Intestinal disaccharidase deficiency
5 surprising habits that ruin your absorption

Disaccharidase deficiency and 5habits that make it worse
Table of Contents

What is disaccharidase deficiency?

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Disaccharidase deficiencies, particularly lactase deficiency, are common gastrointestinal disorders that affect both adults and children. Disaccharidases are enzymes that break down disaccharides, the complex sugars found in food. When the body does not produce enough of these enzymes, digestion becomes difficult and disaccharides remain undigested, leading to a range of gastrointestinal symptoms. Among disaccharidase deficiencies, lactase deficiency is the most prevalent, but maltase, palatinase, and sucrase deficiencies are not uncommon.

Symptoms of disaccharidase deficiencies may include gas, bloating, abdominal cramps, diarrhea or constipation, and other digestive issues. If left untreated, these conditions can lead to malnutrition and other severe health problems.

According to statistics, up to 70% of people worldwide experience some form of lactase deficiency. Diagnosing disaccharidase deficiencies is typically done through a biopsy or breath test. While there is no cure for lactase deficiency, there are methods to manage its symptoms. 

5 surprising factors aggravating disaccharidase deficiencies

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Besides the inability of the intestinal enzymes to break down disaccharides, several additional factors may aggravate the symptoms within the context of this deficiency. Here are 5 of them and specific tips to help your absorption:

Increased osmotic events due to indigested foods

Intestinal disaccharidase deficiency and tight junctions dysfunction

Mechanism

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In the context of deficiency in disaccharidase activity, the malfunction of tight junctions leads to the compromise of the barrier within the intestine. The outcome of this situation is the sustained presence of undigested carbohydrates in the intestinal lumen. These substances prompt an elevation in the osmolarity within the gut, which in turn induces the influx of water through the process of osmosis, culminating in ‘osmotic bloating’. The resulting discomfort in the abdomen and problems related to digestion is the cumulative effect of both the dysfunctional tight junctions and the lack of enzyme activity.

Intervention

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The introduction of supplementary external enzymes, such as lactase supplements, enhances the metabolism of disaccharides. This effectively circumvents the malfunctioning endogenous disaccharidase activity present in the duodenum and as a result, supports the normal digestion process of carbohydrates.

Enterocyte damage due to foodborne arsenic

Intestinal disaccharidase deficiency and foodborne arsenic

Mechanism

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Exposure to arsenic in food can cause damage to enterocytes, thereby disturbing the regular operation of these cells in the intestine. This harm intensifies digestive complications in situations of disaccharidase deficiency by further obstructing the digestion and absorption of carbohydrates. The ensuing presence of unabsorbed carbohydrates and water in the gut lumen escalates stool volume and fluidity, leading to diarrhea, a common symptom of lactose intolerance.

Intervention

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  • Reduce dietary arsenic intake by avoiding high-arsenic foods such as rice.
  • Consider installing a water filtration system at home.
  • Supplement diet with antioxidants like vitamin C and E to protect the brush border on the enterocyte membrane
  • Regularly monitor for arsenic levels.

Reduced gut blood flow from overtraining

Intestinal disaccharidase deficiency and overtraining

Mechanism

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Overtraining can activate the body’s stress response, thereby redirecting blood flow from the GI tract towards the muscles and heart to sustain high-intensity activities. In individuals presenting with disaccharidase deficiency, this diminishes the capacity of the gut to break down disaccharides after meals, heightening malabsorption issues. This condition, together with potential gut ischemia, can amplify abdominal pain following food intake.

Intervention

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  • Uphold a moderate level of exercise intensity, steering clear of overtraining.

  • Integrate rest days into your fitness regimen.

  • Ensure appropriate hydration and nutrition before and post-workout sessions.

  • Adopt a practice of consuming smaller, frequent meals as opposed to large ones.

  • Be observant of your body’s reaction to physical exertion and modify your routine as needed, ensuring the health of the mucosal lining of the colon.

Overfermentation of starch due to late dinners

Intestinal disaccharidase deficiency and late dinners

Mechanism

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The problem of disaccharidase deficiency is worsened by late dinners, which have the potential to amplify digestive issues by compelling digestion during the body’s inherent resting phase. This can result in the incomplete breakdown of carbohydrates, leading to subsequent microbial fermentation in the small intestine. This process often exhibits itself as bloating and excessive production of hydrogen gas.

