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Some people like to believe that fermentation (or more specifically bad bacteria) are IBS culprits. There is some data, but not a lot. People have experimented with replacing ALL of one�s gut bacteria with new bacteria. That�s not a procedure for the faint of heart, though.Anyway, fermentation should only be an issue if bacteria and substrate (sugar) meet. That generally can�t happen in the upper gut because it washes away most bacteria, so the only way things could be problematic if the sugar gets through. Lactose gets through in a fair number of people, but for some reason, doesn�t seem to cause a problem despite the popular belief. People have proposed the reason is that the good bacteria eat the lactose! In fact, a popular idea is to feed the good bacteria special sugars they like. Known as fructoligosaccaharides, or FOS. The Japanese have experimented with this with apparently mixed results. Another sugar which can get through is fructose or fruit sugar. That could make fruits problematic, but which ones, I am not sure. It also depends on the load of the sugar..small amounts shouldn't be a problem, but one study found bad bacteria and fructose as an apparent cause for IBS symptoms. Incidentally, when fructose is combined with glucose (it is when you eat sucrose, or table sugar), the fructose absorbs better. Another thing of note is that prunes have a known laxative effect, but it doesn't seem to be related to its sugar content. I don't think any of this is related to the outside of the gut, so that throws out the blood sugar concept. You don't get alter that too much without get very ill (diabetes).The upper gut symptoms could be related to intrinsic motility disorder of the stomach.

 

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Malabsorption can be specific or generalized. Specific malabsorption can result from enzyme deficiency such as lactase deficiency causing lactose malabsorption. Lactose is a cobmination of gluocse and galactose.It�s also possible to has isomaltase deficiency, which would prevent one from breaking down maltose (a combination of two glucose molecules). Another one is sucrase deficiency, preventing digestion of sucrose (table sugar), which is glucose and fructose. Corn syrup is actually a pregdigested version of sucrose.Fructose malabsorption probably results from a defect in the transporter proteins that are involved with facilitated diffusion of it across the intestinal cell membrane.Generalized malabsorption means that some disease process is affecting the absorption of all nutrients. Fat is often affected the worst and the excess fat in the stool is called steatorrhea. That results in weight loss. Many diseases can cause this, but IBS does not.What Alley is referring to is the food combining diet. There is no truth to it, however. You can feel free to combine fruits, meats, breads, whatever. The digestive system is a very good mixer and the enzymes are very powerful. They don�t mind. Fermentation does not take place in the uppger gut because bacteria (with the exception of ulcer bacteria) don�t live there.Abnormal Delayed gastric emptying can cause bloating. That would be an intrinsic disorder of the gut. That could happen with anything you eat, but it could be worse with fat ingestion since fat triggers gastric inhibitory peptide which does keep food in the stomach longer, which is a normal part of digestion.