Open Access Case Report DOI: 10.7759/cureus.14349 Sucrase-Isomaltase Deficiency Causing Persistent Bloating and Diarrhea in an Adult Female Varsha Chiruvella 1 , Ayesha Cheema 1 , Hafiz Muhammad Sharjeel Arshad 2 , Jacqueline T. Chan 3 , John Erikson L. Yap 2 1. Internal Medicine, Medical College of Georgia at Augusta University, Augusta, USA 2. Gastroenterology and Hepatology, Medical College of Georgia at Augusta University, Augusta, USA 3. Pediatric Endocrinology, Medical College of Georgia at Augusta University, Augusta, USA Corresponding author: Varsha Chiruvella,
[email protected] Abstract Congenital sucrase isomaltase deficiency (CSID) is an autosomal recessive disorder which leads to chronic intestinal malabsorption of nutrients from ingested starch and sucrose. Symptoms usually present after consumption of fruits, juices, grains, and starches, leading to failure to thrive and malnutrition. Diagnosis is suspected on detailed patient history and confirmed by a disaccharidase assay using small intestinal biopsies or sucrose hydrogen breath test. Treatment of CSID consists of limiting sucrose in diet and replacement therapy with sacrosidase. Due to its nonspecific symptoms, CSID may be undiagnosed in many patients for several years. We present a case of a 50-year-old woman with persistent symptoms of bloating in spite of extensive evaluation and treatment. Categories: Endocrinology/Diabetes/Metabolism, Gastroenterology Keywords: sucrase-isomaltase, starch intolerance, disaccharidase assay, ibs, hydrogen breath test Introduction Congenital sucrase isomaltase deficiency (CSID), also known as genetic sucrase deficiency, is a multifaceted intestinal malabsorption disorder with an autosomal recessive mutation in the sucrase-isomaltase (SI) gene on chromosome 3 (3q25-q26). Sucrase-isomaltase is a type II membrane enzyme complex and member of the disaccharidase family required for the breakdown of α-glycosidic linkages in sucrose and maltose.