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Several studies have measured the intestinal absorption of fructose using the hydrogen breath test. [42][43][44][45] These studies indicate that fructose is not completely absorbed in the small intestine. When fructose is not absorbed in the small intestine, it is transported into the large intestine, where it is fermented by the colonic flora. Hydrogen is produced during the fermentation process and dissolves into the blood of the portal vein. This hydrogen is transported to the lungs, where it is exchanged across the lungs and is measurable by the hydrogen breath test. The colonic flora also produces carbon dioxide, short-chain fatty acids, organic acids, and trace gases in the presence of unabsorbed fructose. [46] The presence of gases and organic acids in the large intestine causes gastrointestinal symptoms such as bloating, diarrhea, flatulence, and gastrointestial pain[42] Exercise immediately after consumption can exacerbate these symptoms by decreasing transit time in the small intestine, resulting in a greater amount of fructose emptied into the large intestine. [47]

Although some artificial sweeteners are not suitable for home-baking, many traditional recipes use fructose. [29]Fructose malabsorption may cause gastrointestinal symptoms such as abdominal pain, bloating , flatulence or diarrhea . [4] [5]

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