Clinical Symptoms Do Not Distinguish Sucrose Malabsorption From SIBO

Area of Science:

• Gastroenterology
• Digestive Health
• Clinical Diagnostics

Background:

• Sucrose malabsorption and small intestinal bacterial overgrowth (SIBO) share overlapping symptoms with disorders of gut-brain interaction (DGBI).
• Sucrose malabsorption prevalence may be underestimated.
• This study investigates sucrose malabsorption in patients undergoing SIBO testing.

Purpose of the Study:

• Determine the prevalence of sucrose malabsorption using the 13C-sucrose breath test (SBT) in patients referred for SIBO testing.
• Assess if patient symptoms can differentiate between sucrose malabsorption and SIBO.
• Evaluate the role of sucrose malabsorption in DGBI symptoms.

Main Methods:

• Recruited 300 patients for SIBO breath testing.
• Administered Rome IV Questionnaire, IBS-SSS, and PAGI-SYM.
• Conducted in-person SIBO breath testing followed by at-home 13C-SBT.

Main Results:

• 140 patients returned the 13C-SBT.
• 22% (25/113) of SIBO-negative patients tested positive for sucrose malabsorption.
• No significant differences in symptoms or diagnostic scores were found between sucrose malabsorption positive and negative groups, except for less abdominal pain in sucrose malabsorption only patients.

Conclusions:

• Sucrose malabsorption is identified in 22% of SIBO-negative patients, suggesting it contributes to DGBI symptoms.
• Symptom profiles are insufficient to predict or distinguish sucrose malabsorption from SIBO.
• Carbohydrate malabsorption syndromes, including sucrose malabsorption, should be considered in functional gastrointestinal disorder evaluations.