Is Sucrose to Blame for Your Gastrointestinal Problems?
Sucrose – common table sugar – is a chemical found in sugar cane and sugar beets. It can be found naturally occurring in foods or added as an ingredient to processed food. When using the Nutrition Facts Panel, it is difficult to determine the exact amount of sucrose in a product since sucrose goes by many different names. On the ingredient list, sucrose can be identified as sugar, cane syrup, brown sugar, and even maple syrup. For those with sucrose intolerance, also known as congenital sucrase-isomaltase deficiency (CSID), sucrose-containing foods are very problematic since they cannot be digested.
It is currently estimated that two to nine percent of Americans of European descent are affected by sucrose intolerance. These individuals lack the enzyme known as sucrase, which plays a vital role in helping the body digest sucrose. Without sucrase, the body is unable to complete sucrose digestion. Moreover, those with sucrose intolerance may be lacking another key digestive enzyme like isomaltose, which is responsible for helping the body break down starches. When individuals with sucrose intolerance eat sucrose or starch, they may develop gastrointestinal symptoms like chronic diarrhea, abdominal distention, bloating, and gas.
Or Is Gluten the Problem?
Typically, individuals blame sucrose for issues like weight gain and cravings for sweets, but rarely do they blame sucrose for gastrointestinal symptoms. Gluten, on the other hand, tends to be blamed for causing gastrointestinal symptoms like stomach aches, diarrhea, and bloating. In fact, for the past several years, increasing numbers of people are taking part in the gluten-free movement by avoiding gluten all together. Grocery store shelves are lined with gluten-free products, and the gluten-free industry is predicted to reach $2 billion in sales by 2020.
Gluten has been tied to celiac disease, an autoimmune disorder that affects the digestive process of the small intestine. Recent research indicates that six percent of the American population is eating a gluten-free diet, but only one percent of the American population has been diagnosed with celiac disease and needs to eat a gluten-free diet. When a person who has celiac disease consumes gluten, the individual’s immune system responds by attacking the small intestines. Typical symptoms of celiac disease include abdominal pain, chronic diarrhea, weight loss, bloating and gas, and fatigue. As you can see, some of the symptoms of celiac disease appear similar to the symptoms of sucrose intolerance. Gluten can be found in products containing wheat, barley, and rye; foods that range from pastas and sauces to soda and beer. For those with celiac disease, the only treatment is a life-long adherence to a gluten-free diet.
Grain products contain more than just the protein gluten. Grains can contain carbohydrates known as fructans, along with fiber and sucrose. Fructans are long chains of carbohydrates that the body has difficulty digesting. For some individuals, fructans can cause symptoms of bloating, distention, gas, and diarrhea. Fructans are found in many fruits, vegetables, grains, and nuts.
Fiber, specifically insoluble fiber, can cause gastrointestinal symptoms in some people. Insoluble fibers are found in foods like wheat bran, whole grains, beans, and some vegetables while sucrose is found naturally in foods such as carrots, bananas, and apples and added to grain products like breads and cereals. It is possible that the sucrose found in grain products may be the dietary offender, and gluten may just be an innocent bystander.
How Can We Determine the Culprit?
During digestion, the intestinal wall plays a vital role in helping individuals digest and absorb nutrients. Sucrase and other key enzymes, like maltase and lactase, live on the surface of the intestinal wall. Thanks to the intestinal wall, these key enzymes help digest foods that contain sucrose, maltose, and lactose.
Because celiac disease is an autoimmune response to gluten, it can wreak havoc on the body, causing inflammation and damage to the intestinal wall. In addition, those with celiac disease may also get what is called acquired sucrose intolerance, or transient sucrose intolerance, which differs from CSID in that the transient version goes away on its own once the celiac disease is successfully controlled.
Many types of proteins and carbohydrates are found in wheat. It is possible that a gluten-free diet may alleviate some gastrointestinal symptoms; but, if sucrose intolerance is present, some symptoms may persist even if a gluten-free diet is followed.
It is important to note that not all individuals with celiac disease have trouble with sucrose, and not all individuals with sucrose intolerance have trouble with gluten. These diagnoses are separate and independent from one another.
Some symptoms of celiac disease and sucrose intolerance overlap. Symptoms of gas and bloating, chronic diarrhea, and abdominal pain can be seen in both diseases. If you suffer from these symptoms on a chronic basis, it may be time to ask your doctor about testing you for both gluten intolerance and sucrose intolerance.
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