What Are Digestive Enzymes?

These supplements may help improve digestion and reduce inflammation

Digestive Enzyme capsules and tablets

Verywell / Anastasia Tretiak

Digestive enzymes are proteins that help you digest food. They are found naturally in the body.

Most digestive enzymes are made by the pancreas. They help your body break down fats, proteins, and carbohydrates.

When the pancreas doesn't make enough enzymes, the body can't easily break down foods and absorb nutrients. This is called malabsorption.

Malabsorption can lead to nutritional deficiencies and uncomfortable symptoms such as:

Digestive enzyme supplements can help prevent this, but they also have many other purported uses. Proponents say they can help people with arthritis, autism, and even cancer.

Digestive enzymes are available by prescription. You can also buy them over the counter (OTC) as supplements.

This article will discuss over-the-counter digestive enzyme supplements, their use, side effects, and potential interactions

Where Do Digestive Enzymes Come From?

The digestive enzymes in supplements come from various sources. These may include the pancreases of animals like pigs, cows, or lambs.

Other enzyme supplements are sourced from plants. For example, bromelain is made from pineapples. Papain comes from papayas. Lactase comes from purified yeasts or fungi.

Supplements may contain a mixture of enzymes, such as:

  • Proteolytic enzymes like bromelain and papain, which are needed to digest protein
  • Lipase, which is needed to digest fat
  • Amylase, which is needed to digest carbohydrates

What Are Digestive Enzymes Used For?

Doctors often prescribe digestive enzymes to people who have conditions of the pancreas. These conditions include:

Some people say OTC enzymes can help digestive issues like:

People who have trouble digesting dairy may take OTC digestive enzymes. These are called lactase supplements. Lactase is the enzyme that digests lactose. Lactose is the main sugar in dairy products. 

Lactase supplements can help prevent indigestion in people who have trouble digesting lactose. 

Similarly, some people lack the enzyme that digests the sugars in beans. For these people, an alpha-galactosidase supplement, such as Beano or Bean Relief, may help.

Recap

Digestive enzymes are used for many health conditions, including digestive issues. People who lack certain digestive enzymes may also find them helpful.

Enzymes for digestion are usually taken with meals. Aside from helping with digestive symptoms, these supplements may have other benefits, such as:

  • Stimulating the immune system
  • Managing arthritis
  • Reducing inflammation
  • Improving liver health
  • Easing the side effects of cancer treatment

A few studies seem to support some of these benefits. As with many dietary supplements, though, there isn't enough evidence to show they have clear health benefits.

Many of the studies are small. Some are poorly designed or have conflicting outcomes. Here's a look at some key findings.

Irritable Bowel Syndrome

Pancrelipase is a digestive enzyme that might help people with irritable bowel syndrome (IBS). 

In one study, 69 IBS patients were given either pancrelipase or a placebo. A placebo is a substance that has no active ingredient. The patients were then asked to eat foods known to trigger their symptoms.

Study results showed the pancrelipase patients did better than those taking the placebo. Patients taking pancrelipase had much greater improvement in symptoms like cramping, bloating, and pain.

Another study looked at a supplement called Biointol. This supplement contains digestive enzymes along with beta-glucan and inositol. Beta-glucan is a fiber. Inositol is a sugar that helps build cells. 

In this small study, 50 IBS patients received the supplement. Their symptoms were compared with a control group of 40 IBS patients. The control group did not take the supplement.

The results indicated that the supplement reduced symptoms. Patients had less abdominal pain, bloating, and flatulence. The control group did not have improvement in most symptoms.

Inflammatory Bowel Disease

Several early studies in animals suggest that bromelain may help people with colitis. Colitis is inflammation of the bowel.

A 2017 study found that bromelain seemed to decrease inflammation in mice with colitis.

Digestive enzymes may also be helpful for people who have IBD-IBS syndrome. People with IBD-IBS syndrome have inflammatory bowel disease (IBD) but also have symptoms of irritable bowel syndrome (IBS).

Symptoms of IBD-IBS syndrome may include abdominal pain and diarrhea. Patients have these symptoms even though they have little or no active inflammation.

A standard treatment for IBD is Asacol (mesalamine). This is an anti-inflammatory drug.

Biointol is a supplement that contains digestive enzymes. This supplement also contains beta-glucan and inositol.

In a 2017 study, IBD-IBS patients were given Asacol with Biointol. Another group received just Asacol.

After four weeks, those who received Asacol and Biointol said they had less abdominal pain. They also said they had less bloating and flatulence.

Those who took only Asacol had just a small improvement in symptoms. For these patients, it was a mild reduction in fecal urgency. Fecal urgency is the sudden, immediate need to use the bathroom.

Recap

Some studies suggest that digestive enzymes may help disorders of the bowel such as irritable bowel syndrome and inflammatory bowel disease. But these studies tend to be small, and not all of them had a comparison group.

Cancer

There are some reports that digestive enzymes may help cancer patients. They do not affect the disease process, though. Instead, they may decrease the complications of treatments.

Unfortunately, there are problems with the studies that have looked into these benefits. Some were not statistically analyzed. Others did not show that OTC enzymes were associated with significant or consistent improvement.

