Herb Blurb: Digestive Enzymes

This month I chose the topic of oral enzyme supplementation since I recently had inquiries about the efficacy of taking digestive enzymes to complement health. As with many herbs and supplements, there is limited scientific support for the effectiveness of these supplements. Many of the human studies lacked proper control, randomization, and appropriate statistical analysis. Also, controlled clinical research is needed to determine if their long-term use is safe.

What is the role of digestive enzymes?
They break down the food we eat into simple nutrients the body's cells can use.

Are digestive enzymes destroyed in the stomach making them useless?
Not all supplemental digestive enzymes are destroyed in the stomach. Some enzymes are acid-resistant and remain active.

Do supplemental enzymes effect the stimulus mechanism for enzymes produced in the body?
There does not appear to be a negative effect of supplemental digestive enzymes on digestive organs.

What are the most common digestive enzymes on the market?
Bromelain
Bromelain contains proteases extracted from the pineapple. It is sold individually or in combination with other enzymes (pancreatin, papin, betaine, lactase, cellulase, etc.)
Marketing claims:

• "Good for respiratory infections"
• "Anti-inflammatory--speeds healing"
• "Reduces angina and blood pressure, and improves cardiovascular conditions"
• "Anticancer agent"
• "Digestive aid"
• "Antibacterial, antidiarrheal properties"

Pancreatin
Pancreatin contains three classes of enzymes: 1) amylases, 2) lipases, and 3) proteases.
Marketing Claims:

• "Helps control digestive disorders"
• "Supports healthy digestion and absorption"
• "Enhances the immune system"

Bottom Line

When prescribed by a physician, digestive enzymes have a role for people with chronic pancreatitis, cystic fibrosis or pancreatic cancer. Pancreatic enzymes may also be prescribed for celiac disease, inflammatory bowel disease, primary biliary cirrhosis, total gastrectomy, and dyspepsia.

  Sources:
1. Helffrich, L. 2000 Complementing Health with Digestive Enzymes. Nutrition in Complementary Care, A Dietetic Practice Group of the American Dietetic Association, Vol. 2 No.6.
2. Sarubin, A. 2000 The Health Professional's Guide to Popular Dietary Supplements. American Dietetic Association.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.