Do Digestive Enzyme Supplements Help with Bloating and Gas?

Digestive enzymes break food into nutritional components in our gastrointestinal (GI) tract. If this process is disrupted, common GI symptoms like bloating, diarrhea, and stomach pain can ensue. It's for this reason that digestive enzyme supplements have been getting attention lately—there is speculation that they boost those processes and help relieve digestive issues.

So, do digestive enzymes work? We dove deeper into what the experts and research have to say about digestive enzyme supplements and their efficacy—so you don’t have to.

Key takeaways

• Digestive enzyme supplements may play an essential role in alleviating several clinical gut and malabsorption disorders.
• Currently, animal-derived enzymes are the standard of care for chronic health conditions. However, a growing body of evidence supports plant-based digestive enzyme therapy.[1, 6]
• Well-designed studies with sufficient power are needed to further characterize the role of digestive enzyme supplements in health promotion and disease treatment.
• Despite anecdotal claims, current clinical evidence doesn't advocate using supplemental enzymes to treat common gut health symptoms. [1, 6]

What are digestive enzymes?

Digestive enzymes are produced by the glands in the mouth, stomach, gallbladder, and small intestine, though most come from the pancreas.

Digestive enzymes help break down the food you eat into molecules small enough to be absorbed by the small intestine and enter the bloodstream—a process that is critically important for converting food into nutrients that the body can use. [1]

Several digestive enzymes exist, each of which plays a distinct role in the body. Primary digestive enzymes include:

• Amylase: Breaks down carbohydrates. Found in saliva, as well as pancreatic and stomach juices.
• Lipase: Breaks down fats. Found in the stomach and pancreas.
• Protease: Breaks down proteins. Found in the stomach, pancreas, and intestines.

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Do digestive enzyme supplements help bloating and other GI symptoms?

Approximately 70 million Americans experience common issues like bloating, gas, diarrhea, and constipation due to the impaired breakdown of food compounds. [2] This has increased speculation that supplements and other exogenous versions of these enzymes may help to alleviate these ailments.

Sources of exogenous digestive enzymes

You can get exogenous digestive enzymes from the following three sources:

1. Prescription enzyme medications

Prescription digestive enzymes are the established standard of care for individuals with chronic health conditions.

These medications contain pancrelipase, a mixture of amylase, lipase, and protease, and are encapsulated in a special coating so they can survive stomach acid and enter the small intestine. These enzymes are typically animal-derived and are regulated and approved by the Food and Drug Administration (FDA). [3, 6]

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2. Over-the-counter supplements

Over-the-counter digestive enzyme supplements are widely available in health food stores and drugstores, as well as on the internet. These types of supplements are not classified as medications and are not regulated by the FDA. Like other supplements found in these common public locations, you cannot be entirely sure of their ingredients nor the exact amounts of enzymes they may contain.

3. Food as source of digestive enzymes

Natural food sources

Various digestive enzymes are derived from our foods: fruit, molds, yeasts, and fungi. Some examples of foods with naturally occurring digestive enzymes include:

• Pineapple: Contains a group of digestive enzymes called bromelain, which helps break down proteins into amino acids.
• Papaya: Contains papain, which breaks down proteins into amino acids. Make sure to eat papayas uncooked, as high heat can destroy their digestive enzymes.
• Mango: Contains amylase, which helps break down carbohydrates.
• Honey: Contains a variety of digestive enzymes. Make sure to purchase raw honey, as it's not exposed to high heat, which can denature enzymes.
• Bananas: Contain amylases and glucosidases, enzymes that digest complex carbs and turn them into sugars. This is why yellow bananas are sweeter than green ones.

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Fermented foods such as kimchi and sauerkraut

The fermentation process incorporates digestive enzymes such as amylase, lipase, and protease. Kefir, a fermented milk product, also contains digestive enzymes that help break down fat, protein, and lactose molecules.



Digestive enzyme insufficiency

Research shows digestive enzymes may only help a subset of people.

In some cases, digestive enzyme production can become dysfunctional, resulting in enzyme insufficiency, which can lead to slowed digestion and symptoms of gastrointestinal discomfort. [1, 3]

For example, those with lactose intolerance do not generate enough of the enzyme lactase and therefore have trouble breaking down and digesting lactose (a sugar found in dairy products). Failure to digest lactose can lead to symptoms like:

• Bloating
• Flatulence
• Diarrhea

Other health conditions that result in low levels of digestive enzymes

Individuals with these conditions are commonly prescribed enzyme pills by doctors to substitute for the lack of natural enzyme production. The most common related diseases include: [1, 3, 6]

• Inflammatory bowel disease
• Chronic pancreatitis
• Cystic fibrosis
• Pancreatic cancer

There's little conclusive evidence that supplemental digestive enzymes are helpful for other common gastrointestinal problems such as: [1, 3]

• Gas
• Bloating
• Heartburn
• Irritable bowel syndrome

Consult a clinician before starting digestive enzyme supplements

Many commercial companies market tests that approximate blood levels of pancreatic enzymes. However, these products do not measure digestive function—in fact, they are only helpful in diagnosing pancreatitis!

So buyer beware: products available to the general public that claim to determine digestive enzyme deficiencies have yet to be tested in clinical trials for their accuracy and efficacy. [1, 3]

Something to digest

If you're still determined to give digestive enzyme supplements a try, it's best to raise the conversation with a GI specialist or Registered Dietitian—both can provide additional clarity and insight based on your individual circumstances.

Recommendations will likely vary widely between patients due to the complexity of the human GI system and the individuality of symptoms.

References:

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923703/

[2] https://www.niddk.nih.gov/health-information/health-statistics/digestive-diseases

[3] https://www.health.harvard.edu/staying-healthy/gut-reaction-a-limited-role-for-digestive-enzyme-supplements

[4] https://pubmed.ncbi.nlm.nih.gov/16482616/

[5] https://pubmed.ncbi.nlm.nih.gov/18401743/

[6] https://pubmed.ncbi.nlm.nih.gov/25103998/

[7] https://pubmed.ncbi.nlm.nih.gov/22195253/