The Bitter Truth of Sucrose Malabsorption

How Sweet it is to Absorb Sucrose, But What if you Can’t?

I once had a client that was diagnosed with sucrose malabsorption, listening to how much her life had been impacted was heartbreaking. She felt trapped in her own house, unable to travel without fear of having an accident. She would have to find the restroom immediately, anytime she was brave enough to venture out

She was to the point of having to wear incontinence undergarments in order to feel comfortable enough to go to the grocery store, only to face the aisles of food she was afraid to eat. She was at the point of desperation when we first met and was willing to do anything to get back to the life she once had prior to developing this condition, so we got to work.

Sucrose malabsorption is becoming a more common diagnosis that can develop due to damage to the gastrointestinal tract from IBS, Celiac disease, or small intestine bacterial overgrowth (SIBO). This can also be a congenital disorder that you are born with. 

In either case, your body does not produce enough of the enzyme sucrase, which is used to break down sucrose properly. 

Symptoms that occur after ingestion of sucrose include excess gas production, bloating, cramping, and diarrhea. Like other digestive problems malnutrition can occur as well as a decreased quality of life.

Sucrose is categorized as a disaccharide, meaning it is made up of two sugar units, glucose and fructose. The enzyme sucrase is what breaks down sucrose into the two individual sugar molecules that are absorbed and used as energy production and storage. Sucrose is commonly known as table sugar, which comes primarily from sugar cane and beets as well as processed foods where sugar is added. 

When you have a sucrose malabsorption you are able to consume individual sugar molecules (monosaccharides), since they are already separated and do not require the enzyme for breakdown. Those with congenital sucrose malabsorption may be prescribed oral solution enzyme replacement therapy. 

For those who have developed this malabsorption, dietary changes are one of the best options for symptom management. 

Start with maintaining a food diary to track the foods eaten and the amounts consumed. This is an important step to understanding triggers and appropriate removal of those foods from your diet. 

Next, is following a two-week elimination diet specifically focused on the removal of sugars and starches in order to calm inflammation and obtain better results. After the two-week elimination period, start with reintroducing starchy foods. You will only reintroduce one food at a time and space reintroduction by three-to-five days. 

The website www.sucroseintolerance.com has a comprehensive list of low-sucrose, low-starch foods to choose from. Other Elimination diets to try can be the FODMAP diet, as consumption of fermentable sugars may continue to inflame your GI tract causing unnecessary symptoms and flare-ups as well as inconclusive results of all of your hard work. 

Learning how to read nutrition labels and what to look for is also key in helping with making appropriate food choices.

Elimination diets are never fun, very hard to adhere to, often are nutritionally incomplete, but they can offer loads of benefits. The client I referred to earlier was determined and focused and strictly followed an elimination diet. She maintained a food diary and would bring it and actual foods to her appointments so we could review the nutrition label together. 

We eventually were able to determine the specific amount, in grams, of sucrose she could consume per day to remain symptom free and have sweets and eat them too

Because of her efforts she was highly successful, she was able to find foods that she could enjoy and eat without fear. Overtime, she was back to her ideal weight, started going back to her yoga class, and to her delight, she was able to travel again. 

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