{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:19:46Z","timestamp":1780352386218,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001352","name":"National University of Singapore","doi-asserted-by":"publisher","award":["C\u2010148\u2010000\u2010003\u2010001"],"award-info":[{"award-number":["C\u2010148\u2010000\u2010003\u2010001"]}],"id":[{"id":"10.13039\/501100001352","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Symptoms following fructose ingestion, or fructose intolerance, are common in patients with functional gastrointestinal disorders (FGID) and are generally attributed to intestinal malabsorption. The relationships between absorption, symptoms, and intestinal gas production following fructose ingestion were studied in patients with FGID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty FGID patients ingested a single dose of fructose 35\u00a0g or water in a randomized, double\u2010blind, crossover study. Blood and breath gas samples were collected, and gastrointestinal symptoms rated. Plasma fructose metabolites and short\u2010chain fatty acids were quantified by targeted liquid chromatography\u2010tandem mass spectrometry. Patients were classified as fructose intolerant or tolerant based on symptoms following fructose ingestion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>The median (IQR) areas under the curve of fructose plasma concentrations within the first 2\u00a0h (AUC<jats:sub>0\u20132\u00a0h<\/jats:sub>) after fructose ingestion were similar for patients with and without fructose intolerance (578 (70)\u00a0\u00b5M\u00b7h vs. 564 (240)\u00a0\u00b5M\u00b7h, respectively, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.39), as well as for the main fructose metabolites. There were no statistically significant correlations between the AUC<jats:sub>0\u20132\u00a0h<\/jats:sub> of fructose or its metabolites concentrations and the AUCs of symptoms, breath hydrogen, and breath methane. However, the AUCs of symptoms correlated significantly and positively with the AUC<jats:sub>0\u20132\u00a0h<\/jats:sub> of hydrogen and methane breath concentrations (<jats:italic>r\u00a0<\/jats:italic>=\u00a00.73, <jats:italic>r\u00a0<\/jats:italic>=\u00a00.62, respectively), and the AUCs of hydrogen and methane concentrations were greater in the fructose\u2010intolerant than in the fructose\u2010tolerant patients after fructose ingestion (<jats:italic>p\u00a0<\/jats:italic>\u2264\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Fructose intolerance in FGID is not related to post\u2010ingestion plasma concentrations of fructose and its metabolites. Factors other than malabsorption, such as altered gut microbiota or sensory function, may be important mechanisms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14150","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T17:42:10Z","timestamp":1618249330000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Fructose intolerance is not associated with malabsorption in patients with functional gastrointestinal disorders"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2556-8933","authenticated-orcid":false,"given":"Clive","family":"Wilder\u2010Smith","sequence":"first","affiliation":[{"name":"Gastroenterology Group Practice Brain\u2010Gut Research Group Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sze Han","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pharmacy National University of Singapore Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren Schou","family":"Olesen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Mech\u2010Sense Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing Yi","family":"Low","sequence":"additional","affiliation":[{"name":"Department of Pharmacy National University of Singapore Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorinda Yan Qin","family":"Kioh","sequence":"additional","affiliation":[{"name":"Department of Pharmacy National University of Singapore Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronaldo","family":"Ferraris","sequence":"additional","affiliation":[{"name":"Department of Pharmacology &amp; Physiology New Jersey Medical School Newark NJ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Materna","sequence":"additional","affiliation":[{"name":"Gastroenterology Group Practice Brain\u2010Gut Research Group Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric Chun Yong","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy National University of Singapore Singapore City Singapore"},{"name":"Singapore Institute of Clinical Sciences Agency for Science, Technology and Research Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04018.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12306"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.07.013"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13978"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.96"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640613505279"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.09.062"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0201410"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-7075-9-89"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2017.12.016"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13497"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm16214"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpba.2017.01.044"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI102736"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.96"},{"key":"e_1_2_9_17_1","first-page":"473","article-title":"Fructose malabsorption syndrome","volume":"16","author":"Putkonen L","year":"2013","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(88)80016-7"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-nutr-082117-051707"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2018.11.008"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.46"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2007.04.008"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0049558"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.03235\u201019"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365529850171549"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016\u20105085(15)32493\u20108"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00253-020-10599-8"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010019\u201009964\u20107"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.201801526RR"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1813780115"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2019.1686322"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.00277"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/130.8.1932"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00018.2018"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00196.2019"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300253"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.11.301"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312361"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12291"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i27.3699"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2018.16"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.33601"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2012.11.012"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI92390"}],"container-title":["Neurogastroenterology &amp; 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