Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI

OBJECTIVES: The objective of this study was to investigate whether ingestion of fructose and fructans (such as inulin) can exacerbate irritable bowel syndrome (IBS) symptoms. The aim was to better understand the origin of these symptoms by magnetic resonance imaging (MRI) of the gut. METHODS: A tot...

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Main Authors:	Murray, Kathryn, Wilkinson-Smith, Victoria, Hoad, Caroline, Costigan, Carolyn, Cox, Eleanor, Lam, Ching, Marciani, Luca, Gowland, Penny A., Spiller, Robin C.
Format:	Article
Published:	Nature Publishing Group 2013
Online Access:	https://eprints.nottingham.ac.uk/2748/

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author	Murray, Kathryn Wilkinson-Smith, Victoria Hoad, Caroline Costigan, Carolyn Cox, Eleanor Lam, Ching Marciani, Luca Gowland, Penny A. Spiller, Robin C.
author_facet	Murray, Kathryn Wilkinson-Smith, Victoria Hoad, Caroline Costigan, Carolyn Cox, Eleanor Lam, Ching Marciani, Luca Gowland, Penny A. Spiller, Robin C.
author_sort	Murray, Kathryn
building	Nottingham Research Data Repository
collection	Online Access
description	OBJECTIVES: The objective of this study was to investigate whether ingestion of fructose and fructans (such as inulin) can exacerbate irritable bowel syndrome (IBS) symptoms. The aim was to better understand the origin of these symptoms by magnetic resonance imaging (MRI) of the gut. METHODS: A total of 16 healthy volunteers participated in a four-way, randomized, single-blind, crossover study in which they consumed 500 ml of water containing 40 g of either glucose, fructose, inulin, or a 1:1 mixture of 40 g glucose and 40 g fructose. MRI scans were performed hourly for 5 h, assessing the volume of gastric contents, small bowel water content (SBWC), and colonic gas. Breath hydrogen (H 2) was measured and symptoms recorded after each scan. RESULTS: Data are reported as mean (s.d.) (95 % CI) when normally distributed and median (range) when not. Fructose increased area under the curve (AUC) from 0 – 5 h of SBWC to 71 (23) l / min, signiﬁcantly greater than for glucose at 36 (11 – 132) l / min ( P < 0.001), whereas AUC SBWC after inulin, 33 (17 – 106) l / min, was no different from that after glucose. Adding glucose to fructose decreased AUC SBWC to 55 (28) l / min ( P = 0.08) vs. fructose. Inulin substantially increased AUC colonic gas to 33 (20) l / min, signiﬁ cantly greater than glucose and glucose + fructose (both P < 0.05). Breath H 2 rose more with inulin than with fructose. Glucose when combined with fructose signiﬁ cantly reduced breath H 2 by 7,700 (3,121 – 12,300) p.p.m. / min relative to fructose alone ( P < 0.01, n = 13). CONCLUSIONS: Fructose but not inulin distends the small bowel with water. Adding glucose to fructose reduces the effect of fructose on SBWC and breath hydrogen. Inulin distends the colon with gas more than fructose, but causes few symptoms in healthy volunteers.
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format	Article
id	nottingham-2748
institution	University of Nottingham Malaysia Campus
institution_category	Local University
last_indexed	2025-11-14T18:19:25Z
publishDate	2013
publisher	Nature Publishing Group
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spelling	nottingham-27482020-05-04T16:39:17Z https://eprints.nottingham.ac.uk/2748/ Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI Murray, Kathryn Wilkinson-Smith, Victoria Hoad, Caroline Costigan, Carolyn Cox, Eleanor Lam, Ching Marciani, Luca Gowland, Penny A. Spiller, Robin C. OBJECTIVES: The objective of this study was to investigate whether ingestion of fructose and fructans (such as inulin) can exacerbate irritable bowel syndrome (IBS) symptoms. The aim was to better understand the origin of these symptoms by magnetic resonance imaging (MRI) of the gut. METHODS: A total of 16 healthy volunteers participated in a four-way, randomized, single-blind, crossover study in which they consumed 500 ml of water containing 40 g of either glucose, fructose, inulin, or a 1:1 mixture of 40 g glucose and 40 g fructose. MRI scans were performed hourly for 5 h, assessing the volume of gastric contents, small bowel water content (SBWC), and colonic gas. Breath hydrogen (H 2) was measured and symptoms recorded after each scan. RESULTS: Data are reported as mean (s.d.) (95 % CI) when normally distributed and median (range) when not. Fructose increased area under the curve (AUC) from 0 – 5 h of SBWC to 71 (23) l / min, signiﬁcantly greater than for glucose at 36 (11 – 132) l / min ( P < 0.001), whereas AUC SBWC after inulin, 33 (17 – 106) l / min, was no different from that after glucose. Adding glucose to fructose decreased AUC SBWC to 55 (28) l / min ( P = 0.08) vs. fructose. Inulin substantially increased AUC colonic gas to 33 (20) l / min, signiﬁ cantly greater than glucose and glucose + fructose (both P < 0.05). Breath H 2 rose more with inulin than with fructose. Glucose when combined with fructose signiﬁ cantly reduced breath H 2 by 7,700 (3,121 – 12,300) p.p.m. / min relative to fructose alone ( P < 0.01, n = 13). CONCLUSIONS: Fructose but not inulin distends the small bowel with water. Adding glucose to fructose reduces the effect of fructose on SBWC and breath hydrogen. Inulin distends the colon with gas more than fructose, but causes few symptoms in healthy volunteers. Nature Publishing Group 2013-10-19 Article PeerReviewed Murray, Kathryn, Wilkinson-Smith, Victoria, Hoad, Caroline, Costigan, Carolyn, Cox, Eleanor, Lam, Ching, Marciani, Luca, Gowland, Penny A. and Spiller, Robin C. (2013) Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI. American Journal of Gastroenterology, 109 . pp. 110-119. ISSN 1572-0241 http://www.nature.com/ajg/journal/v109/n1/full/ajg2013386a.html doi:10.1038/ajg.2013.386 doi:10.1038/ajg.2013.386
spellingShingle	Murray, Kathryn Wilkinson-Smith, Victoria Hoad, Caroline Costigan, Carolyn Cox, Eleanor Lam, Ching Marciani, Luca Gowland, Penny A. Spiller, Robin C. Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI
title	Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI
title_full	Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI
title_fullStr	Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI
title_full_unstemmed	Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI
title_short	Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI
title_sort	differential effects of fodmaps (fermentable oligo-, di-, mono-saccharides and polyols) on small and large intestinal contents in healthy subjects shown by mri
url	https://eprints.nottingham.ac.uk/2748/ https://eprints.nottingham.ac.uk/2748/ https://eprints.nottingham.ac.uk/2748/

Differential effects of FODMAPs (Fermentable Oligo-, Di-, Mono-Saccharides and Polyols) on small and large intestinal contents in healthy subjects shown by MRI

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