Bacterial Overgrowth or Sucrose Intolerance: How Can You Tell?

Bacterial Overgrowth or Sucrose Intolerance: How Can You Tell?

Many stomach problems are linked to different disorders with symptoms that include recurring diarrhea, gassiness, or abdominal pain. As a result, it’s often difficult for both you and your doctor to figure out the correct diagnosis for what’s causing your stomach problems. So, what can you do to help your doctor find out what’s going on with you?

But first, let’s learn more about two conditions where the symptoms can look very similar and can challenge even the most experienced doctor to find the correct diagnosis: small intestine bacterial overgrowth (SIBO) and Sucrose Intolerance from Congenital Sucrase-Isomaltase Deficiency (CSID). Both of these conditions can have similar symptoms: diarrhea, gassiness, abdominal pain, or a combination of the three.

  • SIBO is a chronic bacterial overgrowth in the small intestine, the part of the gut right after the stomach. In SIBO, bacteria that is normally found in the gut is overgrown in an area where it shouldn’t be: the small intestine.
  • CSID is a deficiency in the enzymes sucrase and isomaltase found in the small intestine. These enzymes are needed to digest sucrose (table sugar) and other sugars found in dietary starches.

Do certain foods cause you to experience gas, bloating, and chronic diarrhea?

It is important that you get the correct diagnosis to manage your stomach problems. Most likely a gastroenterologist – a doctor specializing in problems of the gut – is the most qualified person to make a definitive diagnosis. However, even then, it can be difficult for your doctor to make a diagnosis because there are so many conditions where you may have those symptoms.

After consulting with your doctor and nutritionist, here are some steps you can take to help figure out which of these conditions you may have. Note: If you are being treated for SIBO and are using some medications to treat acid reflux, then your symptoms may get worse if you actually have CSID.

  1. You can try eliminating starches and sucrose, or table sugar, from your diet for two weeks. If you can successfully do that and your symptoms dramatically improve, then you may have CSID.
  2. You can drink a 4-ounce solution of water mixed with 4 tablespoons of sugar. This test is called the “4-4-4-Sugar Challenge.” If your typical stomach symptoms occur within 2 to 3 hours after you drink the solution, then you may actually have CSID and should check with your doctor to get a confirmed diagnosis of CSID. Please check with your doctor before doing this test..
  3. You can try a low-FODMAP diet. If you have SIBO, your symptoms should improve. If you have CSID, then it’s unlikely that you will see any relief.

Remember, before you try any of these diets or tests, talk with your doctor and nutritionist.

Your doctor can order other tests to help confirm if you have SIBO or CSID. The bottom line is that your increased involvement in your care and knowledge about your condition can help you and your doctor better manage your symptoms.


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Sucrose Intolerance May Be More Common Than You Think