How can I tell the difference between inulin intolerance and an intense awakening event?

Occasionally some children will have a very intense reaction to inulin even at extremely low doses. The most common extreme side effects of inulin are increased hyperactivity, anxiety, and even aggression. An awakening reaction from the reduction in propionic acid may have an identical intensity and appearance as inulin intolerance but can often be determined by prior history.nnChildren with increased anxiety and aggression due to inulin intolerance often had little to none of these behaviors before starting inulin. Whereas children with increased aggression and anxiety due to the awakening often had significant pre-existing negative behaviors that have just escalated. nnIf there is still confusion over whether you are dealing with inulin intolerance or an awakening effect, I recommend my patients stop the inulin and switch to rifaximin.