Read this factsheet to find out
What are digestive enzymes?
Digestive enzymes are a type of proteins that your body produces to break down food into smaller molecules that can be used or stored as energy. There are three broad types of digestive enzymes: amylase, protease & lipase. Many enzymes end with the suffix of -ase.
What happens when your body doesn’t produce enough of an enzyme?
In certain conditions, your body may struggle to produce any or enough of a digestive enzyme. In this case, a digestive enzyme supplement can be taken orally to replace the digestive enzyme that your body is struggling to produce. Some digestive enzymes are available over the counter (OTC), while others require a doctor’s prescription.
Timing of a digestive enzyme supplement
Digestive enzymes must be taken just before you eat. This ensures that the enzymes are ready to do their work as soon as food gets to your stomach and small intestine. In some circumstances, you may choose to break up the dose. For example, if you’re eating a large meal that takes longer than usual to eat, or if you’re a slow eater, your doctor may recommend taking half the dose at the start of the meal and the rest halfway through your meal.
Below we discuss the circumstances where taking a digestive enzyme is warranted.
Irritable Bowel Syndrome (IBS)-related enzymes
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAPs). These molecules are resistant to digestion in your small intestine and reach your large intestine intact. They are then fermented by the gut bacteria in your large intestine, resulting in gas production, which causes symptoms such as bloating, abdominal discomfort, and flatulence. While not everyone is sensitive to the effects of FODMAPs, many people with IBS are.
Digestive enzymes can assist in the breakdown of certain FODMAPs, which may reduce symptoms associated with IBS. The two digestive enzymes that have been researched to help reduce IBS-related symptoms are:
Lactose is the main carbohydrate found in milk and milk products and is a type of FODMAP. Lactose intolerance occurs when our small intestine doesn’t produce enough lactase. Some people may only have lactose intolerance, while for others, lactose intolerance may be part of a broader IBS diagnosis. A lactase enzyme supplement may be helpful in this case.
Alpha-galactosidase is an enzyme that helps breakdown oligosaccharides, particularly galactooligosaccharides (GOS) which are found in
The alpha-galactosidase enzyme is actually not made by the body, which means that GOS reach the large intestine undigested. This is usually not a problem for most healthy individuals. However, it can be for IBS sufferers who have more sensitive guts, especially when GOS-containing foods are consumed in larger volumes. An alpha-galactosidase enzyme supplement may be helpful in this case.
Using digestive enzymes to manage IBS-related enzymes
Other enzymes for IBS
Currently, we only have evidence to support the use of lactase and alpha-galactosidase as enzymes for IBS management. There are other enzymes on the market, such as xylose isomerase (enzyme to break down fructose) and other mixtures of enzymes, however, we don’t have much research on their safety, nor do we know if they are effective in IBS management.
Other strategies to manage lactose intolerance
Natural digestive enzymes
Note that there are also natural sources of digestive enzymes. While they are not the same as a digestive enzyme supplement, including these foods in your diet can potentially aid digestion and promote good gut health.
Low FODMAP examples include:
Now let’s talk about exocrine pancreatic insufficiency
Exocrine Pancreatic Insufficiency (EPI)
What is it?
EPI occurs when your pancreas doesn’t produce sufficient digestive enzymes, which means you don’t have enough lipases, proteases and amylases. This is different to IBS-related enzyme shortage and is much more severe. A variety of conditions cause EPI, including:
Signs and Symptoms
The lack of enzymes means there is undigested food in your intestines which causes gut pain, bloating, and diarrhoea. Severe cases of EPI result in fatty, foul-smelling, loose stools as well as malnutrition and unhealthy weight loss due to the inability to digest and absorb the nutrients from food.
As EPI is associated with severe conditions, anyone with EPI should closely work with a doctor. EPI can be managed through a medication called Pancreatic Enzyme Replacement Therapy (PERT) which, as the name suggests, supplies your body with the replacement pancreatic enzymes. Most PERT medications are only available via prescription. While some PERT medication is available OTC in lower doses, they should still only be taken if indicated by your doctor.
Exocrine Pancreatic Insufficiency:
Last modified: November 11, 2021
Last modified: July 15, 2022