The digestive system, also known as the GI tract (gastrointestinal tract), stretches for as long as 9 meters within the human body. Most individuals are unaware that the digestive system effectively extends from the mouth all the way up to the anus. Problems in the digestive system can result in a host of ailments and this includes pain in the abdomen, traces of blood in the stool, flatulence, bloating, constipation, incontinence, diarrhea, and heartburn. Commonly experienced symptoms include nausea, vomiting and difficulty in swallowing solids or liquids. Additionally, there is also the risk of individuals ending up with colon cancer.


A large number of adults in the US are known to suffer from digestive ailments, and the most common issue is discomfort after a meal. Digestive ailments result in lesser production of digestive enzymes, that impact in different ways. From undigested compounds in the large intestine, lesser absorption of nutrients, and significantly lower energy levels, the effects of digestive ailments can affect routines. Various options are presently available for treating the condition, and this includes digestive enzymes. Let us take a detailed look at the possibility of digestive enzymes side effects in addition to the efficacy of the product.


What role do digestive enzymes perform? How does it help treat ailments?


Food that is consumed follows a sequence of actions during and after digestion. This includes the breaking down of the consumed food into nutrients and energy. This is performed by proteins, that are produced in the body. Food typically comprises proteins, fat and carbohydrates, and the breakdown of food is carried out by different enzymes that are responsible for specific categories of food.  Enzymes responsible for this digestive process are released in different parts of the body, such as the liver, the mouth, the small intestines, the pancreas and the stomach. These enzymes typically mingle or mix with the food during the process. Due to one of various conditions, there is a possibility of these enzymes being released or produced in lesser quantities than required. As a result, the digestive process does not function as required, resulting in the conditions mentioned above.


The role of supplementary digestive enzymes is to increase the level of enzymes, and aid the digestive system. Digestive enzymes available as oral supplements include proteases, lipases and amylases, that are considered as essential for smooth function of the digestive system. Supplements are available in three different forms, and patients are recommended formulations that are suitable for specific conditions. For instance, delayed release capsules, are intended to stay for a longer period in the stomach and work after reaching the lower portion of the GI tract. These capsules, with an enteric coating are generally used for a targeted outcome, in the lower GI tract, and will not dissolve in the stomach easily.


The uncoated formulation of the supplements is combined with a proton pump inhibitor.  The purpose of taking the supplement alongside the PPIs is to restrict or regulate stomach acid. This is necessary to prevent the enzymes from being neutralized by the acid in the stomach. As part of the digestive system or process, stomach acid is released during or after consumption of food. By regulating the amount of stomach acid, the combination of PPIs and enzymes help in proper digestive process.  The mini-microsphere delayed release oral supplements are the latest formulations in the market. This category of supplements is also intended to offer a delayed release of the enzymes, albeit in a more advanced and convenient form. Available as tablets, as capsules and in powder form, mini-microsphere formulations are recommended on the basis of assessment of the condition.


Are digestive enzymes prescription medications?


Digestive enzymes belong to the category of prescription medication and OTC supplements. Prescription category of digestive enzymes are recommended for patients diagnosed with specific medical conditions that have an impact on the digestive system. Cystic fibrosis, or pancreatitis is typically treated with medications that include digestive enzymes. Available as oral formulations, the FDA approved digestive enzymes are used in recommended dosages as per the condition.


Digestive enzymes are also available as OTC supplements and are typically purchased over the counter for symptomatic relief. This includes flatulence, bloating that is not linked to ailments or diseases. Individuals who consume beans in large quantities may end up with flatulence as a result of the heavy carbohydrates. Digestive enzymes available over the counter contain alpha-galactosidase that is known to break down the carbohydrates, thereby offering relief from flatulence. Different types of OTC formulations are available for different symptoms. The sugar in milk also needs to be broken down as lactose that is not digested fully can result in gas and diarrhea. The lactose may move down to the colon and this could result in symptoms that are unpleasant in nature apart from the risk of developing lactose intolerance. Individuals who require enzymes to support this function or prevent this condition typically opt for lactase digestive enzymes.


