A large number of Americans contend with digestion related issues such as bloating and flatulence, apart from lesser nutrient intake in the body, despite healthy meals. This is attributed to digestive ailments, where the body produces lesser digestive enzymes. Consequently, undigested compounds accumulate in the large intestine, and this is a reason for various conditions mentioned above. This afflicts almost 25% of the adults in the US, indicating the prevalence rates. Other conditions attributed to this includes less energy levels among the affected, which impacts routines. To counter this, digestive enzymes available as supplements help in aiding the digestion process. In the subsequent sections, we will learn all about digestive enzymes side effects and simple methods to handle the effects.
How do digestive enzymes work to help digestion?
Proteins are produced in the body, and these proteins help in the breaking down of consumed food into various nutrients and the energy stored in the cells. The body naturally produces different types of enzymes that help in the breaking down of various food types; such as enzymes for proteins, enzymes for fat and enzymes for carbohydrates. These enzymes, released in the mouth, typically mix with the food, and are essential for digestion to take place in the body. These enzymes are also released in the pancreas, in the small intestines and the liver. Individuals with ailments are likely to have inadequate production/release of digestive enzymes, and this causes the various conditions outlined earlier.
Types of digestive enzymes
While digestive enzymes in supplement form contain proteases, lipases and amylases; supplements are generally categorized into the following categories:
- Prescription – These enzymes are typically recommended for patients diagnosed with specific medical conditions. This includes cystic fibrosis and pancreatitis and the formulations are orally administered. Approved by the FDA, these supplements are intended to be taken in recommended dosages only. The highlight of this category of enzymes is that there are documented reports about the use and possible undesirable effects of the enzymes.
- OTC – Typically purchased by individuals without any prescription for managing gas formation or bloating, these OTC products are intended to offer fast acting relief. Circumstances that prompt usage of these OTC products include flatulence after consumption of beans, wherein the carbohydrates cause flatulence. Similarly, alpha-galactosidase helps boost digestion through faster and more effective breaking down of carbohydrates. Other OTC products include lactase digestive enzymes intended to help break down the sugar in milk or milk products. This offers good relief, as the lactose that is not digested, will start moving to the colon, along with water required for diluting, and this may result in the formation of gas and ultimately diarrhea. Symptoms caused by these actions include lactose intolerance among individuals.
- Combination enzymes – These digestive enzymes are new OTC formulations that are actually a combination of enzymes. There is a distinct difference between the OTC enzymes mentioned above and these enzymes. Containing enzymes derived from plants and animals, it is essential to use these enzymes only after a careful understanding of the possible outcome. This will avoid side effects, attributed to the source of the enzymes – a popular example is the product derived from pineapples, with bromelain, that could interact with blood thinner medications of patients, with possible serious consequences.
Quick peek at coated and non-coated formulations of digestive enzymes
Available as non-coated capsules, delayed release (coated) capsules and mini-microsphere delayed release formula, the enzymes help individuals achieve desired outcomes through suitable formulations. Here is a quick look at the main differences between the coated, non-coated products.
An enteric coating on the delayed release capsules prevents the capsules from dissolving in the stomach. This helps protect the enzymes, which are eventually released in the lower GI (gastrointestinal) tract. This is important as the desired mechanism of action is intended to occur in the lower GI tract, to deliver outcomes that offer relief from digestive conditions. Delayed release formulations are essentially used for a targeted effect in patients.
The non-coated varieties are intended to be consumed with proton pump inhibitor, for the desired results. This medication, neutralizes or reduces stomach acid, which may destroy the enzymes. By neutralizing or reducing the stomach acid, the proton pump inhibitor helps the digestive enzymes to work as desired, and deliver the desired outcomes through unhindered mechanism of action.
The third variety of digestive enzymes, include the oral mini-microsphere delayed release formulations. Available as tablets, in powder form and as capsules, it is necessary to choose a type depending on the suitability of a variety for specific conditions. This is best decided by a specialist after necessary evaluation.
