Do Digestive Enzymes Prevent Deficiencies and Improve Gut Health?

Digestive enzymes - what are they?
The popular expression “you are what you eat” really does carry a certain amount of wisdom. But it would be more accurate to say “you are what you digest.” And this is where digestive enzymes, or enzymes, help us, the key to good digestion, a healthy gut and getting all the nutrients you need.

Oddly enough, until relatively recently, little was known about the mechanism of the digestive system. Today, the number of diseases associated with malabsorption of nutrients due to a lack of digestive enzymes is increasing.

Why are these enzymes so important? The role of digestive enzymes is primarily to act as catalysts to speed up specific, vital chemical reactions in the body.

They help break down large molecules into particles that are easier to digest. These particles are used by the body to maintain optimal performance and health.

Types

All major digestive enzymes can be divided into three classes:

1. proteolytic enzymes necessary for protein metabolism.
2. lipases, which are necessary for the digestion of fats.
3. amylase, necessary for the breakdown of carbohydrates.

There are several types of enzymes found in the human body, including:

• Amylase. It is found in saliva and pancreatic juice and converts large starch molecules into maltose. Amylase is necessary for the metabolism of carbohydrates, starch and sugars, which predominate mainly in plant foods (potatoes, fruits, vegetables, cereals, etc.).
• Pepsin. It is found in gastric juice. Pepsin helps break down proteins into smaller polypeptide units.
• Lipase. It is produced by the pancreas and secreted in the small intestine. After combining with bile, lipase converts fats and triglycerides into fatty acids. It is necessary for the proper digestion of foods such as nuts, oils, eggs, meat and dairy products.
• Trypsin and chymotrypsin. These endopeptidases continue to break down the polypeptids into even smaller particles.
• Cellulase. It helps digest high fiber foods such as broccoli, asparagus, and beans, which can cause gas.
• Exopeptidase, carboxypeptidase and aminopeptidase. They help release individual amino acids.
• Lactase. It converts lactose into glucose and galactose.
• Saharaza. Breaks down sucrose into glucose and fructose.
• Maltase. Converts the sugar maltose into smaller glucose molecules.
• Other enzymes that help digest sugar/carbohydrates include invertase, glucoamylase, and alpha-galactosidase.

How does pancreatic insufficiency manifest?

People with pancreatic enzyme deficiency develop digestive insufficiency. They cannot digest proteins, fats and carbohydrates fully. As a result, for example, the phenomenon of creatorrhoea and steatorrhea occurs. In the first case, undigested muscle fibers can be found in the feces after eating meat, and in the second, neutral, undigested fat exists in the feces due to a lack of pancreatic lipase.

As a result, complaints arise about instability of digestion, bloating, intolerance to certain types of food, alternating constipation and diarrhea. This leads to chronic damage to the intestines - secondary dysbiosis and vitamin deficiency develop (after all, many vitamins are produced by microbes living inside us), and immunity decreases. It is for the correction of these disorders that enzymatic preparations are intended.

How do digestive enzymes work?

Digestion is a complex process that begins with chewing food, when enzymes are released into saliva. Most of the work is done by the gastrointestinal fluids, which contain digestive enzymes that affect certain nutrients (fats, carbohydrates and proteins).

By producing specific enzymes, we help absorb various types of food. In other words, our body produces enzymes specific for carbohydrates, proteins and fats.

Digestive enzymes are not just useful, they are vital. They convert complex foods into easily digestible compounds, including amino acids, fatty acids, cholesterol, simple sugars and nucleic acids (which help build DNA).

Enzymes are synthesized and secreted in various parts of the digestive tract, including the mouth, stomach and pancreas.

Below we have described in a little more detail the 6 main stages of the digestion process, which begins with chewing, which triggers the secretion of digestive enzymes in the gastrointestinal tract:

1. Salivary amylase, produced in the mouth, is the first digestive enzyme involved in the absorption of molecules. And this process continues after the food enters the stomach.
2. The parietal cells of the stomach then begin to release acids, pepsin and other enzymes, including pancreatic amylase. The process of breaking down partially digested food into chyme (a semi-liquid mass of partially digested food) begins.
3. Gastric juice neutralizes the action of salivary amylase, promoting the work of pancreatic amylase.
4. After about an hour, the chyme moves into the duodenum, where acidity causes the release of the hormone secretin.
5. This in turn causes the pancreas to produce hormones, bicarbonate, bile and various digestive enzymes, the most important of which are lipase, trypsin, amylase and nuclease.
6. Bicarbonate changes the environment of the chyme from acidic to alkaline, which not only allows enzymes to break down food, but also kills bacteria that cannot survive in such conditions.

