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Carb malabsorption: what is it?

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Carbohydrate malabsorption, or intolerance, makes it difficult for people to digest certain carbohydrates, causing gastrointestinal distress. Lactose intolerance is a common form. Diagnosis is difficult, but treatment usually involves dietary changes and enzyme substitutes.

Carbohydrate malabsorption, sometimes also known as “carbohydrate intolerance,” is a medical condition that makes it very difficult for people to digest some or all carbohydrates properly. Many different foods fall into this category, although bread, pasta, and fruit are among the most common. Enzymes such as lactose, which is found in milk, are also considered carbohydrates. People suffering from malabsorption are unable to tolerate this type of food or digest it poorly. The condition often causes a significant amount of gastrointestinal distress, including gas, bloating, and stomach cramps. In some cases it will go away on its own, but it is more common for people to change their diet to avoid “problem” foods and, in some cases, start taking medications to control symptoms and flare-ups.

Carbohydrate basics

Carbohydrates are often referred to simply as “carbs” and are one of the major building blocks of human fuel. They include most starches and sugars. The body is able to metabolize them quite quickly, converting them into almost instantaneous energy in the bloodstream. Some dietitians warn that these nutrients can have adverse health effects when consumed in excess, largely because they usually don’t provide any kind of lasting or sustained energy. However, most experts agree that people need at least some carbohydrates to stay healthy and maintain proper biological functions.

People who are unable to absorb starches and sugars do not break them down or break them down only partially during digestion. This usually means they don’t get any quick energy and usually hinder the digestion of other nutrients that the body is also processing. Unprocessed carbohydrates passing through your digestive tract can cause a variety of problems ranging from mild cramping to severe blockages.

Main causes

There are a couple of different reasons people develop this condition. Sometimes they are born with it, but it can also develop over time, just like food sensitivities or allergies can. It is usually related to intestinal enzymes, which are proteins that aid in the digestive process. People who don’t get enough are sometimes unable to keep up with demand, particularly when a lot of carbohydrates are consumed at once.

In most cases a person will only have trouble digesting certain carbohydrates, such as lactose. Lactose intolerance is one of the most common forms of carbohydrate malabsorption. Low enzyme levels play a big part in this particular condition, and even drinking fruit juices that contain sorbitol, which is a specific sugar alcohol, can exacerbate it.

Symptoms
Symptoms of this condition can include cramping, diarrhea, and gas. These usually occur when undigested carbohydrates eventually reach the colon. Fluids tend to accumulate around the fibers and unabsorbed material begins to ferment. This often creates gases that can make a person feel bloated and uncomfortable.
Some experts and researchers believe that malabsorption of certain carbohydrates, such as lactose and fructose, may also be linked to depression. The effects appear to be more profound in women; in men, however, the condition doesn’t always have the same intersection with mental health. It can, but it’s not that common. Malabsorption can also cause stunted growth and low weight in children and can also have an effect on brain development and cognition.

Diagnosis and treatment
In reality, diagnosing carbohydrate intolerance can be somewhat difficult, as the symptoms often overlap with a range of intestinal and digestive problems. Healthcare professionals who suspect a specific carbohydrate problem may conduct a breath test, in which the patient breathes into a special machine that breaks down the chemical composition of each exhalation. The goal is usually to measure hydrogen levels, which are usually low when carbohydrates are digested properly; when they’re not, the digestive tract often has excess hydrogen that is trapped and often exits through the breath. People usually need to eat carbohydrate-rich foods just before being tested to get accurate results.
The simplest treatment is usually dietary. People are often encouraged to limit or reduce their intake of certain carbohydrates and to space out how often they eat foods containing these types of starches. Enzyme substitutes may be prescribed in some cases, and some other medications may also help. The condition is rarely ever truly cured, but it can usually be managed so that people affected can lead mostly normal lives.

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