The Role of Digestive Enzymes in Digestive Health

Digestive enzymes, prebiotics, probiotics, and postbiotics are ingredients for a healthy and happy gut and digestive system. Let's break this down further.

In order to successfully utilize nutrients in the food you eat, compounds are needed to break down the sugars, starches, proteins, and fats. This breakdown is where digestive enzymes come into play. 

Digestive enzymes are compounds that naturally occur in the body to help break down food into the nutrients needed for survival (Denhard, n.d.). Digestion starts with amylase found in saliva (and the pancreas!) that helps break down carbohydrates. Organs in the body along the digestive tract also produce digestive enzymes, including lipase and protease, made in the pancreas. Lipase breaks down fats or lipids, and protease breaks down proteins. Additionally, the small intestine produces lactase, an enzyme that breaks down lactose (a sugar found in dairy products). 

The following are a few more commonly used digestive enzymes (Phillips & Haynes, 2017): 

• Glucoamylase - Breaks down sugars leftover after amylase digestion
• Peptidase - Breaks down protein compounds
• Bromelain - Found in pineapples and helps break down protein
• Papain - Found in papaya and helps break down protein
• Phytase - Digests phytic acid, a compound found in plants
• Cellulase - Digests cellulose, a form of starch found in plants
• Alpha-galactosidase - Digests legumes, such as beans and cruciferous vegetables
• Beta-gluconase - Breaks down certain types of fibers from foods such as cereal and oats (Group, 2015)
• Invertase - Breaks down sugars sucrose (found in table sugar) and maltose (maltose)
• Xylanase - Digests plant compounds called xylans

In a few clinical trials, digestive enzymes in IBS patients were associated with a reduction in symptoms. For example, in a randomized, double-blind placebo-controlled clinical trial, IBS patients who received protease enzymes had more regular bowel movements, relieving constipation, and reduced symptoms including abdominal pain, gas, or bloating (Weir et al., 2018). While only a few studies exist to support the use of digestive enzymes for IBS, more research is needed to fully understand the best methods to reduce IBS symptoms with digestive enzymes. 

The Role of Probiotics in Digestive Health

Within each person's GI tract is a unique and individualized community of trillions of healthy (and unhealthy) bacteria and microorganisms. These living species work together to fight infections, support digestive health, and even prevent harmful bacterial overgrowth (Harvard School of Public Health, n.d.). 

While probiotics and digestive enzymes are often believed to be similar, they are actually quite distinct. In contrast to digestive enzymes, which help break down carbohydrates, proteins, and fats in the body, probiotics provide the GI tract with healthy bacteria to support the hard work of the enzymes (Denhard, n.d.). Deficiencies in digestive enzymes called enzyme insufficiency, and lack of healthy gut bacteria can lead to similar symptoms, including abdominal bloating or gas.

Both supplements and food, such as yogurt, kombucha, or kefir, can contain probiotics. There are hundreds of species of healthy bacteria that can be found in probiotics. For example, a commonly used bacteria is Lactobacillus, but even this bacteria has over 120 different variations (Mayo Clinic, 2021).

In a systematic literature review of the existing research on probiotics and IBS, out of 35 studies, seven reported that IBS patients receiving the probiotic experienced improved IBS symptoms compared to placebo control (Dale, Rasmussen, Asiller, & Lied, 2019). The researchers also found that probiotics were most effective in treating IBS when the probiotic had multiple strains of bacteria and was used over a long period.

Similarly, research supports probiotic use for treating patients' symptoms of small intestinal bacterial overgrowth (SIBO). In a meta-analysis and systematic review, researchers concluded that probiotic supplementation in SIBO patients led to decontamination of SIBO and decreased abdominal pain (Zhong et al., 2017). 

The Role of Prebiotics and Postbiotics in Digestive Health

In addition to probiotics, prebiotics and postbiotics also play a role in gut health. Prebiotics are unique to probiotics in that they are not the healthy bacteria and microorganisms themselves but actually the food that feeds these beneficial compounds. Prebiotics are often found as forms of fiber, including those found in many vegetables and fruits found at your local grocery store (Mayo Clinic, 2021). 

In addition, postbiotics are compounds released from living microorganisms, such as probiotics, but they are not living. Research shows that postbiotics have anti-inflammatory, antioxidant, and even anti-cancer properties (Zolkiewicz, Marzec, Ruszczynski, & Feleszko, 2020).

Digestive enzymes, prebiotics, probiotics, and postbiotics play crucial roles in digestion and gut health.

References:

Dale, H. F., Rasmussen, S. H., Asiller, Ö. Ö., & Lied, G. A. (2019, September 2). Probiotics in Irritable bowel syndrome: An up-to-date systematic review. Nutrients. Retrieved May 13, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769995/#__ffn_sectitle 

Digestive enzymes. Clinical Education. (n.d.). Retrieved May 13, 2022, from https://www.clinicaleducation.org/news/digestive-enzymes/ 

Denhard, M. (2022, February 10). Digestive enzymes and digestive enzyme supplements. Johns Hopkins Medicine. Retrieved May 13, 2022, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/digestive-enzymes-and-digestive-enzyme-supplements 

Group Founder, E. (2015, October 21). What is beta-glucanase? Dr. Group's Healthy Living Articles. Retrieved May 13, 2022, from https://explore.globalhealing.com/beta-glucanase/ 

Mayo Foundation for Medical Education and Research. (2021, February 27). Prebiotics, probiotics and your health. Mayo Clinic. Retrieved May 13, 2022, from https://www.mayoclinic.org/prebiotics-probiotics-and-your-health/art-20390058 

The microbiome. The Nutrition Source. (2020, May 1). Retrieved May 13, 2022, from https://www.hsph.harvard.edu/nutritionsource/ microbiome/#what-is-microbiome

Weir , I., Shu, Q., Wei, N., Wei, C., & Zhu, Y. (n.d.). Efficacy of actinidin-containing kiwifruit extract zyactinase on constipation: A randomised double-blinded placebo-controlled clinical trial. Asia Pacific journal of clinical nutrition. Retrieved May 13, 2022, from https://pubmed.ncbi.nlm.nih.gov/29737803/ 

Zhong , C., Qu, C., Wang, B., Liang, S., & Zeng, B. (n.d.). Probiotics for preventing and treating small intestinal bacterial overgrowth: A meta-analysis and systematic review of current evidence. Journal of clinical gastroenterology. Retrieved May 13, 2022, from https://pubmed.ncbi.nlm.nih.gov/28267052/

Żółkiewicz, J., Marzec, A., Ruszczyński, M., & Feleszko, W. (2020, July 23). Postbiotics-a step beyond pre- and probiotics. MDPI. Retrieved May 13, 2022, from https://www.mdpi.com/2072-6643/12/8/2189