At this stage, most of the work is done. However, people suffering from digestive enzyme deficiencies need support in the form of nutritional supplements.

There are even digestive enzymes for sale for cats and dogs, because animals can also suffer from this disease.

Acidin-pepsin

This drug contains enzymes that work in the stomach at the first stage of protein digestion. Gastric proteases can only break down food in an acidic environment. Against the background of atrophic gastritis, when the inflammatory process lasts for a long time, the glands that produce enzymes and gastric juice die. People with this problem feel heaviness in the stomach after eating, become full too quickly, and belch air. Dumping syndrome is also possible: if insufficiently processed food enters the intestines, such patients feel severe weakness after eating (even fainting often occurs), sweating, drowsiness, hiccups, and pale skin appear. In such cases, the use of the drug “Acidin-pepsin” is indicated, the active substance of which is an extract from the pig stomach mucosa. You need to take 2 tablets with meals, dissolving them in half a glass of water. The product has a very reasonable price.

Acidin-Pepsin

Belmedpreparaty, Belarus

Hypo- and anacid gastritis, achylia, dyspepsia.
from 100

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Who needs enzymes? (Signs of Deficiency)

The answer to this question may involve many more people than you might suspect.

Symptoms such as bloating, gas, abdominal pain and fatigue may be due to an inability to fully digest food. In this case, these people may benefit from taking additional digestive enzymes. Other signs indicating an enzyme deficiency may include:

• Acid reflux
• Dyspepsia (pain or discomfort in the upper stomach area)
• Cravings for certain foods
• Thyroid problems
• Heartburn, indigestion, belching
• Thinning and hair loss
• Dry or dull skin
• Concentration problems or brain fog
• Fatigue in the morning
• Sleep problems
• Arthritis or joint pain
• Muscle weakness, fatigue before exercise
• Mood swings, depression and irritability
• Headaches and migraines
• Worsening PMS symptoms

People with the following conditions may feel better with supplemental digestive enzymes:

Digestive diseases

If you suffer from any gastrointestinal condition such as acid reflux, gas, bloating, leaky gut, irritable bowel syndrome (IBS), Crohn's disease, ulcerative colitis, diverticulitis, malabsorption, diarrhea or constipation, then digestive enzymes can help you.

They can “calm” the digestive organs, reduce abdominal pain and bloating, which are associated with intestinal diseases.

Age-related enzyme deficiency

As we age, the environment in the stomach becomes more alkaline, which prevents the pancreas from producing enough enzymes.

In addition to concomitant diseases, the risk of developing digestive problems associated with a lack of gastric juice or digestive enzymes increases with age. Quite often this leads to acid reflux.

Hypochlorhydria

Hypochlorhydria (insufficient stomach acid) makes it difficult to absorb minerals, vitamins and other elements from food, resulting in nutritional deficiencies.

Liver diseases and other enzyme-related diseases

Liver diseases often result in a concomitant deficiency of digestive enzymes. The most common is alpha-1 antitrypsin deficiency, a genetic disorder that affects one in 1,500 people.

Symptoms may include unintentional weight loss, recurring respiratory infections, fatigue and rapid heartbeat.

Diseases whose diagnosis may not be associated with reduced production of digestive enzymes include:

• Crohn's disease
• Iron or vitamin B12 deficiency
• Vitamin D deficiency

Symptoms of enzyme deficiency may also include:

• Changes in stool. The stool may become paler, greasy, or float.
• Complaints related to the gastrointestinal tract. Bloating, diarrhea, especially within an hour after eating, flatulence and indigestion may be signs of enzyme deficiency.

Pancreatic insufficiency

Pancreatic insufficiency is the inability of the pancreas to secrete enzymes needed for digestion. This is a common problem among people with pancreatic cancer.

Taking medications containing pancreatic enzymes (replacement therapy) may be useful for patients with pancreatic cancer, chronic pancreatitis, cystic fibrosis, and patients who have had bowel surgery to speed up healing.