Intervention

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  • Steer clear of late-night dinners; strive to finish your meals 3-4 hours before sleep time.
  • For your evening meal, opt for foods that are easily digestible, reducing the intake of complex carbohydrates that break down into glucose.
  • Incorporate both probiotics and prebiotics into your diet to nurture a healthy gut microbiome, thereby diminishing microbial fermentation.
  • Exercise portion control to prevent overeating during nighttime
  • Adhere to a consistent meal schedule to align with your body’s circadian rhythm, ensuring optimal monosaccharide absorption.

Reduced gut motility from sedentary lifestyle 

Inetstinal disaccharidase deficiency and transit time

Mechanism

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In the scenario of deficiency in disaccharidases, a sedentary lifestyle may result in decreased intestinal motility. This can culminate in extended interaction time between undigested disaccharides such as sucrose and the intestinal mucosa, inducing an osmotic imbalance and fluid accumulation. Consequently, conditions such as abdominal distension and increased flatulence, common symptoms of carbohydrate intolerance, are heightened.

Intervention

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Every IBS is unique

  • Make it a point to participate in routine physical exercise, like walking, cycling, or swimming, to boost intestinal motility.
  • If your job involves sitting at a desk, make an effort to stand or move around every hour.
  • Integrate foods high in fiber into your diet to promote better gut motility.
  • Partake in yoga or stretching activities, which can aid in triggering bowel movements.
  • Ensure you’re adequately hydrated to facilitate intestinal function.
  • Preserve regular meal times to encourage consistent bowel movements.
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FAQ

Which foods are high in disaccharides?

  1. Sugary foods and sweets: Sucrose, is the main component of table sugar and is also found in high amounts in sweets and desserts.
  2. Dairy products: Lactose is a disaccharide found in milk and other dairy products.
  3. Certain fruits: Some fruits, like bananas and dates, contain relatively high amounts of the disaccharide sucrose.
  4. Processed foods: Many processed foods contain added sugars, which often include disaccharides.
  5. Certain grains: Maltose, another type of disaccharide, is found in some grains and is also produced when certain foods are cooked or processed.
  6. Honey: Honey is rich in disaccharides.
  7. Certain vegetables: Some root vegetables, like beets and carrots, contain sucrose.

Cohen, Stanley A. “The clinical consequences of sucrase-isomaltase deficiency.” Molecular and cellular pediatrics 3 (2016): 1-4.

Shahid, Faaiza, et al. “Studies on the effect of sodium arsenate on the enzymes of carbohydrate metabolism, brush border membrane, and oxidative stress in the rat kidney.” Environmental toxicology and pharmacology 37.2 (2014): 592-599.

De Oliveira, Erick Prado, and Roberto Carlos Burini. “The impact of physical exercise on the gastrointestinal tract.” Current Opinion in Clinical Nutrition & Metabolic Care 12.5 (2009): 533-538.

Grant, Crystal Leigh, et al. “The impact of meal timing on performance, sleepiness, gastric upset, and hunger during simulated night shift.” Industrial health 55.5 (2017): 423-436.

Yurtdaş, Gamze, et al. “Risk factors for constipation in adults: a cross-sectional study.” Journal of the American College of Nutrition 39.8 (2020): 713-719.

Puertolas, Mora V., and Amanda C. Fifi. “The role of disaccharidase deficiencies in functional abdominal pain disorders—a narrative review.” Nutrients 10.12 (2018): 1835.

 

 

Theodoros Prevedoros
BIOCHEMIST MSc
With extensive experience evaluating over 3000 cases in various specialties, including gastroenterology, pediatrics, and endocrinology, Theodoros has collaborated with more than 25 doctors from Greece and Cyprus and over 10 laboratories worldwide.

With a background in Chemistry and Biochemistry from the National and Kapodistrian University of Athens, Theodoros brings a wealth of knowledge in functional medicine and advanced treatments to his role. He possesses exceptional skills in analysis, pattern recognition, diagnostic translation, and storytelling. He is also FMU certified in Functional Medicine and has received training in advanced treatments from the Saisei Mirai Clinic in Japan.
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