Irritable Bowel Syndrome (IBS) is a common gut condition that revolves around abdominal pain. It has been linked to FODMAPs, which are sugars that can trigger symptoms in patients. People have come up with digestive enzyme supplements to help them tolerate FODMAPs better, and in this article, we’ll take a look at some supplements that you can try to help with IBS.
What are digestive enzyme supplements?
Digestive enzyme supplements come as pills or powder and are designed to break down large food molecules into smaller ones.
Our bodies naturally produce digestive enzymes to be able to absorb nutrients from diet. Diet contains large molecules that can’t move across the gut lining to enter blood. The body uses digestive enzymes to break these molecules into simpler ones, which can easily diffuse across the gut lining.
This allows us to obtain nutrients from our diet — if it weren’t for digestive enzymes, we would quickly become malnourished and deficient in important nutrients.
Examples of some natural digestive enzymes include amylase (breaks carbs), protease (breaks down protein into amino acids), trypsin (breaks protein), and lipase (breaks down fat).
In some patients (like those with pancreatic insufficiency), the body stops producing these digestive enzymes. This leads to ineffective digestion and loss of nutrients. And this is why digestive enzyme supplements were initially made. The goal was to counter the body’s inability to produce digestive enzymes by supplementing it with synthetic enzymes to improve digestion and prevent malabsorption of nutrients.
How do digestive enzyme supplements help in IBS?
Digestive enzymes help IBS patients in two ways.
First, they help break down FODMAPs. FODMAPs are sugar molecules that can pass undigested to the large intestine, where they meet a large colony of bacteria. In healthy patients, colonic bacteria feed on FODMAPs, which increases the number of good bacteria and maintains gut health.
In IBS patients, the gas that’s released as bacteria digest FODMAPs can cause bloating, abdominal pain, cramping, and a feeling of fullness. We’re not sure exactly why this happens but one explanation is that IBS patients are hypersensitive to even small changes in the gut gas and water content.
By taking digestive enzyme supplements — like FODMAP Digestive Enzymes — patients can reduce the delivery of undigested FODMAPs to the large intestine and alleviate some of their symptoms.
Second, many IBS patients are also lactose-intolerant, meaning they lack the enzyme to break down lactose. Lactose is a sugar found in dairy products and IBS patients can experience bloating, pain, cramping, and nausea after consuming dairy if they’re also lactose-intolerant.
These patients can take lactase (the enzyme that breaks lactose) supplements to improve their symptoms and enjoy dairy foods.
What are the best digestive enzymes to take for IBS?
This is hard to say because every IBS patient is different. A supplement that may do wonders for one patient might not work at all for another.
Scientifically speaking, most studies have focused on two enzymes — lactase and alpha-galactosidase. So it’s safe to say that these two will improve your IBS symptoms if you’re intolerant to lactose or galactooligosaccharides (the molecule that alpha-galactosidase breaks).
Galactooligosaccharides (GOS) are found in foods like:
- Green peas
- Soy milk (produced from soybeans)
If you get symptoms after eating these foods, an alpha-galactosidase enzyme supplement may be beneficial.
While evidence for the effectiveness of other supplements is scarce, they include:
- Xylose isomerase supplements, which break down fructose
- Caricain, which breaks down gluten
How to use digestive enzymes?
Before you use a specific enzyme (like lactase), it’s important to establish whether you’re really intolerant to the molecule it breaks down (like lactose).
A food diary is a good tool for doing this, where you write down what you ate and how you felt after eating for 1-2 months. The diary can then be reviewed by a doctor or a dietitian to establish the foods that trigger your symptoms.
In IBS patients, a general supplement that breaks down all FODMAPs may be useful. But you should remember that it’s not a replacement for standard IBS treatment. FODMAP digestive enzymes work best in the context of a low-FODMAP diet and allow you to tolerate any “hidden” FODMAPs that may slip under your radar.
Over-the-counter digestive enzyme supplements are not regulated by the FDA, which means we don’t really have dosage and regimen guidelines for them. However, inadequate dosage will make these enzymes ineffective, which is why it’s important to review a product with your doctor before buying it.
For example, in this study conducted by Monash University, patients who were given full-dose alpha-galactosidase supplementation showed improved IBS symptoms but those given half-dose supplementation failed to show improvement.
Since digestive enzymes don’t work for everyone, it’s good to begin a 2–3-week trial. If your symptoms improve, you can continue it. Otherwise, you may want to look for another supplement or talk to your doctor if your symptoms are too uncomfortable.
Remember to always consult a doctor before starting any supplement!
What helps IBS symptoms naturally?
Digestive enzyme supplements can sometimes cause nasty side-effects like bloating, diarrhea, and constipation. In this case, trying natural enzyme-rich foods may be a good idea. These include:
- Honey — contains amylase, protease, and diastase
- Pineapples — contain the enzyme bromelain, which breaks proteins
- Mangoes — contain amylase
- Bananas — contain glucosidase and amylase
- Avocados — contain lipase, which breaks fat
If you are intolerant to FODMAPs, check the low FODMAP servings of these foods.
There’s no “best” digestive enzyme to take for IBS. Many companies manufacture these enzymes, and it’s important to go with a company that is research-oriented and has medical doctors on board.
Most research has been focused on lactase and alpha-galactosidase supplements, so it’s difficult to say whether other types will work for you.
Nonetheless, before starting any supplement, review it with your doctor. It’s also important to continue medical treatment for IBS — supplements are not a replacement for that.
Finally, some supplements may cause nasty GI side effects. If that happens with you, you can try natural foods that are rich in digestive enzymes.