Do Enzyme Supplements Help With Digestive Problems? -


From a crusty baguette to a big thick steak, some foods may be hard to digest, particularly as we age. Enzyme capsules taken before a meal can relieve discomfort by helping the body to break down problem foods, say companies that sell the pills. Doctors say some enzyme supplements work well, but others need more human studies.

A number of enzyme products are aimed at particular foods and digestive concerns.

Digestive enzymes are proteins that work like scissors to break down foods. The pancreas, where many of these enzymes are made, can slow down as we age, which can result in bloating and other gastrointestinal discomfort, says Steven Lamm, clinical assistant professor at New York University School of Medicine and a paid consultant to Enzymedica Inc., a Venice, Fla., company that sells enzyme capsules. Gastroenterologists say it is true the pancreas can slow down with age, but gastrointestinal upsets can be from many causes.

Prescription enzymes are often given to patients who have "pancreatic insufficiency," in which the pancreas doesn't make enough enzymes to digest food, doctors say. But many people with milder gastrointestinal problems—such as gas and bloating—are turning to enzymatic dietary supplements for relief. Sales of over-the-counter digestive enzymes in the U.S. hit $136 million in the past 12 months, up 4% from two years ago, according to Spins LLC, a Schaumburg, Ill., market-research firm.

The concept of an over-the-counter enzyme blend seems "reasonable" but "there are not high-quality, well-designed studies" that prove they work in humans, says Lin Chang, director of the digestive health and nutrition clinic at the University of California in Los Angeles.

Also, says David Whitcomb, a professor of medicine at the University of Pittsburgh, many over-the-counter enzymes are made in fungi—resulting in proteins that digest food efficiently but haven't been tested for humans.

The first over-the-counter enzymes to hit the U.S. market had narrow applications. Lactase, an enzyme that digests a sugar in milk and is lacking in lactose-intolerant people, went on sale in pill form in the 1980s. In 1991, alpha-galactosidase, which aids in digesting beans, cabbage and broccoli, appeared under the brand name Beano, now sold by Medtech Products Inc., Tarrytown, N.Y. Lactase works well, doctors say, and at least four small, published human trials have found the main ingredient in Beano can reduce gas after a meal of beans.

Many newer products aimed at a broader spectrum of foods and digestive concerns are now on the market, but they haven't been tested in human trials. Enzymedica's Digest Gold is a blend of enzymes, including proteases for digesting protein; amylase, for starches and lipase, for fat. Mega-Zyme, sold by a North American unit of Germany's Dr. Willmar Schwabe GmbH & Co. in Green Bay, Wis., contains a powerful enzyme blend the company's website says can "help relieve occasional gas and bloating."

Neither company has done clinical trials on its enzyme products, though Enzymedica says it is planning human trials. Both companies say lab tests show their enzymes do what they are expected to do. For example, says Jeremy Appleton, a naturopathic doctor at Schwabe, proteases are tested to make sure they efficiently break down proteins. He says Schwabe doesn't know of any side effects but adds people with fungal allergies should use the products with caution.

A number of products, such Enzymedica's Gluten Ease 2x, which hit the market last year, are aimed at people who get sick from eating gluten. Humans haven't evolved with the ability to fully digest gluten, says Alessio Fasano, director of the Center for Celiac Research at Massachusetts General Hospital in Boston. In most people, gluten doesn't cause problems, but in people with celiac disease, it causes an autoimmune reaction, Dr. Fasano says. People with "gluten sensitivity" can have symptoms such as stomach aches, joint pain, fatigue and headaches, he adds.

Enzymedica's website notes the product isn't for celiac patients, who need to avoid even trace amounts of gluten. Dr. Fasano agrees, but says patients with gluten sensitivity could try the enzymes. But since the enzymes can work slowly, he says he is skeptical the capsules will work fast enough for many patients, who experience symptoms in minutes or hours.

Enzymedica founder Tom Bohager says lab tests show the product works quickly—with an average of 60% large gluten molecules broken down in a half-hour and 75% at 90 minutes. The company says customers have reported only occasional side effects—such as stomach cramping. In the case of cramps, the company recommends reducing the dose.


via Do Enzyme Supplements Help With Digestive Problems? -