Can Digestive Enzymes Help my IBS?

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!

Comments

[Gerry Rowland]

Very helpful-there has been some discussion of enzymes on fruct-mal list, mostly mixed to negative

[DiJ]

Beano contains wheat which can be a problem for some. It also contains mannitol. And it contains cod, flounder and redfish which is a mystery to me...

[Lemon247]

I'm currently trying the Garden of Life Ω-Zyme digestive enzymes (ingredient list here: http://www.gardenoflife.com/ProductsforLife/DigestiveHealth/%E2%84%A6ZymeULTRA/tabid/643/Default.aspx), which does have the alpha-galactosidase and a whole mess of other enzymes. I get a bit scared when taking these everything-and-the-kitchen-skin pills, in case something else in it sets me off. But so far galactans (soy flour, soy yogurt, coffee) seem to be giving me the most trouble, so I figured I'd give it a go.

[IBS Sufferer]

I have IBS-C, along with a fecal odor. I have tried multiple enzymes and they have never helped my IBS or odor.
Thank you for this information!

[Cheryl White]

Surprisingly enough, once I read the first edition of IBS - Free at Last (and now the second edition of course), I have saved a lot of money by NOT buying digestive enzymes. I don't need them thanks to Patsy's book. Perhaps never did. They may have been adding to my digestive issues with some of the added FODMAP ingredients.

[Patsy Catsos]

Great thought ;) If anyone isn't sure they want to spend the money on the book...just compare to the cost of one bottle of digestive enzymes. Thanks, Cheryl.

[Sue]

I finally got the last piece to my health puzzle when I started taking Digest Spectrum (Enzymedica). I am IBS-D. Took a few tries to tolerate the DS, but now I take one with every meal & my symptoms have lessened even further. I am having normal BMs for the first time in years! DS also helps with the digestion of phenols (amines and chemicals which behave like amines). Since taking DS my night time severe reflux has also lessened. I belong to an FM support group (lots of members) and many of them have also had positive results using DS. My DH recently started taking them and he has also had positive results, even though he has no intolerances..he says he just feels better. No nausea and/or reflux & indigestion. After initial scepticism, I am now a total convert to digestive enzymes..but, like everything, you need to find the one which works for you.

[janeray1940]

Celiac, fructose intolerant, and IBS-D here. I've been taking Solaray Super Digestaway for a little over a month now, and it's been AMAZING. This product contains pancreatic enzymes and is supposed to help with the digestion of everything - protein, fats, and carbs. And it really has! Hasn't solved the D issues entirely but I've had probably a 90% reduction in symptoms.

[Wendy Schwartz]

I am thinking that while digestive enzymes don't really help with FODMAPS, they might help with proteins which can be used by bacteria as an alternate food source when dietary FODMAPS are low. I am curious to hear what you think of that. I haven't read your book yet. I am going to get it now. I suffer from IBS/SIBO symptoms and haven't been able to really do a full blown elimination diet so I am going to study up and do this after a trip I am taking when I can be in a more controlled eating environment. Until then, I will still do my best to avoid FODMAPS.

So glad to have found you today. Not too many people I know have both a BS and MS in Nutrition. I suspect you and I may know some people in common from our college years as we both attended around the same time. I was at NYU.

[Patsy]

Hi Wendy, to clarify, are you wondering whether proteolytic enzymes might help some people with IBS/SIBO?

[Valentina]

I'm taking an enzyme supplement that contains dandelion root: is this allowed during the elimination phase?

[Patsy]

Don't know for sure about the dandelion root. In general, if supplements aren't essential I suggest stopping them during the elimination phase, but if it has been a long term part of your regimen and especially if recommended by your health care provider then it is OK to continue.

[Valentina]

Thank you. I was asking because I've found several websites that claim that dandelion leaves and dandelion tea cointain fructans... But I didn't found this statement on your book so I'm puzzled... I don't want to change consistently my routine because I want to see clearly the difference between the FODMAP and non-FODMAP diet. I must stop taking my probiotics supplement because I've noticed it contains FOS, but I'm not sure about dandelion root and I want to make things right...

[Patsy]

Hmmm. Well I haven't seen any original source about dandelion leaves yet, but if and when I do I will blog about it. Good luck and hope you feel better soon.

[Valentina]

Thank you, I hope as well... This is an example of what I've found about dandelion
http://www.allergyassist.com.au/pages/Fructose-Malabsorption-and-FODMAP%E2%80%99s.html Here they say that dandelion is problematic in large amounts, so I don't think that a few milligrams in a pill can cause so much trouble...

[Cherry Foster]

I just bought some Beano, but was sad to find it has mannitol in it... Am still going to trial it though, maybe it won't affect me.

[Beth]

Patsy, is dandelion tea allowed on fodmaps? I believe dandelion leaves are not allowed, but what about dandelion tea? Thanks so much.

[Patsy Catsos]

Dandelion leaves and tea have not been analyzed, so I don't know if they are low in FODMAPs.