Digestive enzyme supplements: do they really work?

Tired of your gastrointestinal disorder leaving you feeling bloated and constipated? Perhaps you’ve searched the internet for supplements that can help to make your tummy feel better.

One of the supposed remedies for easing flare-ups of conditions such as irritable bowel syndrome (IBS) are digestive enzyme supplements. But with so many brands being marketed out there, is it possible that they all really do help to manage such symptoms? We spoke to an expert gastroenterologist Dr Aathavan Loganayagam to find out.

What are digestive enzymes?

Digestive enzymes are proteins that assist our bodies to breakdown and absorb the fats, proteins, and carbohydrates we consume from food. Examples include amylase, which is secreted by the salivary glands and used to break starch into glucose units; lactase which is produced by cells lining the interior wall of the small intestine and used to break lactose into glucose and galactose units, and proteases which break proteins into peptides and amino acids.
 

In your expert opinion, do all digestive enzyme supplements work?

Usually, digestive enzymes are produced by and secreted into the gastrointestinal tract, so in most people, digestive enzyme supplementation is not necessary.

However, in people suffering from certain disorders, such as cystic fibrosis or pancreatic insufficiency, digestive enzyme production may be insufficient and enzyme supplementation may be an essential therapy. One example is Creon therapy for pancreatic exocrine insufficiency.

Other enzyme therapies with some evidence supporting their efficacy include lactase supplementation for lactose intolerance and alpha-galactosidase supplementation for GOS-sensitive individuals with IBS.

There is, however, a much larger group of digestive enzyme supplements available, that lack evidence to substantiate their bold marketing claims. This includes promoting weight loss, curing allergies and improving digestion. Indeed, some carry risks, including interactions with other medications and contamination.
 

How can gastrointestinal symptoms be managed?

So if digestive enzymes are not the answer, what can people do to manage their gastrointestinal symptoms? It starts with a diagnosis that should be made by a gastroenterologist. If the cause of your gastrointestinal symptoms is IBS (a condition characterised by gastrointestinal symptoms and known to affect ~15% of the population worldwide), then a dietitian-led, low FODMAP diet may help, as the diet is effective in ~3/4 IBS sufferers.

If you would like to discuss any gastrointestinal symptoms that you have been experiencing, do not hesitate to book an appointment with Dr Loganayagam now.