Congenital Sucrase-Isomaltase Deficiency (CSID) vs. Exocrine Pancreatic Insufficiency (EPI)

Congenital Sucrase-Isomaltase Deficiency (CSID) vs. Exocrine Pancreatic Insufficiency (EPI)

On the road to being diagnosed with Sucrose Intolerance caused by Congenital Sucrase-Isomaltase Deficiency (CSID), many of you looked online for clues. In your search for answers, you may have come across something called exocrine pancreatic insufficiency (EPI), also called pancreatic insufficiency.

If you do have Sucrose Intolerance, it makes sense that you might have found websites talking about exocrine pancreatic insufficiency. Both these disorders cause similar gastrointestinal symptoms. But while Sucrose Intolerance and exocrine pancreatic insufficiency share some overlapping symptoms, they’re very different conditions; and treating one won’t help control the other.

What is Sucrose Intolerance?

Sucrose Intolerance is a disorder of the small intestine that limits your ability to break down sucrose and other sugars found in starches. If you have Sucrose Intolerance, you lack or have low levels of the digestive enzymes sucrase and isomaltase. Symptoms such as bloating, gas, and diarrhea show up soon after consuming foods with high levels of sucrose.

What is Exocrine Pancreatic Insufficiency?

An enzyme deficiency is also at play in exocrine pancreatic insufficiency (EPI). In EPI, you lack or have low levels of exocrine pancreatic enzymes. The deficient enzymes causing EPI are needed by the body to digest fats, proteins, and carbohydrates. As with CSID, EPI causes unpleasant gastrointestinal symptoms, including diarrhea, gas, bloating after a meal, and weight loss.

Key Distinguishing Factors

There are a few key differences that may be used to help distinguish between these two disorders:


While Sucrose Intolerance and EPI both cause diarrhea, there are different qualities to look for that can help differentiate between the two.

A typical Sucrose Intolerance symptom is watery diarrhea. With EPI, the diarrhea is typically watery as well, but it has also been known to have a foul odor and greasy appearance, to the extent that you may see a ring of oil in the toilet water. This oil is due to the improper digestion of dietary fats. This type of fatty diarrhea is called steatorrhea.

Preexisting conditions

Individuals with EPI often have a coexisting condition such as cystic fibrosis, acute or chronic pancreatitis, or pancreatic cancer; or they may have recently undergone major, upper-gastrointestinal surgery.

Those conditions are not linked with Sucrose Intolerance. Acquired Sucrose Intolerance may occur as a result of other disorders that irritate or inflame the intestinal lining, such as celiac disease or a gastrointestinal infection. But CSID is an inherited, lifelong condition while EPI is usually temporary.

Different triggers

If it is possible that you might have Sucrose Intolerance, you should avoid foods containing sucrose and starch. Common sucrose-containing foods include white and brown sugar; high-sucrose fruits, such as apples, bananas, melons, and tropical fruits; and sweet vegetables, such as yams, carrots, and potatoes.

Grains, such as wheat, oats, rice; starchy vegetables, such as corn and potatoes; and beans or legumes such as black beans, peas, and lentils should also be avoided. Most breads, cereals, and crackers contain sucrose and / or starches and should also be avoided. If you have Sucrose Intolerance, visit for a complete list of foods to avoid.

If you have EPI, you are advised to limit your consumption of dietary fats found in foods such as nuts, cheese, red meat, and poultry skins.

Call to action: Symptoms of Sucrose Intolerance and EPI can be similar, making your path to a proper diagnosis more difficult. Take the Sucrose Intolerance quiz and talk with your physician about your symptoms, to help reach a proper diagnosis.

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Sucrose Intolerance May Be More Common Than You Think