Which Sugar Is Causing My Upset Stomach? Lactose or Sucrose?
Have you ever eaten a meal and 20 to 30 minutes later you had that rumble in your stomach and thought you had better find a bathroom quick?
Do you wake up in the morning with a nice flat belly, but by 6 p.m. look like you’re six months pregnant?
Have you tried every diet out there and nothing seems to help?
Have any of these issues been going on for as long as you can remember?
Have you ever considered sugar as the reason you are having these symptoms?
Depending on how you answered these questions, you could very well have a lactose or sucrose intolerance. Well, we may be able to shed some light on the reasons behind these symptoms.
Let’s take a look at Sucrose Intolerance caused by Congenital Sucrase-Isomaltase Deficiency (CSID) and lactose intolerance and how you can figure out what your problem really is.
Sucrose Intolerance Caused by CSID
Sucrose Intolerance caused by CSID is a rare, genetic disease that is characterized by the symptoms of chronic diarrhea, abdominal pain, and gas and bloating. Sucrose is table sugar. It is a disaccharide, which means it is made up of two smaller sugars, glucose and fructose. Sucrose must be separated into these smaller sugars before it can be absorbed from the intestine into the bloodstream.
In the small intestine, an enzyme called sucrase acts on the sucrose in foods to separate glucose from fructose. If you have a functioning sucrase enzyme, you can eat sugar with no adverse side effects. If you are deficient in functioning forms of sucrase, the sugar is not separated and winds up in the large intestine where bacteria feed on it, causing those yucky symptoms.
Lactose intolerance is a condition caused by a deficiency in lactase, the enzyme that breaks milk sugar into smaller sugars for absorption. Lactose is also a disaccharide, made up of glucose and galactose. Lactose also must be broken down into these smaller sugars before they can be absorbed into the bloodstream. Most of you have heard of lactose intolerance and know that the symptoms of gas and diarrhea following a meal or snack with milk or cheese are an indication of the intolerance. These symptoms develop for the same reason—lactose that isn’t absorbed winds up in the large intestine where it is broken down by bacteria. Lactose intolerance is fairly common and happens to many people as they get older.
When you have symptoms of gas, bloating, diarrhea, and cramping after meals and explain your symptoms to your doctor, one common reaction is a preliminary diagnosis of lactose intolerance. For many, this diagnosis may be correct. With the help of over-the-counter lactase or lactose-free products, you can eat ice cream or queso without any symptoms. However, for some of you, lactose isn’t the problem, or isn’t the only problem, and CSID should be considered.
Figuring out Your Problem
How can you find out if sucrose is causing your symptoms? The gold standard for assessing sucrase function is a biopsy from the small intestine, an invasive procedure performed by a gastroenterologist. But you can also use breath testing to help identify a possible sucrase deficiency.
Two breath tests – the Sucrose Hydrogen Breath Test and the 13C-Sucrose Breath Test – can provide information to your doctor that can help determine if you might have CSID. These tests, which can be performed in your home, consist of drinking a sugar-water solution and blowing into a series of test tubes for analysis. However, taking these tests might cause severe symptoms if you are sensitive to sugar. For this reason, some people should not take these breath tests. It’s a good idea to check with your doctor first. If you do suspect that sugar is causing you issues, talk to your doctor about testing you. Gastroenterologists are doctors who are familiar with both tests.
Sugar is present in many of the foods you eat; and it’s not just the sugar in processed foods like ice cream or cake, but there is also sugar in many vegetables and fruits, like carrots and oranges. Because sucrose is in so many foods, eliminating it entirely from your diet is quite difficult. Combined with some diet modifications and drug therapy, the symptoms of CSID can be reduced significantly, allowing for a healthy diet that even may include some dessert.
Do you think you might have CSID? Take the quiz* at www.sucroseintolerance.com to gain insight as to whether you should talk to your doctor about being tested for CSID.
*This quiz is not a diagnostic.
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