Articles

Digestive Enzymes

Introduction

Products classified as digestive enzymes help facilitate digestion, the absorption of nutrients, the maintenance of proper pH in the gastrointestinal tract, and act as a barrier against invasion of viruses and bacteria. There are seven basic types of digestive enzymes each with various sub-classifications and differing functions. The basic enzymes and their specific functions are as follows: amylase digests starches, cellulase digests fibers, lactase digests dairy products, lipases digest fats, oils and triglycerides, maltase digests starch and grains, proteases digest proteins and sucrase digests sugars.

Some enzymes are extracted from animal sources such as the pancreas, liver, and stomach of cattle or pigs. Examples of animal enzymes include oxbile, trypsin, chymotrypsin, rennin, pepsin, and pancreatin. Other digestive enzymes are derived from plants such as bromelain from pineapple and papain from papaya.

Impaired digestive function can produce many symptoms and is associated with a wide variety of clinical conditions such as gas, bloating, heartburn, indigestion, malabsorption disorders, malnutrition, dysbiosis, leaky gut, diarrhea, constipation, lactose intolerance, food allergies, celiac disease, etc. However, there is a disappointing lack of scientific studies regarding the use of digestive enzyme products in the treatment of health conditions. The use of digestive enzymes to treat symptoms and clinical conditions associated with digestive problems comes mostly from clinical observations, anecdotal comments, and manufacturer’s product claims. Even though there is a lack of scientific research to verify the effectiveness of digestive enzymes, these products have become well accepted and are commonly used.

Dosage Info

Dosage Range

Not applicable because dosages vary widely due to different clinical conditions, patient’s individual responses, and different types of digestive enzyme products available.

Most Common Dosage

Not applicable because dosages vary widely due to different clinical conditions, patient’s individual responses, and different types of digestive enzyme products available.

Dosage Forms

Tablets, capsules, and powders.

Reported Uses

Digestive enzymes are used as a therapy for a variety of digestive disorders. One study indicated that administration of pancreatic enzymes resulted in a significant reduction of gas and bloating associated with the ingestion of high calorie, high fat meals. (1) Pancreatic enzymes may also be useful in certain cases of dyspepsia. (2) Other studies have supported therapies with pancreatic enzymes and include malabsorption, (3) , (4) chronic pancreatitis, (5) and steatorrhea. (6)

Probably the most commonly used digestive enzyme is lactase. Individuals who are lactose intolerant do not produce enough lactase to properly digest milk and dairy products. Lactase-containing enzyme products help people reduce the symptoms associated with this condition. (7) Adding a few drops of lactase to a quart of milk and allowing it to stand overnight substantially reduces the amount of lactose present. Chewing lactase-containing tablets reportedly helps people digest solid lactose-containing foods.

Toxicities & Precautions

Introduction

[span class=alert]Be sure to tell your pharmacist, doctor, or other health care providers about any dietary supplements you are taking. There may be a potential for interactions or side effects.[/span]

General

This dietary supplement is considered safe when used in accordance with proper dosing guidelines.

Health Conditions

If you have ulcers or esophageal reflux and your digestive enzyme product contains betaine hydrochloride, talk to your doctor before taking this dietary supplement.

Pregnancy / Breast Feeding

This dietary supplement should not be used if you are pregnant or breast-feeding an infant without first consulting a physician.

Age Limitations

This dietary supplement should not be used in children under 2 years of age unless recommended by a physician.

References

  1. View Abstract: Suarez F, Levitt MD, Adshead J, Barkin JS. Pancreatic supplements reduce symptomatic response of healthy subjects to a high fat meal. Dig Dis Sci. Jul1999;44(7):1317-21.
  2. View Abstract: Worning H. Exocrine pancreatic function in dyspepsia. Digestion. 1987;37(Suppl 1):3-13.
  3. Carroccio A, Guarino A, Zuin G, et al. Efficacy of oral pancreatic enzyme therapy for the treatment of fat malabsorption in HIV-infected patients. Aliment Pharmacol Ther. Oct2001;15(10):1619-25.
  4. View Abstract: Ritz MA, Fraser RJ, Di Matteo AC, et al. Evaluation of the 13C-triolein breath test for fat malabsorption in adult patients with cystic fibrosis. J Gastroenterol Hepatol. Apr2004;19(4):448-53.
  5. View Abstract: Layer P, Keller J. Pancreatic enzymes: secretion and luminal nutrient digestion in health and disease. J Clin Gastroenterol. Jan1999;28(1):3-10.
  6. View Abstract: Lankisch PG, Lembcke B, Kirchhoff S, et al. Therapy of pancreatogenic steatorrhea. Comparison of 2 acid-protected enzyme preparations. Dtsch Med Wochenschr. Jan1988;113(1):15-7.
  7. View Abstract: Ramirez FC, Lee K, Graham DY. All lactase preparations are not the same: results of a prospective, randomized, placebo-controlled trial. Am J Gastroenterol. Apr1994;89(4):566-70.