

  1. Fedewa, A., & Rao, S. S. C. (2014, January). Dietary fructose intolerance, fructan intolerance and fodmaps. Current gastroenterology reports. URL. Accessed Sept 15, 2023.
    2. (2022, December 9).
  2. What is fructose intolerance?. Cleveland Clinic. URL. Accessed Sept 15, 2023.
  3. (n.d.). Hereditary fructose intolerance: Medlineplus genetics. MedlinePlus. URL. Accessed Sept 15, 2023.
  4. Professional, C. C. medical. (n.d.). Low Fodmap Diet: What it is, uses & how to follow. Cleveland Clinic. URL. Accessed Sept 15, 2023.
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