Bloating and Sucrose Intolerance: The Missing Link

By: Enrique Hernandez-Sanchez, MD
Pediatric Gastroenterologist

Bloating, or the feeling or having a distended abdomen full of gas, is an extremely common complaint heard in gastroenterology offices, by pediatricians and family medicine doctors.

Many diseases can cause bloating and doctors are relatively proficient at detecting potential causes of this condition (e.g., Celiac disease, lactose intolerance and bacterial overgrowth), but in many cases the tests yield negative results.

Eventually, many patients are labeled as having “irritable bowel syndrome” (IBS) and are prescribed generic treatments that include probiotics, antispasmodics or peppermint oil. Yet many times they do not improve and continue to suffer from their symptoms.

Up to 40% of patients with IBS actually suffer from sucrose intolerance, formally known as genetic sucrase-isomaltase deficiency, or GSID.

Sucrose is formed when the sugars glucose and fructose bind together. In order to break this bond, humans need the presence of an enzyme called sucrase, which is present in the lining of the small bowel.

Unfortunately, many children are born with a reduced amount of this enzyme and the result is that sucrose is not absorbed and continues traveling down the bowel. This pulls water from the intestinal lining cells, causing diarrhea and cramps. When it eventually reaches the large intestine, the bacteria ferments the sugar and forms hydrogen gas, which leads to bloating.

Unless your physician orders a sucrose hydrogen breath test or a disaccharides analysis (a test from tissue obtained during an upper endoscopy which is the best way to diagnose sucrose intolerance), you will probably remain undiagnosed for a long time.

If you, your family or friends suffer from bloating, ask your physician to be tested for this very common but frequently missed condition!

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