ABNORMALITIES OF

CARBOHYDRATE
DIGESTION
Lecture 2nd year MBBS
By Dr HAJIRA KHAN
 In general , humans possess an efficient system
of carbohydrate digestion and absorption .
 Since only the monosaccharide's are absorbed,
any defect in the activities of disaccharides
results in the passage of undigested
disaccharides into the large intestine.
 The disaccharides draw water from intestinal
mucosa by osmosis and causes diarrhea.
 Further, bacterial action of these undigested
carbohydrates leads to
flatulence( accumulation of gas in an
 Disaccharides are the intestinal brush border
enzymes.
 Any alteration in the mucosa of the small
intestine caused by severe diarrhea, malnutrition
(deficiency in right amount of nutrients) ,
intestinal diseases or drug therapy will lead to a
temporary acquired deficiency of disaccharides.
 The patients with such disorders are advised to
restrict the consumption of sucrose and lactose.
 Hereditary disorders with deficiency of individual
disaccharides in infants and children causes
intolerance of specific disaccharides
LACTOSE INTOLERANCE
 Lactose intolerance is the most common
disorder of carbohydrate digestion in
humans.
 This is due to a defect in the enzyme
Lactase( B- galactosidase).
 It is estimated that more than half of the
world,s adult population is affected by
lactose intolerance .
 It is more commonly found in Africans and
Asians compared to Europeans.
 Continued consumption of lactose by lactose
intolerant indiviuals causes typical symptoms of
flautance.
Flautance:
 Flautulence is characterized by increased
intestinal motility, cramps and irritation.
 This occurs after ingestion of certain
carbohydrates and is explained as
follows
 The carbohydrates ( di, oligo and
polysacchrides) not hydrolysed by ἀ- amylase
and other intestinal enzymes cannot be absorbed.
 Lactose is not hydrolyzed in some individuals due
to the deficiency of lactase.
 The disacchrides and oligosacchrides can be
degraded by the bacteria present in ileum *(lower
part of small intestine) to liberate
monosacchrides.
 The latter can be metabolized by the bacteria.
 As the monosacchrides are utilized by the
intestinal bacteria, gases such as hydrogen ,
methane and carbon dioxide -----besides
lactate and short chain fatty acids are released
 These compounds cause flautlence.
 The occurance of flautlence after the ingestion
of leguminous seeds ( bengal gram, redgram,
beans, peas, soya bean) is very common.
 They contain several non-digestible
oligosacchrides by human intestinal enzymes.
 These compounds are degraded
and utilised by intestinal
bacteria causing flatulence.
 Raffinose containing galactose,
glucose and fructose is a
predominant oligosacchride
found in leguminous seeds.
LACTOSE INTOLERANCE
 Lactose intolerance may be primary( congential)
or secondary (acquired).
 Acquired Lactose intolerance may be occur due
to a sudden and high intake of milk based diets.
 Lactase is an inducible enzyme.
 Therefore in acquired intolerance , if milk is
withdrawn temporarily, diarrhea will be limited.
 For lactose intolerant people, consumption of
curd in benefical, since lactobacilli present in
curd contain the enzyme lactase.
 Further, yeast rich in lactase, can
also be used for treatment of
lactose intolerance.
 The best treatment for lactose
intolerance is elimination of lactose
from the diet(i.e severe restriction
of milk and dairy products).
SUCRASE DEFICIENCY
 The deficiency of the enzyme
sucrase causes intolerance to dietary
sucrose.
 It is estimated that about 10% of
Eskimos of Greenland and 2% of
North Americans are affected by this
order.
 The treatment is to remove sucrose
from the diet.