Bloating and Sucrose Intolerance: The Missing Link

Bloating and Sucrose Intolerance:  The Missing LinkBloating, 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 such as (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 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) and 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 breath test, or 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.

The most frustrating thing of all is that effective therapy is available. Treatment begins with a restriction of sucrose in your diet (which is present in certain fruits, juices, sugar cane, syrups, honey and candy), adding a probiotic containing saccharomyces boulardii (Florastor) and for most patients, a medication called Sucraid, which contains the actual missing enzyme, sucrose.

Patients usually will add 1-2ml of Sucraid to each meal or snack that contains sucrose to prevent the development of symptoms.

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