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in Females
Carbohydrate Malabsorption Syndromes and
Early Signs of Mental Depression in Females
M. LEDOCHOWSKI, MD, B. WIDNER, DSc, B. SPERNER-UNTERWEGER, MD, T. PROPST, MD,
W. VOGEL, MD, and D. FUCHS, PhD
Fructose and lactose malabsorption are characterized by impaired duodenal fructose trans-
port or by the deficiency of mucosal lactase, respectively. As a consequence, the nonabsorbed
saccharides reach the colon, where they are broken down by bacteria to short fatty acids, CO2,
and H2. Bloating, cramps, osmotic diarrhea, and other symptoms of irritable bowel syndrome
are the consequence and can be seen in about 50% of carbohydrate malabsorbers. We have
previously shown that fructose as well as lactose malabsorption were associated with signs of
mental depression. It was therefore of interest to investigate possible interactions between
fructose and lactose malabsorption and their influence on the development of signs of
depression. In all, 111 otherwise healthy volunteers (81 females and 30 males) with gastro-
intestinal complaints were analyzed by measuring breath H2 concentrations after an oral dose
of 50 g lactose and of 50 g fructose one week apart. They were classified as normals, isolated
fructose malabsorbers, isolated lactose malabsorbers, and combined fructose/lactose malab-
sorbers. All patients filled out a Beck’s depression inventory–questionnaire. Twenty-five
individuals (22.5%) were neither fructose nor lactose malabsorbers (group 1), 69 (62.2%)
were only fructose malabsorbers (group 2), 4 (3.6%) were only lactose malabsorbers (group
3), and 13 (11.7%) presented with fructose and lactose malabsorption together (group 4).
Isolated fructose malabsorption and combined fructose/lactose malabsorption was signifi-
cantly associated with a higher Beck’s depression score. Further analysis of the data show that
this association was strong in females (P , 0.01), but there was no such association between
carbohydrate malabsorption and early signs of depression in males. I
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