In addition to the above OTC formulations, there are a new category of OTC products that are known as enzyme combinations. Slightly in variation with regular OTC categories of digestive enzymes, these are derived from plants, animals and are not the safest for all users. It is necessary to check the formulation for the contents and choose one that is suitable. This accounts for one of the various possibilities of digestive enzymes side effects, and the cited example is of a formulation that contains bromelain. This could have an adverse impact on individuals on medications such as blood thinners, anticoagulants. It is therefore necessary to seek medical advice or know the product and its ingredients fully before taking a decision about continued use.


Can digestive enzymes help treat digestive ailments? What ailments can be managed with the supplements?


Digestive enzymes can help treat conditions caused as a result of impaired functioning of the digestive system. Lipases are necessary for fat digestion, while amylases are necessary for carbohydrates digestion. Supplementary digestive enzymes known as pancreatic enzyme products or PEPs are known to help patients with problems in the digestive system. Proteins are secreted from the pancreas, and when other medical conditions cause this functioning to be affected, the release of the digestive enzymes is affected. The use of PEPs is known to deliver desired results. This is ideal for individuals with specific conditions, such as patients who have had their pancreas removed partly.


Other conditions include cystic fibrosis, tumors in the pancreas, and patients diagnosed with cancer of the pancreas. Another syndrome that results in impaired functioning of the digestive system is Schwachman-Diamond syndrome that refers to a congenital disorder. Patients with the condition may have typical symptoms such as bone marrow dysfunction, and also have clear visible changes such as being short in stature, or certain abnormalities in the skeletal structure.  In addition to the above, digestive enzymes can also be used for treating patients with Crohn’s disease, celiac disease, other gastrointestinal conditions, and digestive health conditions.

Do digestive enzymes cause drug interactions?


The possibility of drug interactions cannot be ruled when digestive enzymes are taken along with other medications or OTC formulations. This includes herbal remedies or supplements for various purposes or outcomes. Drug interactions may typically result in reduced efficacy in one of the two products/medications taken together, or drug interactions could result in increased side effects of either of the medications/products taken together. Commonly reported side effects include lesser efficacy of digestive enzymes when calcium supplements or antacids are taken with the digestive enzymes. Other interactions include medications such as alpha-glucosidase inhibitors, and medicines for controlling blood glucose levels. Patients need to ascertain the possibility of interactions of digestive enzymes with medications or OTC products before taking the two together.


What digestive enzymes side effects are possible?


Side effects that are rare in nature include allergies that could quickly turn into an emergency. It is necessary to treat allergic reactions with suitable care to prevent the possibility of the situation turning serious in nature. Certain symptoms are indicative of the onset of adverse effects, and the best option is to discontinue the intake of the digestive enzymes and seek medical assistance. For instance, difficulty in breathing, wheezing, a tight feeling in the chest and swelling on the face are all indicative of adverse outcomes. Allergies include rashes and hives and need to be treated at the earliest. Symptoms include itching, reddish skin-color, peeling and blisters on the skin.


Outcomes that are considered as mild


Mild outcomes of the supplements are also possible and include pain in the stomach, flatulence and gas. These effects are not known to last beyond a few days and are also known to resolve naturally. Any abnormal pain in the neck, headache, constipation or diarrhea are all indications of mild effects that may be experienced. During the initial period of starting the supplements, individuals are known to experience nausea, or vomiting or an upset stomach. These symptoms also subside with use, as the body adjusts to the digestive enzymes gradually.


Other possible undesirable outcomes include cough, sore throat, stuffy nose and ear pain. Side effects also include heartburn, and a bowel condition medically known as fibrosing colonopathy. This condition refers to an inflammation in the colon, that also causes scarring. The enzymes, depending on the manufacturing process or ingredients may also cause allergies in individuals who have history of allergies to pork products. Certain products contain ingredients from pork, and this may cause allergies, or may not be suitable for individuals who exclude pork from diets.  It is also generally not taken by pregnant women or women planning a pregnancy, as the outcomes have not been adequately studied to certify safety and efficacy among this category of users.

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