Exactly How Digestive Enzymes Can Help Your Gut Health

If there’s one thing I know for sure, it’s that healthy digestion is the foundation of health and wellness. As a functional medicine practitioner, I rarely see patients that don’t have some form of gastrointestinal issue going on, whether that is bloating, constipation, or an undiagnosed food sensitivity. 

In most cases I see multiple contributing factors behind digestive distress, and one of them can be a lack of digestive enzymes, which your body uses to break down and absorb food. 

That’s where digestive enzyme supplements come in—sometimes. I’ve also seen these supplements be overused or thought of as a complete solution to gut problems, which they shouldn’t be. 

So let’s explore what digestive enzymes actually do, why they matter, when supplementation makes sense, and how to support your digestive system more broadly. 

What Are Digestive Enzymes? 

Digestive enzymes are specialized proteins that are responsible for breaking down the food you eat into smaller pieces, which the body can then better absorb, utilize, and turn into energy. 

The body produces digestive enzymes naturally, and they work throughout the digestive tract. 

Salivary enzymes start breaking down carbs and fats as soon as you put food into your mouth, stomach enzymes begin protein digestion with the help of stomach acid, and pancreatic enzymes (produced in the pancreas and secreted into the small intestine) finish the breakdown of food into absorbable amino acids, sugars, and fatty acids.  

There are three primary categories of digestive enzymes, which break down the three main macronutrients into smaller pieces: 

• Lipases: These enzymes break down fats from foods like avocado and olive oil into smaller fatty acids that can be easily absorbed, as well as glycerol for energy and hormone production
• Proteases: These enzymes break down protein, from foods like chicken and eggs, into peptides and amino acids 
• Amylases: These enzymes break down carbohydrates, from foods like potatoes and oats, into sugar molecules including glucose and maltose  

Within and outside of these categories, there are many individual types of digestive enzyme that break down specific food components. A few examples include:

• Cellulase: This enzyme helps digest plant fibers
• Lactase: This enzyme helps break down lactose (milk sugar) from dairy products 
• Sucrase and maltase: These enzymes helps break down sucrose and maltase into glucose and fructose 
• Alpha-galactosidase: This enzyme breaks down galactooligosaccharides (GOS), a type of complex carbohydrate found in beans and legumes

Why Take a Digestive Enzyme Supplement?

Although the body naturally produces digestive enzymes, there are various factors that can hinder production. Low levels of digestive enzymes means difficulty digesting food, which can lead to symptoms including bloating, cramping, abdominal pain, and reflux. 

Causes of low digestive enzyme production may include: 

• Age: Pancreatic enzyme output decreases as we get older (1) 
• Low stomach acid: This prevents the activation of pepsin and impairs pancreatic signaling
• Chronic stress: Being in constant fight or flight mode diverts energy away from digestion
• Inflammatory gut conditions: Irritable bowel syndrome (IBS), SIBO, IBD, and celiac disease are among the digestive health conditions that can damage the intestinal lining and enzyme-producing cells (2)  
• Pancreatic illness: Chronic pancreatitis, cystic fibrosis, and other pancreatic conditions can cause exocrine pancreatic insufficiency (EPI), a condition where the pancreas fails to secrete enough enzymes. 
• Medication use: Antacids, PPIs, and certain other medications can indirectly decrease enzyme production by reducing stomach acid production. (3) 
• Poor diet: Eating a standard American diet or a high level of inflammatory foods can lead to low stomach acid and inflammatory gut conditions, both of which can cause low digestive enzyme production. 

Supplemental digestive enzymes can help to fill the gap. In some cases, they’re indicated for long term use (such as with EPI in cystic fibrosis). 

In other cases, they can help to ease the burden on your digestive system while you’re actively working to heal your gut. But in many other instances, they’re really just acting as a bandaid. Ultimately, digestive enzyme supplements shouldn’t be relied on alone to solve digestive problems—but they can be very helpful in the right context. We’ll explore this more below. 

And what does the research say? The majority of digestive enzyme research is focused on pancreatic illness including chronic pancreatitis, with studies showing improved nutrient absorption and decreased pain. (4) 

More recent research has also shown that multi-enzyme supplementation can significantly improve digestive conditions including dyspepsia (indigestion), safely reducing pain and improving sleep quality. (5) Studies on enzyme supplementation for gastrointestinal diseases and other conditions not necessarily marked by clinical enzyme deficiency are ongoing. (6) A small trial also showed benefits for children with autism spectrum disorder (ASD), which often involves digestive dysfunction. (7) 

Types of Digestive Enzyme Supplements

There are different kinds of digestive enzyme supplements available, depending on what your needs are. In the case of EPI, pancreatic enzyme replacement therapy (PERT) is often recommended, consisting of prescription-strength pancreatic enzymes derived from animals. 

Many digestive enzymes can also be derived from plant sources, such as papain from papaya and bromelain from pineapple. (You can also increase your intake of these foods for a natural enzyme boost, but you won’t get as much from food sources as from supplements). 

Some people will take a specific enzyme to help them digest a specific food. A common example is lactase to help digest lactose. While there are some exceptions, overall, this is an approach I would recommend using sparingly. 

