Is There a Test for a Child Who Might Have Sugar Intolerance?
Even though Sucrose Intolerance, informally referred to as “Sugar Intolerance,” is a rare disease, it’s a no-brainer for your pediatrician to check for the intolerance if your child has the telltale symptoms of Congenital Sucrase-Isomaltase Deficiency (CSID).
Testing is especially helpful to make sure this rare condition isn’t overlooked or misdiagnosed. That can happen all too easily because the symptoms of Sucrose Intolerance are pretty much the same as those of other, common GI disorders.
Dr. J. Thomas Lamont, a gastroenterologist at Harvard Medical School, advises that when a child has loose stools three to four times a day for at least four weeks, it is considered chronic diarrhea and should be discussed with a doctor.
If your baby is not only filling diaper after diaper with watery poop but also has colicky gas, bloating, fussiness, and vomiting, it’s time to ask the doctor to consider CSID.
If not diagnosed accurately and treated properly, CSID can impact your child’s development. That’s because a child’s body can’t digest certain sugars in foods and absorb all the important vitamins and minerals needed for healthy growth.
The good news is that if your baby does have Sucrose Intolerance, there is treatment to make it easier than ever to manage the condition and put an end to colic, diarrhea, and the other disagreeable symptoms.
Here’s an overview of the tests that can help your child’s doctor make an accurate diagnosis:
Assay for Sucrase (Endoscopy)
Your doctor may want to take a look inside your baby’s digestive tract (which runs from mouth to butt) to see what’s going on.
This test is invasive because a child has to be put to sleep so that the doctor can place a tube, called an endoscope, down the child’s throat. He will look around the gut as well as take a few very small samples (called a biopsy) of the tissue lining the walls of the intestine.
These samples are sent to a lab that can measure the amount of the sucrase enzyme activity that is in the tissue, the chemicals necessary for the intestine to break down sugars in the foods we eat.
Sucrose Intolerance is inherited. That means the gene, or DNA, necessary to digest certain sugars has been damaged.
With a simple genetic test, the doctor collects a sample of your child’s DNA, either from blood, by a swab of the inside the cheek, or from saliva spit into a test tube.
The DNA sample is sent to a lab that is equipped to see if any damaged genes point to CSID.
Two simple breath tests can help aid in the diagnosis of CSID.
Both tests are based on the principle that when a person isn’t digesting certain sugars, it can be detected by the gases they breath out. While taking the tests, individuals who have Sucrose Intolerance may experience unpleasant GI symptoms due to the large amount of sucrose consumed during the test.
Sucrose Hydrogen/Methane Breath Test. The first of these two tests measures the amount of hydrogen gas in a person’s exhaled breath.
The test starts with drinking a watery solution with sugar in it. There are several sugars that can be tested. If the doctor suspects your baby or older child has Sucrose Intolerance, the water contains table sugar.
Every 30 minutes, your baby blows into a specially-sealed test tube. The entire test usually lasts about 3 hours.
If your child is not digesting the sugar in the watery solution, it will be consumed by bacteria that normally live in the intestine (your gut). When bacteria eat sugar, the process is called “fermentation” and the result is hydrogen gas. The excess hydrogen gas can be detected in exhaled breath and pinpoint the cause of your child’s bloating and gassiness.
13C-Sucrose Breath Test. This breath test starts with your baby drinking a solution of water and sucrose (table sugar) that has a natural chemical called 13carbon or 13C.
If your baby is able to digest the sucrose, it will be broken down and one of the byproducts will be carbon dioxide that has the 13C.
Just like the other breath test, your child blows into a specially sealed test tube every 30 minutes. This test lasts about 1½ hours.
If your child isn’t able to break down sugar, there won’t be much, if any, 13C in the breath.
Sugar Challenge Test
After checking with your child’s pediatrician, you can administer a test at home called the 4-4-4 Sugar Challenge. You stir 4 tablespoons of table sugar into 4 ounces of water and have your child drink it on an empty stomach.
If symptoms of bloating and gas or diarrhea develop in the next 4 to 8 hours, it means your child may have Sucrose Intolerance.
However, because these symptoms can be very uncomfortable, this test is not appropriate for infants or young children. Be sure to talk to your doctor before giving your child this test.