What is the primary mechanism by which fructose malabsorption leads to gastrointestinal symptoms?

A Increased glucose production in the liver
B Abnormal gut motility due to fructose-induced inflammation
C Osmotic diarrhea caused by unabsorbed fructose in the intestine ✓
D Impaired insulin signaling pathway

Explanation

Fructose malabsorption occurs when the small intestine fails to absorb fructose properly, leading to an increase in unabsorbed fructose in the intestine. This unabsorbed fructose acts as an osmotic agent, pulling water into the intestinal lumen and resulting in osmotic diarrhea.

Source

American Journal of Clinical Nutrition
Metabolic and Nutritional Disorders Gastroenterology Carbohydrate Malabsorption Medium MEDICAL Confidence: high