Natural springs

Many raw vegetables and fruits contain enzymes that improve digestion.

Raw fruits and vegetables grown in good, nutritious soil are the best natural sources of digestive enzymes. Try to include foods such as:

• a pineapple
• papaya
• kiwi
• kefir
• yogurt
• bananas
• mango
• miso, soy sauce and tempeh (fermented soy products)
• sauerkraut
• kimchi
• avocado
• Apple vinegar
• raw honey
• bee pollen

Digestive enzyme products are primarily manufactured using the following sources:

• Fruits are mainly pineapple and papaya. Bromelain, an enzyme derived from pineapple, breaks down a wide range of proteins, has anti-inflammatory properties and can withstand a wide range of pH (acid-base). Papain, an enzyme obtained from fresh papaya, is effective in breaking down both small and large proteins.
• Animals. These drugs include pancreatin, obtained from bovine or pig sources.
• Plants. These drugs are derived from probiotics, yeast and fungi.

Festal

The active ingredient of Festal is pancreatin (protease, lipase and amylase). It also contains bile components and hemicellulase, which breaks down fiber (normally it is produced by intestinal microflora). "Festal" improves the absorption of fats and fat-soluble vitamins, corrects biliary insufficiency (when the activity of the gallbladder is reduced or it is removed). This is a complex drug for improving digestion: Festal compensates for pancreatic insufficiency, helps with overeating, poor liver and gall function. The drug is indicated for biliary dyskinesia, cirrhosis, cholecystitis. "Festal" improves the breakdown of fiber, reduces bloating, and relieves flatulence. You can buy Festal in almost any pharmacy, its price is affordable.

Festal

Turk Hoest, India

— insufficiency of the exocrine function of the pancreas (including in chronic pancreatitis, cystic fibrosis);
— chronic inflammatory-dystrophic diseases of the stomach, intestines, liver, gall bladder; - as part of combination therapy for conditions after resection or irradiation of these organs, accompanied by impaired digestion of food, flatulence, diarrhea. from 63

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Nutritional supplements

Since proteins, sugars, starches, and fats require specific types of enzymes, it is best to take a product that includes all of these types.

Many experts believe that the most effective are drugs that contain a full range of enzymes that improve digestion. Look for supplements that include the following enzymes:

• alpha-galactosidase (derived from the fungus Aspergillus nigra and is thought to aid in the digestion of carbohydrates).
• amylase (produced by the salivary glands)
• cellulase
• glucoamylase
• invertase
• lactase
• lipase
• malt-diastase
• protease (or acid protease)
• beta-glucanase
• pectinase
• phytase

When selecting enzymes, we recommend following the following guidelines based on symptoms and current health:

• If you have problems with the gallbladder and are looking for a natural remedy for its treatment, then pay attention to preparations containing lipase and bile salts.
• In preparations containing betaine hydrochloride, pepsin is certainly present.
• Some medications may contain lactase, which until recently could only be purchased as a separate medication. This enzyme helps people who have problems absorbing sugar from dairy products.
• Preparations with protease help digest protein. They will be especially useful for people with autoimmune and inflammatory diseases.
• Blends with added herbs such as peppermint and ginger also support digestion.
• Some people require more pancreatic enzymes than others. For this reason, choose a drug based on your personal needs. Most foods contain some amount of pancreatin, which is a combination of three pancreatic enzymes.

Mezim Forte

Another drug that contains an extract from the pancreas of animals (pancreatin). The advantage of this inexpensive enzyme product is its tablet form (the tablet shell is enteric-soluble). This means that Mezim does not dissolve in the stomach under the influence of an acidic environment, but enters the intestines, working there. The only disadvantage of this drug is that it does not come into sufficient contact with food (and this is important for the enzymes to work). Therefore, Mezim, unlike more effective drugs, is usually prescribed to healthy people who need periodic intake of enzymes due to overeating, for example, and not because of gastrointestinal diseases.

Mezim Forte

Berlin-Chemie/Menarini, Germany

Insufficiency of exocrine pancreatic function (chronic pancreatitis, cystic fibrosis);
chronic inflammatory-dystrophic diseases of the stomach, intestines, liver, gall bladder. Conditions after resection or irradiation of these organs, accompanied by impaired digestion of food, flatulence, diarrhea (as part of combination therapy); to improve digestion of food in patients with normal gastrointestinal function in case of errors in nutrition; preparation for x-ray and ultrasound examination of the abdominal organs. from 48

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Are there food enzymes for vegetarians?

