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Gastrointestinal system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
The onset of hereditary permanent lactose deficiency very rarely occurs before the age of 2 years but increases in frequency through childhood. Soya formulae usually contain sucrose or glucose polymer which, when hydrolysed, liberates glucose which cannot be absorbed in individuals with hereditary glucose-galactose malabsorption. Following infectious diarrhoea most infants develop lactose intolerance; some may also develop sucrose intolerance. In lactose intolerance hydrogen appears late in the breath as it is liberated from the disaccharide by the colonic bacteria. Bacterial overgrowth of the small bowel is associated with mucosal injury and depression of disaccharide enzyme levels, which presents as sugar intolerance.
Sucrose intolerance in adults with common functional gastrointestinal symptoms
Published in Baylor University Medical Center Proceedings, 2022
Christine L. Frissora, Satish S. C. Rao
About 70% of the adult population is affected by some form of carbohydrate malabsorption. Sucrose malabsorption may be more prevalent than previously recognized.1 Sucrose intolerance, caused by a deficiency in sucrase enzyme activity in the small intestine, presents with postprandial cramping, bloating, gas, and diarrhea. These are common symptoms that are often attributed to functional gastrointestinal (GI) disorders, such as irritable bowel syndrome (IBS). There are increasing reports of patients diagnosed with IBS whose symptoms are actually due, at least in part, to carbohydrate malabsorption, including sucrose.2–5 Sucrose intolerance due to congenital sucrase-isomaltase deficiency (CSID) is rare. Secondary or acquired sucrose intolerance is more common and caused by intestinal brush border injury. The gold standard test for sucrase deficiency is the sucrase enzyme activity assay from duodenal biopsies. Alternatively, the sucrose breath test is a noninvasive way to diagnose sucrose malabsorption.6 When sucrase deficiency is detected, a trial therapy of dietary modification and enzyme replacement therapy can be initiated. Our objective was to describe our clinical experience with a large group of adult patients presenting with chronic GI symptoms who were screened for sucrose malabsorption using breath testing and to discuss clinical outcomes in a subgroup who were followed up in our clinic.