Review of Digestive Enzymes Therapy


This is a thorough review of digestive enzymes therapy. Do you frequently have symptoms of bloating, gas, abdominal distention, or diarrhea when you drink milk or eat cheese? Are your stools lose, greasy and they float? Is your hair dull, thin and falls down? Are your nails weak and brittle? These symptoms might be caused by an enzyme deficiency in your body and could get better with the appropriate digestive enzymes therapy.

Read more to find out about digestive enzymes, who are they for, why are they important and how they should be taken. If after reading my article, you think that you might have a clinical condition that would need enzymes to get better, it is very important that you contact your doctor for a specific treatment.

Review of Digestive Enzymes Therapy

Review of Digestive Enzymes Therapy

Review of digestive enzymes therapy

What are enzymes?

Enzymes are molecules that either build other molecules or break them down into smaller particles. Digestive enzymes are hydrolases because they break down food particles into smaller particles inside the water of the gastrointestinal tract for the digestion process to function properly so that, those small particles can be absorbed through the intestine´s wall into the bloodstream.

Digestive enzymes are naturally produced by our bodies during the digestion process, it starts in the mouth with the salivary glands, followed by the stomach, the pancreas, the liver and finally, the small intestine. Many of the digestive issues that people have is not so much because of food intolerance but, because of the lack of enzymes to break down food molecules so that, they can be properly absorbed.

Digestive enzymes break down particles of fats (lypases), proteins (proteases) and carbohydrates (amylases) but, if there is lack or insufficiency of digestive enzymes then, food particles are not properly absorbed because they are not properly broken down so, they cause an osmotic water distention of the intestine. This generates a hypersensitivity of the nerves in the intestine´s walls. Alll these changes, lead to gas, bloating, abdominal pain, diarrhea and or constipation.

Therefore, digestive enzymes treatment is very important for patients suffering from conditions like pancreatic insufficiency and other gastrointestinal disorders, because by taking the digestive enzymes, they will have the tool to break down the food into smaller particles that can be properly absorbed.

Review of Digestive Enzymes Therapy

Who are digestive enzymes treatment for?

Digestive enzimes are specifically, very useful in patients who have a deficiency or lack of the production of any enzyme, for instance:

  • Patients with a deficiency in the proper functioning of the pancreas (pancreatic insufficiency) will have deficiencies in excreting amylase, protease and lypase into the small intestine so, they will alleviate their symptoms with enzymes supplements, which will allow them to break down carbohydrates, proteins and fats into smaller particles so that all the nutrients can be properly absorbed.
  • Patients with a deficiency in lactase can´t break down lactose (the carbohydrate present in milk and dairy products). For that reason, when they drink milk or eat cheese, they feel terrible gastrointestinal symptoms. They can be aliviated by taking lactase supplements that will allow them to break down lactose to be properly absorbed at the small intestine.

Digestive enzymes can help alleviate gastrointestinal symptoms that might be caused by many gastrointestinal disorders like irritable bowel syndrome (IBS), small intestine bacterial overgrowth (SIBO) or Chron´s disease specially when there is a lack of digestive enzyme’s in the body.

Digestive enzymes treatment is for obtaining relief for the symptoms of many gastrointestinal disorders.


What are the symptoms of digestive enzyme deficiency?

The symptoms of digestive enzyme deficiency are gas, bloating, abdominal distention, abdominal pain, constipation and or diarrhea. Those symptoms are present in many conditions such as irritable bowel syndrome (IBS) and small intestine bacterial overgrowth, but they also can be found in Crohn´s disease, lactose intolerance or in pancreas insufficiency, diabetes,  celiac disease, cystic fibrosis, even cancer, just to name a few.

People with pancreatic insufficiency usually have light-colored, loose, greasy stools that float because of the inability to absorb fats.

One of the topics covered at the IBS and SIBO Summit was how the symptoms might differ according to the enzyme deficiency, in this case, Dr. Mark Pimentel, MD, explained really well that, when people experience gastrointestinal symptoms (bloating, abdominal distention, gas, abdominal pain) after eating or within the first 30 minutes, the most probable cause of the symptoms is a deficit in the secretion of hidrocloric acid and pepsine.

In this particular case taking hicrocloric acid and pepsin would be a good idea to help relief the symptoms. Also, when you lack of hidrocloric acid, you are not able to ionize the mineral through absorption and you are not going to be able to break down proteins properly so, you will look this sign in your hair (easily falling out, thin and dull) and nails (cracked and weak).

