Carbohydrates are a group of nutrients essential for various body functions. Commonly referred to as sugars, carbohydrates are an important source of energy or calories. They are also crucial for regular functioning of the blood system, blood clotting, immune system, fertilization, RNA (ribonucleic acid) and overall body development. When we consume carbohydrate rich foods, the body system breaks them down and absorbs them through the bloodstream. There are two major types of carbohydrates, namely simple carbohydrates and complex carbohydrates. Complex carbohydrates are suggested to be a healthier and easy to digest source of carbohydrates of the two. Some common food sources of carbohydrates include beans, legumes, bakery products, various types of pasta, fruits, cereals, rice, potatoes and some vegetables. When a person cannot digest foods that contain carbohydrates, the condition is referred to as carbohydrate malabsorption. This condition is also referred to as carbohydrate intolerance. Since carbohydrates are one of the major group of nutrients, this condition is considered as a deficiency of carbohydrates.
Although they are divided into simple and complex, carbohydrates are divided into four main chemical groups, namely, monosaccharides, disaccharides, oligosaccharides and polysaccharides. Amongst these types, monosaccharides and disaccharides are mainly available in food sugar sources like fructose, lactose and sucrose. Oligosaccharides and polysaccharides store energy and play a role in classification of human blood groups. When a person consumes any of these carbohydrates, they undergo enzymatic breakdown, a process which goes on until they reach the small intestine, where they are hydrolyzed by certain digestive enzymes, so that they can be easily absorbed by the various body systems. However, when the body lacks these important digestive enzymes that are present in intestine, it leads to carbohydrate intolerance. There are various reasons why a person may suffer with enzymatic deficiency. The reasons for enzymatic deficiency that cause carbohydrate malnutrition is divided into three main groups, congenital, acquired, and secondary malabsorption.
- Congenital Malabsorption: Congenital carbohydrate malabsorption is extremely rare. In such cases, newborns and infants show various signs like constant crankiness, restlessness, loss of sleep, colicky behavior, diarrhea, slow development, etc. Several congenital diseases like celiac disease, cystic fibrosis, etc., may be responsible for congenital carb malabsorption.
- Acquired Malabsorption: Acquired lactase deficiency, (hypolactasia), milk protein allergies for soy milk and cow milk, acute onset of viral or rotaviral enteritis, etc., may cause acute or primary malabsorption of carbohydrates in infants, toddlers and adults.
- Secondary Malabsorption: Similar to congenital malabsorption, secondary malabsorption of carbohydrates is also uncommon. It is mainly caused due to various diseases of the liver, pancreas and intestines. In this case, the manifestation depends on the type of disease which has caused the malabsorption syndrome.
As mentioned in the points discussed above, the most common symptoms of carb malabsorption are related to the digestive system. Symptoms of simple and complex carbohydrate intolerance are mostly confused with the symptoms of irritable bowel syndrome (IBS). A newborn or an adult is likely to develop a few indigestion symptoms soon after they consume foods that contain carbohydrates. Some common signs and symptoms include bloating, flatulence, diarrhea, abdominal cramps, borborygmi or crumbling stomach, nausea and vomiting. Patients also show weight loss or no progress in their constant underweight condition. Interestingly, symptoms of carb malabsorption or carb intolerance are evident after ingestion of at least 8 oz of liquid or 2g of solid foods that contain carbohydrates. When a set of these symptoms is observed after eating such foods, one should stop consumption of all the foods that contain carbohydrates, at least until proper medical intervention. It is important to consult a health care provider as soon as troubled digestion is observed after eating.
During clinical diagnosis, a confirmatory breath test is performed by the doctor. In the breath test, the patient is made to eat 50g lactose and immediate sensitivity to it is carefully observed. The doctor may also monitor blood glucose levels. Complete clinical history of the patient is also demanded by the doctor. Patients who are suffering with carbohydrate intolerance also have a medical history of milk and dairy product intolerance. In serious cases, jejunal biopsy or endoscopy is also carried out. When carbohydrate intolerance is confirmed, the doctor will advise a few dietary restrictions while the symptoms last, which is followed by some long term dietary changes. Avoiding all types of dietary sugars and consuming enzymatic supplements are the two important things that the doctor may suggest. Lactose intolerance foods and a carbohydrate intolerance diet may also be recommended by the respective doctor or dietitian.
In some cases of carbohydrate malabsorption, patients who are willing to eat carbohydrate rich foods can still eat small servings of these foods, without experiencing any major side effects. However, whether they are allowed to do so or not, entirely depends on the advice of the doctor and the severity of carbohydrate intolerance.
(Disclaimer: The information provided in the above article is for educational purposes only. It should not be used without prior professional medical advice.)