Locations:
Search IconSearch

What Is Fructose Intolerance?

How to cope when your stomach says no to fruit

filling up cup with fructose rich fountain soda

You thought you were doing the healthy thing by making a fruit smoothie. But now your stomach is screaming. Could fructose intolerance be the culprit?

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Fructose is a simple sugar. It’s naturally found in fruits and some vegetables. For people with fructose intolerance, an innocent wedge of watermelon or handful of raisins can be a total day wrecker.

“Fructose intolerance is defined by a constellation of symptoms including flatulence, bloating, diarrhea and abdominal pain,” says gastroenterologist Alberto Rubio-Tapia, MD. In other words, it stinks. Find out if fructose intolerance could be causing your discomfort.

There are 2 types of fructose intolerance

The term “fructose intolerance” can be a bit confusing. That’s because it refers to two different conditions, with very different outcomes:

  1. Dietary fructose intolerance.
  2. Hereditary fructose intolerance.

Dietary fructose intolerance

If you have dietary fructose intolerance, cells in your intestine don’t absorb fructose as they should. There aren’t good estimates of how many people have it, says Dr. Rubio-Tapia. But it’s fairly common.

In people with dietary fructose intolerance (sometimes called fructose malabsorption), eating foods high in fructose can lead to uncomfortable symptoms, including:

  • Gas.
  • Bloating.
  • Diarrhea.
  • Stomach pain.

Hereditary fructose intolerance

This is a genetic condition in which people are born without an enzyme that breaks down fructose. Without this enzyme, they can’t digest fructose at all.

Advertisement

Symptoms show up soon after babies start eating their first solid foods. These babies typically show signs including:

  • Nausea.
  • Bloating.
  • Diarrhea.
  • Vomiting.
  • Abdominal pain.
  • Low blood sugar.
  • Strong dislike of sweets.
  • Problems with growth and development.

Unlike dietary fructose intolerance, hereditary fructose intolerance can cause serious illness. Undigested fructose can build up in the body, damaging the liver and kidneys. If someone with the disorder keeps eating fructose, it can eventually lead to seizures, coma and organ failure.

Genetic testing can confirm a diagnosis of hereditary fructose intolerance. People who have the condition should work with a nutritionist or dietitian to avoid fructose altogether. By cutting out the sugar, they can lead healthy, active lives.

Diagnosing dietary fructose intolerance

Unfortunately, diagnosing dietary fructose intolerance isn’t always simple. Symptoms can sometimes overlap with other conditions, such as irritable bowel syndrome. “There’s no single test we can do to be 100% sure,” says Dr. Rubio-Tapia.

Doctors can perform a fructose breath test to measure how much methane and hydrogen a patient breathes out after drinking a liquid with fructose. That isn’t completely conclusive but can point doctors toward a diagnosis.

Your healthcare provider will also ask about your eating patterns to look for clues. It can help to keep a food log of your symptoms so you can track whether they show up after high-fructose meals.

How to manage dietary fructose intolerance

For people with dietary fructose intolerance, there is no one-size-fits-all solution, says Dr. Rubio-Tapia. “Most people can tolerate some fructose, but everyone has a different sensitivity to it,” he says.

If you suspect fructose intolerance, your doctor will probably recommend an elimination diet. For several weeks, you won’t consume any fructose. Then you can slowly begin reintroducing fructose-containing foods to find out how much you can tolerate without symptoms.

“It’s helpful to work with a dietitian during this process to find what works and make sure you’re still getting adequate nutrition,” he says.

High-fructose foods to avoid (and lower-fructose fruits to try)

Most fruits contain fructose, but there are exceptions. And some non-fruit foods have hidden fructose. High-fructose corn syrup is a common sweetener found in everything from yogurt to soda, so it’s important to read labels.

Common high-fructose foods include:

  • Most fruits, especially dried fruits and fruits canned in juice or syrup.
  • Vegetables including artichoke, asparagus, broccoli, leeks, mushrooms, okra, onions, peas, red pepper, shallots and tomato products.
  • Foods with wheat as the main ingredient, such as wheat bread and pasta.
  • Sweeteners such as honey, agave nectar and high-fructose corn syrup.
  • Sodas and desserts sweetened with fructose.

Advertisement

Fortunately, some fruits fall on the lower end of the fructose scale. Some people with dietary fructose intolerance have luck with these lower-fructose picks:

“Some people may be able to tolerate certain fruits better than others. Listen to your body,” Dr. Rubio-Tapia says. It might take some trial and error, but your happy stomach will thank you.

Advertisement

Learn more about our editorial process.

Related Articles

Person making a batch of brownies in a large bowl, adding eggs to the mix
April 1, 2025/Nutrition
What Is High Fructose Corn Syrup? And Why It’s Bad for You

High fructose corn syrup is a common sweetener in packaged foods and can contribute to weight gain and inflammation

Artificial sweetener in wooden bowl on kitchen towel, with spoonful nearby
January 8, 2025/Heart Health
What’s Erythritol? And Is It Bad for You?

Erythritol is found in a range of ‘diet,’ ‘sugar-free’ and ‘keto-friendly’ foods — but research has linked it to heart attack and stroke

Adding spoonful of allulose to mug of coffee
November 4, 2024/Nutrition
What You Need To Know About Allulose

Although allulose is an FDA-approved sugar substitute, more research is needed to understand its safety

Person pouring packet of sugar subsitute in cup of coffee, cell phone on table, spoon in hand
June 28, 2024/Nutrition
Stevia Is Sweet — But Is It Good for You?

Studies and the FDA say this herbaceous alternative is safe in moderation, so go ahead and sprinkle away!

Bowl of artificial sweetener with a spoonful
June 7, 2024/Heart Health
Eating Foods With Xylitol Can Be a Risk to Your Heart

Xylitol in processed food can increase risk of heart attack and stroke — but there’s no danger in xylitol in oral care products

Yacon syrup in small glass jar displayed with yacon root all on a piece of burlap.
August 4, 2023/Nutrition
Is Yacon Syrup Healthy?

All-natural, plant-based and low-calorie, but it can also cause some serious digestive discomfort

Closeup of sugar substitute in granulated and pill form on a blue background.
July 18, 2023/Nutrition
Do You Need To Cut Out Aspartame?

Moderation is important for lowering risks

raw honey poured into tea cup
June 14, 2023/Nutrition
Substitutes for Sugar: What To Try and What To Limit

Fruit is the best option for a healthy sweetener, but limit refined sugar and artificial sweeteners

Trending Topics

Person in bed sleeping on their side, covers off
Breathing Problems? Try These Sleep Positions

If you’re feeling short of breath, sleep can be tough — propping yourself up or sleeping on your side may help

A couple looking at skyline, with one person slightly behind the other, head bent down
What Is Anxious Attachment Style — and Do You Have It?

If you fear the unknown or find yourself needing reassurance often, you may identify with this attachment style

Glasses and bottle of yellow-colored prebiotic soda, with mint, lemon and ginger garnish
Are Prebiotic Sodas Good for You?

If you’re looking to boost your gut health, it’s better to get fiber from whole foods

Ad