For example, if you’re lactose intolerant, you may want to take a lactase enzyme if you consume the occasional milk product at a holiday dinner, rather than taking them daily as a way to avoid making healthy dietary changes. 

For overall digestive support, such as when you’re dealing with gut inflammation or dysbiosis, a comprehensive blend containing proteases, lipases, amylases, and sometimes other digestive enzymes is often the best choice. The Enzymes from my Art of Being Well line is a broad spectrum formula to assist with overall digestion. You can also get The Enzymes formulated together with HCl (stomach acid) for more comprehensive digestive support.

Digestive Enzymes Within Your Gut Healing Plan

Where do digestive enzymes fit within your gut health plan? If you struggle with gut health issues, digestive enzymes may play a helpful and supportive role, but they’re not the end all be all. 

If you’re not doing so already, the first step is always to switch to a whole foods based, anti-inflammatory diet. This and other lifestyle changes can help to restore the balance of your gut microbiome, heal leaky gut, and resolve other issues that may be underlying your digestive symptoms. 

Part of my treatment plan might include digestive enzymes, but the smartest route is to always remove the trigger of your digestive issues, instead of trying to mitigate the damage once you’ve eaten the problem food. True health starts with healthy nutrition, and you can’t supplement your way out of a poor diet. 

I’ll give you an example. When I see a patient with histamine intolerance, one of the first supplements I recommend is DAO. This is a supplemental version of the natural digestive enzyme we make to digest dietary histamine. Why do I recommend this? 

Because the patient’s system is overloaded with histamine. Our first step is to reduce this burden on the body, which DAO helps with. But we don’t stop there. Our next step is to ask questions like: why is the body overloaded with histamine? Why is the body not making enough DAO, or releasing so much histamine that the body can’t keep up with dietary sources? How can we correct those problems? 

In other words, DAO is reducing the burden and making space for healing, but it’s not doing the healing work. 

It’s very important to understand that digestive enzyme supplements don’t help your body produce its own enzymes, or do any other kind of repair. That’s why they need to be used alongside gut healing strategies that do address root causes and improve digestive function. 

How To Restore Digestive Enzyme Production Naturally

There are several things you can do to support natural enzyme production, alongside supplementation as needed. As I mentioned above, working to address the root cause of digestive dysfunction is essential, as well as eating a healthy diet. 

Eating slowly and mindfully can also help your digestive system better prepare and process your food. 

Low stomach acid is one of the most common causes of insufficient digestive enzyme production. It’s best to work with a healthcare professional to determine whether or not this is an issue for you, but if so, a small amount of apple cider vinegar mixed with water before meals can be very helpful. Ginger and honey can also help stimulate digestive secretions. 

While these don’t help you produce more enzymes yourself, you can also increase your intake of enzyme-rich whole foods, including: 

• Pineapple
• Papaya
• Avocado
• Kiwi
• Mango
• Fermented foods (if tolerated) 

Digestive Enzymes Are Supportive (But Not a Complete Solution)

At the end of the day, digestive enzymes aren’t a license to eat all the gluten, dairy, and gut-damaging foods you want, and they don’t solve underlying digestive issues. But when used correctly with a healthy nutrition plan, they can definitely help you cut down on post-meal discomfort like bloating and gas. 

For more support with your digestive health, please schedule a consultation with our functional medicine telehealth center. 

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.

Photo: Unsplash

FAQs

Sources

• Löhr, J. M., Panic, N., Vujasinovic, M., & Verbeke, C. S. (2018). The ageing pancreas: a systematic review of the evidence and analysis of the consequences. Journal of internal medicine, 283(5), 446-460.
• Jiang, Z., Mei, L., Li, Y., Guo, Y., Yang, B., Huang, Z., & Li, Y. (2024). Enzymatic regulation of the gut microbiota: mechanisms and implications for host health. Biomolecules, 14(12), 1638.
• Lehault, L. W. B., & Hughes, D. M. (2017). Review of the long-term effects of proton pump inhibitors. Federal Practitioner, 34(2), 19.
• de la Iglesia-García, D., Huang, W., Szatmary, P., Baston-Rey, I., Gonzalez-Lopez, J., Prada-Ramallal, G., … & Sutton, R. (2017). Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis. Gut, 66(8), 1354-1355.
• Ullah, H., Di Minno, A., Piccinocchi, R., Buccato, D. G., De Lellis, L. F., Baldi, A., … & Daglia, M. (2023). Efficacy of digestive enzyme supplementation in functional dyspepsia: A monocentric, randomized, double-blind, placebo-controlled, clinical trial. Biomedicine & Pharmacotherapy, 169, 115858.
• Ianiro, G., Pecere, S., Giorgio, V., Gasbarrini, A., & Cammarota, G. (2016). Digestive enzyme supplementation in gastrointestinal diseases. Current drug metabolism, 17(2), 187-193.
• Saad, K., Eltayeb, A. A., Mohamad, I. L., Al-Atram, A. A., Elserogy, Y., Bjørklund, G., … & Nicholson, B. (2015). A randomized, placebo-controlled trial of digestive enzymes in children with autism spectrum disorders. Clinical Psychopharmacology and Neuroscience, 13(2), 188.