sugar intolerances

What is carbohydrate malabsorption?

You hear a lot about sugar these days and how bad it is for you. The funny thing is glucose, which is a sugar, is the primary source of energy for our brains. So, for starters, not all sugars are bad. Foods are made up of different types of sugars. These sugars are digested, metabolized, and absorbed by different mechanisms in order to fuel our body with glucose efficiently. If any of these processes are not operating normally, a variety of issues can arise. Improperly digested and poorly absorbed sugars usually result in pretty miserable digestive issues, like gas, bloating, abdominal pain, and diarrhea. For someone experiencing gastrointestinal (GI) symptoms, it is important to consider the specific types of sugar consumed and determine if one or more of them may be contributing to specific GI symptoms.

Carbohydrates are made up of starch, sugars, and fiber. In the United States we eat about half of our daily calories from carbohydrates. Technically, sugars are called disaccharides (two sugar units) and monosaccharides (one sugar unit). Disaccharidases (enzymes) are required to break the disaccharides into monosaccharides. Once properly digested, these smaller sugar particles can be absorbed into the bloodstream where they are carried off for processing. Here is how the process is supposed to work:

What happens if you are missing one of these enzymes, or the transporter mechanism required to facilitate sugar absorption is defective? Unable to cross from the small intestine into the blood stream, the offending sugar continues its way downstream through the large intestine and ends up in the colon. Bacteria in the colon go to work breaking the poorly digested sugar down through a process called fermentation. As you may know, fermentation produces a lot of gas and often results in bloating, abdominal pain, gas, and diarrhea. If this happens every time you ingest a certain type of sugar, then you have an intolerance to that particular sugar.

Two other similar sugar intolerances are fructose and sucrose. Someone with a fructose intolerance experiences GI symptoms when they consume too much fructose. Fructose is found in fruit, vegetables, honey, and agave. GI symptoms are usually alleviated after determining tolerance to the types and amounts of fructose-containing foods.

Similarly, someone with a sucrose intolerance experiences GI symptoms when they consume too much sucrose. Sucrose is commonly referred to as table sugar and is an added ingredient to many processed foods such as cereals, snack bars, bakery items, cookies, and candy. Sucrose is also found in some fruits and vegetables. Some of those with a higher sucrose content include pineapple, apricots, dates, mangos, beets, and carrots. Determining tolerance to the type and amount of sucrose-containing foods can help alleviate GI symptoms caused by a sucrose intolerance.