Fructose malabsorption is thought to be a major cause of irritable bowel syndrome. In fructose malabsorbers, the fructose passes through the small intestine, where it would normally be fermented, and into the colon. Here bacteria ferment the fructose, producing short chain fatty acids, hydrogen and carbon dioxide. The gasses are then thought to cause bloating, one of the major symptoms of irritable bowel syndrome. The presence of fructose, a sugar, in the colon, also causes an osmotic effect that draws water into the colon and this can lead to a loose stool. Fructose malabsorption is associated with other symptoms, one of which is depression. For example, in one study, researchers investigated the association between depressive symptoms and irritable bowel symptoms in a number of otherwise healthy individuals. The results of the study showed that those subjects with symptoms of irritable bowel syndrome has significantly higher scores on the Beck’s scale for depression, compared to those without any symptoms.
It is not clear why irritable bowel syndrome would be associated with depressive symptoms. However, the gut is a major source of neuronal activity and is a producer of the same neurotransmitters found in the brain and central nervous system. The nervous system also directly connects the gut to the brain via the vagus nerve. Therefore the fructose may affect the gut, and this may have repercussions for mental health through alterations in neuronal and hormonal activity. Fructose in fruit appears to be less problematic that refined crystalline fructose in terms of its negative effects on physical and mental health.
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