Carbohydrate malabsorption disorders refer to conditions in which the body cannot properly absorb certain sugars found in foods. These sugars include sucrose (table sugar), fructose (found in fruits and honey), and lactose (found in milk and dairy products).
Sucrose intolerance, also known as sucrose-isomaltase deficiency, is a rare condition in which the body cannot break down sucrose due to a lack of the enzyme sucrose-isomaltase. Symptoms of sucrose intolerance include abdominal pain, bloating, gas, and diarrhea after consuming foods containing sucrose. Healthcare providers should utilize a patient’s medical history, diet journal, and a sucrose malabsorption breath test to confirm a positive diagnosis.
Fructose malabsorption, also known as fructose intolerance, occurs when the body is unable to properly absorb fructose due to a lack of the enzyme aldolase B. Symptoms of fructose malabsorption include abdominal pain, bloating, gas, and diarrhea after consuming foods high in fructose, such as fruits, honey, and high fructose corn syrup. Healthcare providers should utilize a fructose malabsorption breath test for diagnosis.
Lactose intolerance is the most common carbohydrate malabsorption disorder. It occurs when the body cannot properly break down lactose due to a lack of the enzyme lactase. Symptoms of lactose intolerance include abdominal pain, bloating, gas, and diarrhea after consuming milk and dairy products. The condition can be diagnosed through a lactose malabsorption breath test or a stool acidity test.
There are currently no treatments to cure carbohydrate malabsorption disorder. Healthcare providers recommend dietary changes to manage and eliminate symptoms:
| Disorder | Foods to Avoid | Alternative Options |
|---|---|---|
| Sucrose Malabsorption | Table sugar, candies, some types of bread | Artificial sweeteners and/or natural sweeteners like honey, agave nectar and maple syrup |
| Fructose Malabsorption | Fruits, honey, high-fructose corn syrup | Artificial sweeteners and/or natural sweeteners like Stevia, xylitol and erythritol |
| Lactose Malabsorption | Dairy products | Lactose-free versions, lactase supplements, Almond milk, soy milk, coconut milk, rice milk, hemp milk, oat milk |
Healthcare experts recommend that patients undergo breath testing for Small Intestinal Bacterial Overgrowth (SIBO) before being tested for carbohydrate malabsorption disorders since SIBO can cause symptoms of malabsorption, such as diarrhea, bloating, and gas, and can lead to false positive results on tests for carbohydrate malabsorption. Additionally, treating SIBO can improve symptoms and eliminate the need for further testing for carbohydrate malabsorption.
Finally, both SIBO and carbohydrate malabsorption can also be a symptom of other underlying conditions such as celiac disease, inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS). Patients who suspect they may have a carbohydrate malabsorption disorder or SIBO should consult their healthcare provider to rule out any underlying conditions and develop an appropriate management plan.