If the gastrointestinal symptoms occur 48 hrs or more after eating, it´s more probable that you have a lack of digestive enzymes. For instance, people who are lactose intolerant have a deficit of the enzyme lactase so, giving them supplements with this digestive enzyme will help them break down the lactose (the sugar found in milk and dairy products) and the symptoms will be relieved.

What are the benefits of digestive enzymes?

There are many types of digestive enzymes so, the benefit will depend on the function that each particular enzyme has in the gastrointestinal tract. For instance, just to name a few enzymes:

  • Lactase: breaks down lactose
  • Pancrelipase: breaks down sugars, fats and proteins. It is a combination of amylase, protease, and lypase. They are all digestive enzyme’s produced by the pancreas.
  • Alpha-Galactosidase: breaks down the carbohydrates in legumes and beans that cause flatulence.
  • Peptidase: breaks down casein in milk and gluten in grains
  • Cellulase: breaks down the fiber (cellulose) in grains, seeds, fruits and vegetables.

How should be taken the digestive enzymes?

The digestive enzymes should be taken in just before meals for optimal digestive effect. However, as Dr. Michael Murray, ND recommended at the IBS and SIBO Summit, they could be taken in between meals when they are used for anti-inflammatory purposes such as autoimmune conditions, pain and inflammation.

You should ask your doctor before taking the digestive enzymes supplements because some of them might cause side effects such as allergic reactions or even more gastrointestinal effects (gas, nausea, bloating, constipation, diarrhea, greasy stools).

Your doctor will recommend what is the optimal dosage that you need for your particular case because the dosage will change depending on the condition to be treated and the type of enzyme. Make sure the enzymes are enteric coated so that they are not destroyed by the acids in the stomach and can reach the small intestine.

Importance of digestive enzymes.

Sometimes, it is specially hard to relieve the symptoms of irritable bowel syndrome. The first advised that you will receive from your doctor is changing your lifestyle habits, avoiding the most fermentable foods that usually might trigger your symptoms, some patients even would have to go through a more restrictive diet, like the low FODMAP diet.

You will be advised to take specific medications for your symptoms, most of the people will get better, but others won´t so, those people will need more to the treatment such as digestive enzymes to help alleviate the symptoms.

Digestive enzymes allow you to absorb carbohydrates, fats and proteins properly by breaking them down into smaller particles that go though the intestine´s wall into your bloodstream and you whole body. A proper digestion and absorption of nutrients is essential for a healthy life.

Are digestive enzymes effective?

There is medicine-based evidence that proves that enzymes are effective for specific conditions, for instance, one study concludes that enzyme supplementation plays an important role for the treatment of some digestive and malabsorption disorders such as lactose intolerance and exocrine pancreatic insufficiency.

However, there is lack of evidence-based medicine to support the use of digestive enzymes for many conditions, in such cases the decision to use them is based more on a clinical experience approach.

Digestive Enzymes. My final opinion.

We can take action into improving many gastrointestinal conditions by using digestive enzymes but, I recommend that you seek your doctor´s advise because each digestive enzyme is used for a specific condition and, with specific dosing depending on the condition and the patient. Therefore, you can´t generalize and believe that you are going to find a digestive enzyme supplement over the counter and that, you are going to get better because maybe, the one you found is not the one you need.

Remember, there are specific enzymes for specific conditions, there is not one-enzyme-fits-all.

There are other aspects you have to take into account for a healthy gut, for instance, the prebiotics intake from a diverse healthy diet like the Mediterranean diet or the Mayo Clinic Diet where you can eat daily low fiber foods like bananas, onions or garlic. Any healthy diet where you eat a diversity of foods will help you have a diverse microbiome, in other words, the good bacteria that normally live in your colon will be more diverse and you´ll feel healthier.

Also, don´t forget to take into account the probiotic foods (yogurt, pickles or soft cheese) which promote the healthy bacteria that live in your colon to keep a healthy well functioning gut.  For more information about irritable bowel syndrome, read my article about what is IBS and SIBO.

There is an online event where you can gather information directly from the experts, if you are interested on this topic, read my article about the online IBS and SIBO Summit.

If you have any comments, please leave them in the section below.

Your friend,

Dr. Verónica Giannoni





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