Benefits of oral digestive enzymes
Oral digestive enzymes known as pancreatic enzyme products (PEPs), are effective in treating various conditions including the following:
- Individuals with partial pancreas removal
- Pancreatic diseases
- Cystic fibrosis
- Pancreatic cancer
- Tumors
- Shwachman-Diamond syndrome
- Gastrointestinal conditions – such as Crohn’s disease
- Impaired digestive health
- Celiac disease
Some of the above conditions are attributed to the inability of the pancreas to secrete complex proteins essential for breaking down food. As a result of the pancreas impaired functions, production of digestive enzymes are affected, and this impacts digestive processes. For instance, the following enzymes are necessary for various actions:
- Proteases for digesting proteins
- Lipases for digesting fat
- Amylases for digesting carbohydrates
Possible drug interactions
Medications and supplements come with the possibility of drug interactions. This could occur when two different products are taken together, such as medications with OTC products, supplements or herbal remedies. One of the consequences of these interactions include an impact on the efficacy of either of the medications or products, or increased side effects of either of the products.
Digestive enzymes may interact with antacids or calcium and result in reduced effectiveness due to the mechanism of action and properties of both the products. Interactions may also occur between digestive enzymes and alpha-glucosidase inhibitors of specific types, apart from medications prescribed for diabetes. Patients on other medications or OTC products are advised to seek medical advice before starting oral digestive enzymes. This is necessary to prevent drug interactions, that may result in reduced efficacy or heightened side effects of other medications.
Digestive enzymes side effects that may be encountered frequently
As mentioned earlier, side effects are a possibility, though there are distinctions between the types of side effects – mild, moderate or adverse. It is necessary to bear in mind that all users of medications or products are highly unlikely to experience undesirable effects. Typically, only a small section of users experience effects. Side effects experienced by individuals may be either long term in nature or short term in nature.
Mild or moderate undesirable effects that may be experienced may resolve naturally, in a short time without the need for medical attention or intervention. For instance, patients may experience stomach pain that is not linked to other conditions. Similarly, there is the possibility of gas formation, or users may experience a throbbing headache. These effects are known to resolve quickly and may not be a cause for concern. Some users are also known to experience neck pain and possible constipation. On a contrasting note, there is also the possibility of users ending up with bouts of diarrhea. Other conditions that may be experienced during the initial stages of treatment include nausea, stomach upset and vomiting; these effects may resolve naturally with continued use of the enzymes. Effects that may also be experienced by users include the following:
- Cough
- Sore throat
- Stuffy nose
- Ear pain
- Heartburn
Typically, these effects are treated or managed symptomatically, as there is not serious underlying condition, other than the mechanism of action of the enzymes/properties that are responsible for the effects.
In addition to the above, there are other possible undesirable effects that may be experienced by a small section of users. For instance, patients may contract a rare bowel condition that is serious in nature. Known as fibrosing colonopathy, this condition causes affected individuals to experience colon inflammation, apart from scarring of the colon. There are clear tell-tale symptoms that may be witnessed by caregivers or reported by patients. For instance, the patient is likely to experience stomach pain, apart from vomiting and diarrhea. There is also the possibility of constipation in patients. In addition to these effects, it is important for patients with known allergies to pork, to avoid the enzymes, as certain categories are made from pork derivatives. Additionally, individuals who avoid pork, due to religious practices or dietary choices are to carefully study the ingredients and wherever necessary, avoid enzymes with pork ingredients.
Digestive enzymes side effects that may be serious in nature
Undesirable effects of the enzymes may sometimes be serious in nature, though such effects occur very rarely. This includes certain allergic reactions that may require suitable emergency medication intervention. This is not limited to digestive enzymes but is a general effect that may be experienced with any product, or could be the outcome of any allergies. Whenever certain symptoms are witnessed or reported, it is important to stop the use of the supplements. Individuals are advised to look out for the following symptoms of allergies:
- Abnormal tightening of the chest
- Wheezing
- Breathing difficulty
- Swelling in the face
- Swelling in the mouth, the tongue, lips and throat
- Rashes
- Hives
- Itching sensations
- Reddish appearance on the skin
- Peeling/blistered skin
Note of caution for pregnant women
Studies have not been conducted on pregnant women or women with suckling infants, to understand the effectiveness of the enzymes and the possible unwanted effects of the enzymes. It is therefore important for [regnant women or women with suckling infants to seek medical advice before using enzyme supplements of any variety. The best option would be to avoid the supplements altogether during both the phases; however, when it is absolutely necessary to use the supplements, suitable advice from specialists may be sought. As a general rule of thumb, all pregnant women and nursing mothers are advised to be properly assessed, and evaluation of potential risks be carried out before taking medications or supplements. This is important considering that the risk of effects may extend to the mother as well as the fetus or the suckling infant.
Education: Master’s in Nursing (MSN) from Johns Hopkins University. Experience: 7 years writing for online health portals and nursing journals, specializing in patient education and chronic illness management.
