Should You Take Digestive Enzyme Supplements?

If you experience frequent or recurring stomach aches, diarrhea, acid reflux, gas, and bloating, you may wonder if taking a digestive enzyme supplement could help. But, over-the-counter supplements like these are not actually designed to treat gastrointestinal ailments, nor can they speed up metabolism.

What are digestive enzymes?

As part of the digestive process, your body produces various enzymes to chemically break down food’s proteins, sugars, fats and complex carbohydrates so these nutrients can be absorbed and used by the body. 

Examples of digestive enzymes include:

• Amylase: made in the mouth (salivary glands) and pancreas; breaks down complex carbohydrates
• Lipase: made in the pancreas; breaks down fats
• Protease: made in the stomach, pancreas and small intestine; breaks down proteins
• Lactase: breaks down lactose, which is the sugar naturally occurring in dairy
• Sucrase: breaks down sucrose, which is the naturally occurring sugar found in fruits and vegetables

Manufacturers of over-the-counter versions of these enzymes argue these products can replace enzymatic deficiencies.

“I am extremely wary of OTC digestive enzymes because the truth is none of these supplements are regulated by the U.S. Food and Drug Administration,” says Morgan Allyn Sendzischew Shane, M.D., a gastroenterologist with the University of Miami Health System’s Comprehensive Women’s Health Alliance. “So, you don’t really know what you are taking.”

Is your body producing enough digestive enzymes?

“If you’re having consistent, bothersome GI symptoms, it’s important to seek care from your primary care provider or a gastroenterologist to make sure there isn’t a greater health concern that needs to be addressed rather than trying to mask the symptoms with supplements,” Dr. Shane says.

“Abdominal bloating, for example, is often due to a dietary intolerance or constipation. But, some people have digestive enzyme deficiencies that need to be addressed directly by their health care professional.”

Your doctor will discuss your diet and medical history and may conduct a physical exam, order bloodwork and recommend imaging scans to determine the root cause of your persistent belly pain, excessive gas and other recurrent GI issues.

If these tests reveal a related medical condition such as lactose intolerance (when the small intestine doesn’t produce enough lactase) or damage to your pancreas (which causes pancreatic enzyme deficiencies), your doctor can prescribe the appropriate digestive enzyme replacement. Talk to your provider or a registered dietician about which dietary and lifestyle changes may help you avoid GI distress.

Can you take OTC supplements instead of prescription enzyme replacements?

“I shy away from recommending supplements in general,” Dr. Shane says. “They tend to be expensive and unregulated with nominal benefit. Lactase supplements are available over the counter. However, most patients don’t find them beneficial because most of the enzyme supplement is denatured (or diminished) in the stomach (an acidic environment).

“Sometimes patients find OTC supplements for gas to be useful,” she says. “And, magnesium, which we use for constipation, can also be used for muscle cramps and headaches with the added benefit of helping people sleep. That being said, there are maximum daily doses that are safe to consume depending on many other health factors. That’s why it’s important to work with your doctor.

“Most of the time, the real answer is addressing any underlying issues and often altering diet to avoid troublesome symptoms in the first place.”

What else can you do to support your digestive health?

Simply put, control what you eat and drink.

“Many whole foods have positive digestive properties for many reasons — not necessarily because they have enzymes in them,” Dr. Shane says. “Most of the benefit from eating fruits, vegetables, seeds and whole grains comes from the varying types of fiber they contain that help promote good gut biodiversity. Sauerkraut, for example, is a naturally fermented food that contains probiotics. Papaya helps with constipation because of the fiber and has actually been studied along with Kiwi in managing chronic idiopathic constipation, which can be a cause of bloating and gassiness.

“Rather than taking something extra, I always recommend patients eat foods that, overall, make them feel good — and avoid ones that don’t,” Dr. Shane says.

Dana Kantrowitz is a contributor for UHealth’s news service.

The UHealth’s Comprehensive Women’s Health Alliance provides specialized care for women’s health at all ages. Call 855-3-4-WOMEN (96636) or request an appointment online.

Tags: Comprehensive Women's Health Alliance, digestive enzyme benefits, digestive enzymes help with bloating, Dr. Morgan Sendzischew Shane, gastroenterology, improve digestive health, Prescription vs. OTC digestive enzymes