Enzymes belong to a type of protein that facilitates specific chemical reactions. Enzymes found in the digestive tract, which aid the chemical breakdown of ingested foods into absorbable molecules and components are called digestive enzymes. Those that break down starch into simple sugar molecules (glucose) are called amylases. Enzymes that break down protein molecules into amino acids are called proteases, while those that break down fats into smaller molecules are called lipases. In addition, we also have enzymes called disaccharidases, which break down compound sugar molecules like table sugar (sucrose), and milk sugar (lactose) into simple sugar molecules for better absorption.
Digestive enzymes are naturally produced by the body during the digestive process. Enzyme production occurs in the mouth, the stomach, the pancreas, and within your small intestine. However, humans lack digestive enzymes that can break down certain compounds from plants such as pectins, cellulose, and other starches, which are collectively known as “fiber.” Fiber, therefore, is non-digestible, but the health benefits we derive from it comes from its failure to be absorbed.
While most people do not need supplemental enzymes, some people do not produce enough digestive enzymes, resulting in symptoms like intestinal discomfort, diarrhea and gas. Eating some foods that contain certain enzymes can help improve digestion. These include pineapples, which contain bromelain, and papaya, which contains papain. Aside from aiding in digestion, these enzymes also have other health benefits, such as supporting immune system function. However, to benefit from these, we will have to eat a lot of these foods, which may not be possible all the time. A more convenient way to obtain additional enzymes may be to take them in the form of health supplements. Studies suggest that taking supplemental digestive enzymes may be helpful in reducing symptoms of indigestion and gas.
Uses of Supplemental Digestive Enzymes
Pancreatic enzymes, such as lipases, proteases and amylases that are derived from animal sources are now available in tablets and capsules. They may be prescribed to aid the digestion in people who have digestive disorders involving a lack of enzymes. Other digestive enzymes also include papain, pepsin, hydrochloric acid, and betaine HCL. Medical conditions where digestive enzymes may be useful include:
- Celiac disease, a condition characterized by sensitivity to gluten, a protein that is found in grains. In this condition, eating foods that contain gluten results in damage to the intestinal tract, which affects digestion and absorption of nutrients. Symptoms include bloating, abdominal pain, fatigue, and weight loss. People with the disease are instructed to follow a strict diet that excludes gluten. Initial studies suggest that taking pancreatic enzymes as part of the treatment for celiac disease may help patients achieve a modest weight gain, but more studies are needed to show the benefits of these enzymes in people with celiac disease.
- Indigestion, which is usually associated with irritable bowel syndrome (IBS). Studies suggest that digestive enzymes such as lipase can help reduce symptoms such as gas, bloating, and fullness, which usually follow a high fat meal. More studies are needed to show the benefits of digestive enzymes in the treatment of IBS.
- Cystic fibrosis, an inherited disease that is characterized by the production of abnormally thick and sticky mucus. This condition is associated with nutritional deficiencies because thick mucus blocks natural enzymes from the pancreas from going to the intestines. Supplemental pancreatic enzymes prescribed by a doctor have been shown to help improve the nutrition of these patients.
- Pancreatic insufficiency, a condition where the pancreas is not able to produce normal amounts of digestive enzymes, may be treated with supplemental enzymes. Symptoms of pancreatic insufficiency include loose, light-colored stools that are foul smelling (a sign of malabsorbed fat). Patients are given prescription enzymes that are taken orally with meals to improve food absorption. These are specially coated formulations designed to resist digestion by stomach acids. Conditions characterized by pancreatic insufficiency include chronic pancreatitis and pancreatic surgery.
- Lactose intolerance, a common condition that occurs when the body is not able to tolerate drinking milk or other dairy products. While most children are able to digest milk, many adolescents and adults are not able to break down milk sugar (lactose) because of the lack of lactase enzyme. Supplemental lactase enzymes are widely available and are effective when taken with dairy foods.
- Vegans and vegetarians who consume high-fiber diets may benefit from plant-derived digestive enzymes to improve their digestion. For example, Beano, a digestive enzyme that contains alpha-galactosidase, which is derived from mold, helps break down fiber found in gas-forming vegetables like beans, cabbage, cauliflower, and broccoli.
Ask your doctor about taking digestive enzyme supplements, because these may have side effects such as stomach upset and nausea. They may also interact with other medications you are taking, such as Orlistat, which blocks the action of lipase.
This information should not take the place of medical advice. We encourage you to talk to your health care providers (doctor, registered dietitian, pharmacist, etc.) about your interest in, questions about, or use of dietary supplements and what may be best for your overall health.
UMMC. Lipase. http://umm.edu/health/medical/altmed/supplement/lipase
US News. Digestive Enzymes: Help or Hype?http://health.usnews.com/health-news/blogs/eat-run/2013/04/23/digestive-enzymes-help-or-hype
Cancer Nutrition Center. Digestive Enzymes. http://www.cancernutrition.com/enzymes.htm
WebMD. Digestive Enzymes. http://www.webmd.com/drugs/2/drug-673/digestive-enzymes-oral/details