Some preparations contain only enzymes of plant origin, which are quite suitable for vegetarians and vegans. They typically contain bromelain, derived from pineapple, and papain, from papaya.

Products formulated specifically for vegans typically contain pancreatin, which is derived from the fungus Aspergillus niger. The most common source of this enzyme is bovine or pig bile.

In addition, some preparations additionally contain herbs and spices. They often contain amla extract, which is not an enzyme, but is used in Ayurvedic medicine as an herbal remedy to improve overall health. It is believed to work in synergy with other compounds.

The best enzymes for digestion

When should you take digestive enzymes?

For optimal results, digestive enzymes should be taken 10 minutes before meals or with your first bite. Protease supplements can be taken between meals in combination with other enzymes.

Start with twice daily and adjust dosage as needed.

Can I take probiotics and digestive enzymes at the same time?

Yes, enzymes should be taken before meals, and probiotics after or between meals.

It is beneficial to get probiotics from fermented foods. For example, yoghurt, kefir, kimchi or sour cream. Probiotics help normalize the gut microbiome, aiding digestion and reducing symptoms such as gas and bloating.

Benefit for health

What are the benefits of digestive enzymes? Mainly because they help digest food. Enzymes should be taken for the following reasons:

• Help treat leaky gut and other conditions by relieving tension in the gastrointestinal tract.
• Maintains a healthy balance of bacteria in the intestines.
• Helps the body break down difficult-to-digest proteins and sugars, such as gluten, casein and lactose (milk sugar).
• Significantly reduces the symptoms of acid reflux and irritable bowel syndrome.
• Improves nutrient absorption, preventing the development of deficiencies.
• Naturally blocks the action of enzyme inhibitors found in foods such as nuts, wheat germ, egg whites, seeds, beans and potatoes.

If you lack digestive enzymes, you may experience constipation. In this case, taking additional enzymes may help. Digestive enzymes are not associated with weight loss and cannot be used for weight loss. However, they can help eliminate cravings for certain foods and help you feel full more quickly.

Forms of release of drugs

Not everyone knows that depending on how the drug is released, its immediate effect will depend. Today, all enzyme-based drugs are available in two forms:

1. Capsules. More recently, drugs began to be produced in capsules, and for some time people were afraid to purchase them until the results of the study were publicly published. So, each capsule has all the shells. The first dissolves in the stomach, and the second only in the intestines. Thus, the effect of the drug taken in capsule form extends to the entire gastrointestinal tract
2. Pills. It just so happens that consumers trust pills more. Their effect extends exclusively to the stomach, since under the influence of gastric juice it dissolves and is absorbed there.

The choice of the best form to take depends solely on the doctor and the patient. Some people, having purchased a capsule, for some reason open it and take only granules, thereby preventing the drug from penetrating the intestines. Under no circumstances should this be done with capsules. As for the tablets, they can be crushed, split into two parts, etc. This will not reduce the effect.

Use in Traditional Chinese Medicine and Ayurveda

Traditional medicine takes a holistic approach to treating digestive problems, which involves changes in diet and lifestyle rather than drugs. Digestive enzymes in drug form only became available 50 years ago. Previously, patients were advised to include more raw foods and foods containing probiotics in their diet.

According to the ancient medical system of Ayurveda, digestion depends on the amount of Agni, the “digestive fire.” It is believed that Agni can be increased by eliminating the causes of indigestion (for example, eating under stress or shortly before sleep), adjusting the diet and strengthening the digestive organs with the help of herbs and home remedies.

In Ayurveda, spices play an important role in supporting digestion. The following are considered especially healing:

• ginger
• turmeric
• caraway
• coriander
• fennel
• cardamom
• fenugreek
• cinnamon
• rosemary
• sage
• oregano

Beet juice removes toxins and improves performance

To increase the amount of digestive fire, you need to drink herbal tea, which promotes the functioning of enzymes. This tea can be prepared by pouring boiling water over cumin, coriander and fennel (1/3 teaspoon each). The drink must be strained before drinking. Eating papaya can also be beneficial as it contains papain, which helps relieve inflammation.

