Carbohydrate intolerance is of two types, primary and secondary. Primary intolerance occurs when there is deficiency of an enzyme due to a genetic defect present since birth or which can develop after a certain amount of time when the production of enzymes reduce naturally in adults. The secondary type of carbohydrate intolerance occurs due to other medical diseases. This may be due to digestive disorders including “celiac disease” and “tropical sprue” which causes an insufficient production of enzymes, leading to the deposition and build up of fat in muscle tissue. Other diseases responsible for carbohydrate intolerance are protein deficiency, intestinal infections and treatment given for cancers, which include chemotherapy and radiotherapy.
The intensity and severity of symptoms are dependent on the magnitude of enzyme deficiency, that is, more the enzyme deficiency, more severe is the symptom. The symptoms usually occur around half an hour to two hours after ingestion of the aversive carbohydrate, which may range from feelings of being mildly bloated to diarrhea. This is because of the fermentation of the undigested sugars by the bacteria in the intestine, which is responsible for the gaseous production, flatulence, cramping and bloating.
In growing children, the chief symptoms include diarrhea and a failure to gain weight. Diarrhea, usually watery in nature (osmotic type) is responsible for throwing out other nutrients out of the intestine before they can be absorbed, causing malnutrition.
Diagnosis Oral tolerance tests are used to assess the individual's ability to digest the carbohydrate being evaluated or investigated. In this test the specific carbohydrate being studied is given by mouth in liquid form and a number of blood tests are done to evaluate its digestion.
Treatment and Cure The body is unable to produce enzymes in primary carbohydrate intolerance, and there is no available cure for the primary disease up to date. Symptomatic relief can be obtained by either avoiding the aversive carbohydrate or by substituting the absence of digestive enzymes with commercially available enzymes e.g., lactose intolerance patients and children should avoid milk products while infants should consume soy-based formula, or drink milk containing lactase enzymes.
The cure for the secondary causes of carbohydrate intolerance is by treating the underlying disease such as intestinal disorders or protein deficiency.
Prognosis & Prevention: Carbohydrate intolerance cannot be prevented because the causes of enzyme deficiency are not known. However, this disease can be controlled by a good diet that avoids the offending sugar and by taking commercially available digestive enzymes, which allows patients having this disease to lead a normal life.