What Exactly Are Digestive Enzymes—And Do You Need One?

When digestive issues like bloating, gas, nausea, constipation, or diarrhea are a regular event after eating, they affect your quality of life. If you experience digestive health issues, you're not alone—up to 70 million Americans are affected by digestive diseases, according to the National Institutes of Health.

This could explain why more consumers are taking notice of digestive enzyme supplements, which are thought to help the body break down food compounds and increase nutrient absorption, relieving symptoms of indigestion in the process.

A 2017 report published by Grand View Research, Inc. estimates that the global digestive enzyme supplements market will hit $1.6 billion by 2025. But with this surge in popularity comes a scroll of questions, including whether they work and how safe they are.

We went to the experts to find out everything you need to know about digestive enzyme supplements. Here's what they had to say.

What Are Digestive Enzymes?

The body secretes various enzymes to break down the foods we eat—some are secreted in the mouth, and others further down in the digestive tract. "The most important enzyme categories are the proteases (which break down proteins), lipases (fats), and amylases (starches and sugars)," said Ken Berry, MD, Tennessee-based board-certified family physician and author of Lies My Doctor Told Me.

Normally functioning glands (in the mouth, stomach, small intestine, gallbladder, and pancreas) are pros at producing enzymes. Our bodies use these enzymes to digest our food and properly absorb nutrients. However, when these glands aren't functioning or are damaged, digestive enzyme supplements are intended to help pick up the slack.

Here's a breakdown of the main digestive enzymes, per Johns Hopkins Medicine:

• Amylase: This digestive enzyme is made in the mouth and pancreas and is responsible for breaking down complex carbs, such as whole wheat products.
• Lipase: Made in the pancreas, this digestive enzyme is important in breaking down fats.
• Protease: Also made in the pancreas, protease is needed to break down proteins.
• Lactase: Made in the small intestine, lactase is necessary for the breakdown of lactose, a sugar found in milk.
• Sucrase: Sucrase is also made in the small intestine and breaks down sucrose, a simple sugar found in foods such as fruits.

Who Might Benefit From Them?

Diseases of the stomach and small intestine can reduce the number of enzymes produced by them, said Dr. Berry, so people with conditions like irritable bowel syndrome (IBS), inflammatory bowel disease, or low stomach acid might find digestive enzyme supplements helpful. The same goes for people with chronic pancreatitis, which can cause a deficiency of pancreatic enzymes.

Having your gallbladder removed can also make it so that there aren't enough enzymes to break down fat properly, making supplementation a necessary measure to reduce digestive issues.

According to Johns Hopkins Medicine, other examples of diseases or conditions that affect the production of digestive enzymes include cystic fibrosis, other gastrointestinal surgeries, and any condition that disrupts your pancreas since so many digestive enzymes are produced there.

Johns Hopkins Medicine also explained that some digestive enzyme insufficiencies might be inherited and present as soon as you are born. Or, they can develop over time due to various conditions or treatments, such as gallbladder removal surgery.

But if you don't have a definite enzyme deficiency (you can find out for sure by having your poop tested), or your symptoms are more of a nuisance than severe, it might be easier on your wallet to simply remove any foods from your diet that cause digestive distress in the first place. "For most people, removing sugars, grains, liquid dairy, and industrial seed oils from the diet can dramatically improve the digestive issues many might try to treat with a supplement," said Dr. Berry.

How Many Kinds of Digestive Enzyme Supplements Are There?

The over-the-counter digestive enzyme supplements on the market are modeled around the three primary categories of digestive enzymes created naturally within the body (protein-, fat- and carb-specific), said Nazir Khaja, MD, California-based gastroenterologist and clinical associate professor at UCLA School of Medicine.

Two more well-known examples are lactase (for digesting lactose found in dairy products) and alpha-galactosidase supplements (for sugars found in cruciferous veggies and legumes). There's also a growing market for supplements that combine digestive enzymes and claim to alleviate multiple gut issues in one shot. "Whether they actually help or not is up for debate because no meaningful studies have proven their merit," said Dr. Berry.

Beyond over-the-counter supplements, Johns Hopkins Medicine explained there are also prescription digestive enzymes. Pancreatic enzyme replacement therapy, or PERT, is a Food and Drug Administration (FDA) regulated treatment. PERT is typically given to individuals with cystic fibrosis (because of the damage that can happen to the pancreas with this condition), and those with frequent pancreatitis.

Can Your Body Become Dependent?

"If your body still makes the digestive enzymes you need, then taking a supplement of them won't help or hurt your health—it'll just lighten your wallet," said Dr. Berry. The one scenario where your body would become reliant on an enzyme supplement is if a legit deficiency is present, making the supplement necessary for proper digestive function.

Can Digestive Enzyme Supplements Interfere With Other Medications?

Digestive enzyme supplements may be labeled as containing natural ingredients (say, derived from plants) and considered safe. However, they can still interfere with other medications, such as oral diabetes medications and blood thinners. If you're thinking about trying a digestive enzyme supplement and are on other meds, it's best to check in with a healthcare professional first to discuss possible interactions, said Dr. Berry.

What's the Safest Way To Try Them?

Reading the label is everything, said Dr. Khaja. Make sure the supplement you're considering contains the enzyme your healthcare professional thinks might help with improving your digestion. Digestive enzymes include proteases (to break down proteins), lipases (fats), and amylases (starches and sugars). Check the ingredients list to ensure it doesn't contain anything you're allergic to or dubious ingredients such as kava or bitter orange, which have been linked to side effects.

The FDA doesn't regulate digestive enzyme supplements. Still, private groups (such as the Natural Products Association and USP Quality Supplements) offer up their own seals of approval for dietary supplements. Products must be made via good manufacturing procedures and contain what's on the label to earn one of these seals. Spotting these seals can help ensure that you buy a better-quality product.

Anytime you're shopping for a supplement, it's a good idea to shop at big-chain retailers, which are more likely to take recalled supplements off shelves.

Are There Side Effects?

There can be. Popping a digestive enzyme supplement if you don't have a specific deficiency can trigger the symptoms you're trying to avoid, such as nausea, bloating, and diarrhea. Allergic reactions can also be an issue for some people, such as itching, rash, stomach pain, and difficulty swallowing. If this happens, stop taking the digestive enzyme supplements, stat, and seek medical attention, said Dr. Khaja.

But even if taking digestive enzyme supplements does improve your digestion sans side effects, it's still a good idea to notify a healthcare professional that you're using them, especially if you'd like to make them a series regular. That way, you can find out about any issues you might run into down the line, said Dr. Khaja, and a healthcare professional is already in the loop should you need a consult.

A Quick Review

Digestive troubles can be frustrating. Since most digestive enzymes are available over the counter, they may be an attractive option depending on your gastrointestinal issues. However, if you do not have a medical condition that makes digestive enzymes necessary, consider any dietary causes of your digestive troubles before taking a supplement.

And, if you do experience regular digestive issues, you may want to reach out to a healthcare professional. A healthcare professional can advise on the next steps or other solutions you can try.