Additional Disaccharide Intolerances

We discussed lactose intolerance in the previous lesson. Lactase is one of three disaccharidase enzymes on the microvilli.

Sucrase-Isomaltase, impairing sucrose and starch digestion, can be congenital (CSID) or secondary (acquired).

CSID is an inborn errors of metabolism. Typically, it is diagnosed when an infant experiences digestive symptoms and failure to thrive after starch/sucrose introduction (during weaning). However, milder forms may go undiagnosed.

This condition should be considered when clients have the following:

  • Functional digestive symptoms (i.e., gas, bloating, diarrhea, pain. etc.) that do not improve with other treatments.
  • Digestive symptoms with increased sucrose/starch intake.

The condition can be diagnosed through the following:

  • Disaccharidase activity (measured with an endoscopic microvilli biopsy)
  • A breath test (similar to the lactose intolerance description)
  • Sucrose and starch elimination and challenge. 
  • Enzyme replacement trial.

Sucraid is a sucrase enzyme replacement. It digests sucrose, but not maltose – so it will improve but not eliminate symptoms. The Sucraid website (AD #19) has many additional resources and employs an expert dietitian.