Wouldn't it be great if you could just take a pill to help with carbohydrate digestion and absorption? Are there such pills that could promise no more trouble with FODMAPs?
The answer depends on which particular FODMAPs are your problems. To figure that out, I recommend you follow the protocol in my book, IBS—Free at Last! Second Edition, now available as a Kindle book or a paperback. I don't recommend using digestive enzymes during the Elimination Phase of the diet. Later, after you've identified the problem carbs, you can go on to consider whether digestive enzymes might help. The short answer is, if you are lactose intolerant, try using lactase enzyme pills. For all the other FODMAPs, there are no magic bullets, but some intriguing possibilities. If you like nitty-gritty details, here are some of my thoughts:
- Lactose. Digestive enzymes probably will help to some degree. Most people are lactose intolerant because they don't product enough of the enzyme lactase. It makes sense, then, that using the enzyme lactase when you eat or drink foods that contain it will probably help you manage your symptoms. Beware of lactase pills that are sweetened with other FODMAPs--check the ingredients (mannitol--ackk!!) Read a previous blog post about lactase pills here.
- Fructose. Insufficient enzymes are not the cause of fructose malabsorption. Fructose does not need to be "digested." It is already the smallest possible sugar unit. That makes it unlikely that taking an enzyme will improve absorption. Still,there is one product on the market in Europe (Fructosin®) that claims it can convert fructose to glucose for absorption. We will all be watching to see whether this type of product will be of any use; way to soon to tell.
- Polyols. I am not aware of any available enzymes that claim to help polyol digestion or absorption.
- Fructans. Fructans are chains of fructose molecules. Humans don't produce enzymes to break the bonds of those chains. That is the normal state of affairs. It seems to me that taking such an enzyme might be of limited value; it would release a flood of free fructose into the gut, with no net decrease in the FODMAP load, perhaps worsening the plight of people with fructose malabsorption. However, certain individuals may absorb fructose well but not tolerate fructans; they might benefit from experimenting with enzymes.
- Galactans. Again, humans normally don't produce enzymes to break down galactans.The enzyme alpha-galactosidase, found in some over-the-counter enzyme products such as Beano® and Digest Spectrum®, is reported to break galacatans/GOS apart into galactose molecules which can then be absorbed by humans. Beano, in particular, has been around for years, and many people report it helps them tolerate foods high in galactans. There has been little published research to back this up; most information available has been provided by the company that makes Beano. This enzyme should be used with caution by people with galactosemia or diabetes.
Most of these enzymes are produced industrially by the mold aspergillis niger, so they should be used with caution by people with allergy or sensitivity to molds.
If you have used any of these supplements, please share your experience with others by leaving a comment!