Enzyme deficiencies causing gut symptoms - the specific carbohydrate diet
It was thought that digestion of foods is entirely done by enzymes produced by the stomach and pancreas. Now it seems that most of the digestion is done here, but the last little bit of carbohydrate/sugar digestion is done by enzymes produced by the lining of the small intestine (the brush border), where the absorption of foods take place. Starch is broken into disaccharides each of which has a specific enzyme on the brush border to split it. The disaccharides (and their corresponding enzymes) are: maltose (maltase); isomaltose (isomaltase); sucrose (sucrase); and lactose (lactase). The monosaccharides produced are glucose, fructose and galactose.
Monosaccharides are the only way in which carbohydrate can be absorbed. If these monosaccharides are stuck together in pairs, so-called disaccharides, such as sucrose, they cannot be absorbed. Neither can polysaccharides (a long chain of monosaccharides stuck together) such as starch. These poly and disaccharides are dependant on enzymes on the brush border for their final digestion and absorption.
If there are no enzymes to digest them, there is no absorption and instead these di and polysaccharides become available for fermentation by micro-organisms in the gut. Fermentation produces toxins as well as symptoms of wind, gas, bloating and gurgling.
Diseases of enzyme deficiency
The best example of this problem is lactose intolerance - inability to digest lactose (milk sugar) which can cause bloating, pain and diarrhoea. Often a temporary lactose intolerance arises following gastroenteritis. Other known diseases associated with enzyme deficiencies are coeliac disease, tropical sprue, cystic fibrosis, Crohn's, ulcerative colitis etc. It may be that many "food allergies" are actually enzyme deficiencies. Many symptoms can arise as a result of inadequate digestion of carbohydrates such as constipation, diarrhoea, mucous production, abdominal pain and failure to thrive.
The SPECIFIC CARBOHYDRATE DIET
This ensures that the only carbohydrates consumed are monosaccharides. These need no digestion and are completely absorbed, so none remain for bacterial fermentation. All other carbohydrates requiring some digestion is not permitted.
- fresh or frozen meat and fish
- eggs, natural yoghurt, cheese.
- most fresh or frozen vegetables (check for added sugar) except those listed below
- fresh and dried fruits (contain fructose), honey, Stevia (a natural sweetener).
- Nuts (not with roasted coating) and pure nut flours or spreads.
- Cooking oils, mayonaise, pickles, olives, mustard, vinegar.
- tea, coffee, dry wine, gin, whisky, vodka
- All grains: wheat, barley, rye, oats, corn, rice, millet, buckwheat, bulgar, spelt.
- All cereals, bread or flour made from these.
- All grain substitutes such as amaranth or quinoa.
- All potato, yams, parsnip, sweetcorn.
- All chickpeas, bean sprouts, soya beans, mung beans.
- All processed meats (contain rusk, starch, lactose and sucrose)
- All sugars (cane, granulated, castor, icing, treacle, molasses, fructooligosaccharides etc)
- All soya milks and beers.
Note: Many sugars sold as fructose and glucose are not pure and have other sugars added (and so are not suitable for the carbohydrate specific diet).
Of course, enzyme supplements are going to be helpful. Sometimes these are required in very high doses. I usually start off with BioCare Polyzyme Forte which contains a range of enzymes for protein, fat and carbohydrate digestion.
Breaking the Vicious Cycle: Elaine Gottschall
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