01 March 2019

Digestive enzyme supplements

Various bottles of tablets/supplements

By Dr Jane Varney - Research Dietitian

Ever wondered if a digestive enzyme supplement could help to manage your gastrointestinal symptoms? The Monash Team recently spoke to the Washington post about this very issue.

So what are digestive enzymes you ask? As they highlight in the article, 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.

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 certain disorders (e.g. 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.

However, as they correctly point out in the article, there is a much larger group of digestive enzyme supplements available, that lack evidence to substantiate their bold marketing claims (e.g. promoting weight loss, curing allergies and improving digestion). Indeed, some carry risks, including interactions with other medications and contamination.

So if digestive enzymes are not the answer, what can people do to manage their gastrointestinal symptoms? As our very own Assoc Prof Jane Muir points out in the article, it starts with a diagnosis that should be made by a medical practitioner. If the cause of your gastrointestinal symptoms is irritable bowel syndrome (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 confirmed by research from our team and elsewhere showing the diet is effective in ~3/4 IBS sufferers.

To learn more about IBS and the FODMAP diet, visit our website.


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