The body makes digestive enzymes to help break down food carbohydrates, fats, and proteins. Healthy digestion and nutrient absorption depend on these enzymes, a protein that speeds up chemical reactions in the mouth, pancreas, and intestines. Certain health conditions like pancreatic insufficiency and lactose intolerance can cause low enzyme levels and insufficiency and may need replacement digestive enzymes to help prevent malabsorption. That's where digestive enzyme supplements come in.
Digestive Enzymes
Digestive enzymes are a vital part of digestion; without them, the body can't break foods down, and nutrients can't be fully absorbed. A lack of digestive enzymes can lead to gastrointestinal/GI symptoms and cause malnourishment, even with a nutritious diet. The result is unpleasant digestive symptoms that can include:
- Poor absorption of nutrients
- Bloating
- Stomach pain
- Nausea
- Vomiting
Digestive enzyme supplements have been used for treating common forms of gut irritation, heartburn, and other ailments.
Enzyme Types
The main digestive enzymes made in the pancreas include:
Amylase
- It is also made in the mouth.
- Breaks down carbohydrates, or starches, into sugar molecules.
- Low amylase can lead to diarrhea.
Lipase
- This works with liver bile to break down fats.
- Lipase insufficiency causes decreased levels of fat-soluble vitamins A, D, E, and K.
Protease
- This enzyme breaks down proteins into amino acids.
- It also helps keep bacteria, yeast, and protozoa out of the intestines.
- A shortage of protease can lead to allergies or toxicity in the intestines.
Enzymes made in the small intestine include:
Lactase
- Breaks down lactose, a sugar found in dairy products.
Sucrase
- Breaks down sucrose, a sugar found in fruits and vegetables.
Insufficiency
When the body does not produce enough digestive enzymes or doesn't release them correctly. A few types include:
Lactose Intolerance
- The body does not produce enough lactase, making digesting the natural sugar in milk and dairy products difficult.
Exocrine Pancreatic Insufficiency
- EPI is when the pancreas does not produce enough of the enzymes necessary to digest carbohydrates, proteins, and fats.
Congenital Sucrase-Isomaltase Deficiency
- The body does not have enough sucrase to digest certain sugars.
Symptoms
Common digestive enzyme insufficiency symptoms:
- Bloating
- Gas
- Stomach aches and pains.
- Cramps
- Diarrhea
- Oily bowel movement stools
- Unexplained weight loss
Talking to a doctor if symptoms persist is recommended, as these could be signs of gut irritation or indicate a more serious condition.
Supplements
Prescription Enzymes
Individuals diagnosed with enzyme insufficiency may need to take prescription digestive enzymes, depending on the severity. These supplements assist in food breakdown and nutrient absorption. The most common enzyme replacement therapy is pancreatic enzyme replacement therapy or PERT. PERT is a prescribed medication that includes amylase, lipase, and protease. Individuals with cystic fibrosis often have pancreatic enzyme insufficiency, as the body can’t release the enzymes properly. And individuals with pancreatitis require PERT because their pancreas develops mucus and scar tissue over time.
Over-The-Counter Enzymes
Over-the-counter digestive enzyme supplements can contain amylase, lipase, and protease and can help with acid reflux, gas, bloating, and diarrhea. Some contain lactase and alpha-galactosidase. Alpha-galactosidase can help break down a non-absorbable fiber called galactooligosaccharides /GOS, mostly found in beans, root vegetables, and certain dairy products.
Certain foods contain digestive enzymes, including:
- Honey
- Avocados
- Bananas
- Pineapples
- Mangos
- Papayas
- Ginger
- Sauerkraut
- Kiwi
- Kefir
Supplementing the diet with some of these foods can help with digestion.
Functional Nutrition
The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*
email: coach@elpasofunctionalmedicine.com
Licensed in: Texas & New Mexico*
References
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Brennan, Gregory T, and Muhammad Wasif Saif. “Pancreatic Enzyme Replacement Therapy: A Concise Review.” JOP: Journal of the pancreas vol. 20,5 (2019): 121-125.
Corring, T. “The adaptation of digestive enzymes to the diet: its physiological significance.” Reproduction, nutrition, developpement vol. 20,4B (1980): 1217-35. doi:10.1051/rnd:19800713
Goodman, Barbara E. “Insights into digestion and absorption of major nutrients in humans.” Advances in physiology education vol. 34,2 (2010): 44-53. doi:10.1152/advan.00094.2009
Vogt, Günter. “Synthesis of digestive enzymes, food processing, and nutrient absorption in decapod crustaceans: a comparison to the mammalian model of digestion.” Zoology (Jena, Germany) vol. 147 (2021): 125945. doi:10.1016/j.zool.2021.125945
Whitcomb, David C, and Mark E Lowe. “Human pancreatic digestive enzymes.” Digestive diseases and sciences vol. 52,1 (2007): 1-17. doi:10.1007/s10620-006-9589-z