For example, an older study reported that OTC enzymes improved the quality of life for colorectal cancer patients. The study claimed these patients had fewer signs and symptoms of disease. It also claimed there was a reduction in side effects from cancer treatment. Other studies, though, have had conflicting results.

Arthritis

Some studies suggest that bromelain may help relieve the pain of osteoarthritis (OA). This may be because it reduces inflammation.

A 2012 review of studies on natural OA remedies found evidence that bromelain might help ease OA pain. The authors noted, however, that many of the studies were poorly designed.

Another study compared Voltaren (diclofenac) with Wobenzym. Voltaren is a prescription non-steroidal anti-inflammatory (NSAID) pain reliever. Wobenzym contains bromelain. It also contains trypsin and rutin. Trypsin is an enzyme that breaks down proteins. Rutin is an antioxidant.

The study included 150 patients with moderate-to-severe OA of the knee.

After 12 weeks, patients taking Wobenzym had less joint pain and better knee function compared to those taking the NSAID. This included improved ability to walk and knee joint flexibility.

Another supplement called Phlogenzym contains the same ingredients as Wobenzym. Studies of Phlogenzym suggest that patients may have only small improvements in pain.

Based on the current research it's hard to know how effective enzymes are at improving OA symptoms. Larger studies are needed.

Muscle Soreness

Studies have also looked into OTC enzymes as a treatment for sore muscles. The evidence on their effectiveness for this is mixed. Many studies are small and dated.

In one older study, 20 men were given protease supplements. Protease is an enzyme that speeds up the breakdown of proteins. This study found that the supplements helped muscles heal. They also seemed to reduce pain after intense exercise.

Another study, however, had different results. It showed no difference between bromelain, Advil (ibuprofen), or placebo in treating muscle soreness after exercise.

A more recent study found that compared to a placebo, the enzyme blend DigeZyme significantly reduced pain after a treadmill running test.

Recap

Studies into the use of enzymes for arthritis and muscle soreness have mixed results. More research is needed to confirm whether or not digestive enzymes are helpful for these conditions.

Autism

Many people with autism spectrum disorders (ASD) have gut problems. These problems may be related to the other symptoms of autism. Still, research on digestive enzymes in children with ASD is mixed.

In one study, children with ASD were given digestive enzymes for three months. These children had improvement in symptoms compared to the control group.

The children who took enzymes had improvements in emotional response and general behavior. They also had improvements in:

  • Quality of stools
  • Abdominal pain
  • Vomiting
  • Food variety (selective eating is a common problem for children with ASD)

Other studies have not found similar effects. A 2010 study also looked at enzyme supplements in children with ASD. Compared to the placebo, the only improvement was in food variety.

More research is necessary. Still, enzymes are inexpensive, easy to obtain, and generally considered safe. For this reason, some researchers encourage their use in kids with ASD.

Talk to your doctor before giving digestive enzymes to your child.

Possible Side Effects

Most enzyme supplements are safe at recommended doses. Still, they may have side effects. Common side effects include:

  • Stomach pain
  • Nausea
  • Diarrhea
  • Vomiting

Some people may also have allergic reactions to digestive enzymes.

Bromelain may have anti-platelet activity. Platelets are the cells that form blood clots.

If you take blood thinners or have low platelets, bromelain could increase the risk of bleeding. 

People who are pregnant or breastfeeding should consult a doctor before taking digestive enzymes.

Digestive enzyme capsules
Verywell / Anastasia Tretiak

Dosage and Preparation

There is no standard dosage for digestive enzymes. Studies often use mixtures of several enzymes and effective dosages vary widely. It's best to follow the directions on the label.

If you're going to try digestive enzymes, consider a short trial period of two or three weeks. If it works, you may want to continue with it. If not, stop taking it.

What to Look For

Digestive enzymes are widely available. They can be purchased online and in many natural foods stores, drugstores, and stores that sell dietary supplements.

A ConsumerLab review showed that some enzyme products may have misleading labels. Some did not have the enzyme action claimed on the label. Others weren't labeled clearly.

Enzyme products vary considerably in enzyme activity. If you decide to try these products, find a brand that has been through third-party quality testing. Organizations that provide third-party testing include:

  • U.S. Pharmacopeia (USP)
  • NSF International
  • ConsumerLab

Quality testing does not guarantee safety. Still, it can help you make the best choice when buying any supplement.

Avoiding or delaying standard care in favor of self-treatment with digestive enzymes may have serious consequences. If you're considering digestive enzymes, consult your doctor first.

Summary

Digestive enzymes are used for many health conditions. There is mixed research into whether or not they are useful for some of these conditions.

Studies have found some evidence they may help people with irritable bowel syndrome and inflammatory bowel disease. They may also help ease the side effects of cancer treatment.

Other studies have found that they may help arthritis pain and muscle soreness. There may also be benefits for kids with autism.

Most research is limited and there are problems with some of the studies, so it is difficult to know how helpful digestive enzymes may really be for these conditions. 

Digestive enzymes may have mild side effects. Always use caution when buying supplements. Look for supplements that have been quality tested.

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18 Sources
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