In Traditional Chinese Medicine, digestion is governed by Qi, “vital energy.” Acupuncture, herbs, movement and stress relief combined with plant-derived enzymes from foods can help improve digestion and manage ailments.

To support digestion, raw fruits and vegetables that have been slightly processed are most often recommended.

Other methods that improve the condition of the gastrointestinal tract include:

• eating local/seasonal foods
• eating organic, unprocessed, non-GMO foods
• limiting sugar intake, liquids during meals and cold foods
• chewing food thoroughly
• refusal to eat 2-3 hours before bedtime
• doing yoga, tai chi, stretching and other forms of exercise to increase appetite

The activity of enzyme preparations
largely depends on factors such as intraduodenal pH and small intestinal motility, which ensure optimal duration of contact of enzymes with food chyme. When the pH in the duodenum decreases to less than 4, lipase is irreversibly inactivated, and trypsin is less than 3.5. At pH less than 5, precipitation of bile salts is observed, which is accompanied by impaired emulsification of fats, a decrease in the number of micelles of bile and fatty acids and a decrease in their absorption.

The main causes of duodenal acidification are increased secretion of hydrochloric acid and decreased secretion of bicarbonates. In these cases, together with enzyme preparations, H2-histamine receptor blockers (ranitidine, famotidine) or proton pump inhibitors (omeprazole, lansoprazole, pantoprazole, rabeprazole) are used to increase intraduodenal pH. Doses of drugs and duration of treatment are determined individually depending on the leading mechanism of this disorder. Motility disorders of the small intestine are also accompanied by impaired mixing of enzyme preparations with food chyme, which reduces their effectiveness. The use of microtablets and microspherical drugs (pancitrate, Creon, lycrease), as well as additional prescription of drugs that normalize intestinal motility (antispasmodics, prokinetics), can significantly improve treatment results.

In case of dysbiosis of the small intestine, the effectiveness of enzyme therapy can be increased by prescribing eubiotics to decontaminate the small intestine.

The choice of combined enzyme preparations is important when diseases of the biliary system and liver are combined with digestive disorders. However, it must be remembered that the use of drugs with bile acids can increase intoxication in severe chronic hepatitis and cirrhosis. In case of chronic diarrhea syndrome, in conditions of secondary malabsorption of bile acids in the intestine, their additional administration can increase diarrhea. In patients with duodenogastric reflux, the use of enzyme preparations containing bile acids (festal, digestal, panzistal, etc.) is inappropriate, since under these conditions bile acids increase the damaging effect of reflux on the gastric mucosa. It has now been established that during exacerbation of chronic pancreatitis, enzyme replacement therapy promotes reverse inhibition of gland secretion, reducing hypertension in the ducts, resulting in an analgesic effect.

It is important to consider that in case of chronic pancreatitis, enzyme preparations should not reduce the pH of the stomach, stimulate pancreatic secretion and increase diarrhea. The drugs of choice in such cases are those that do not contain bile and extracts of the gastric mucosa (pancreatin, somilase, solizym, trienzyme, creon, pancitrate, etc.). In hyperacid conditions, the inclusion in complex therapy of dosage forms containing components of gastric juice (panzinorm) is pathogenetically unjustified. The use of panzinorm for hyperacid gastritis and peptic ulcers increases the activity of proteolytic enzymes and increases the acidity of the stomach, which can clinically manifest itself as a debilitating symptom such as heartburn.

To correct creatorrhea, smaller doses of drugs are required, since the secretion of pancreatic proteases remains preserved for a long time even with pronounced structural changes in the pancreas. In addition, in enzyme preparations taken orally, the activity of lipase and then proteases decreases first. Enzyme preparations for CP with exocrine insufficiency are prescribed for a very long time, often for life. Their doses can be reduced when following a strict diet with limited fat and protein and should be increased when the diet is expanded.

The effectiveness of treatment with enzyme preparations

assessed clinically and by laboratory diagnostic methods.
In this case, the most informative are scatological examination of feces and tests based on determining the excretion of fat in feces. Research is carried out using the Van de Kamer method (quantitative determination of fats in feces), infrared spectrophotometry, radioisotope and other methods. Currently, the elastase test is widely used to assess exocrine pancreatic insufficiency. Unlike existing non-invasive tests, the elastase test can detect endocrine pancreatic insufficiency already in the early stages of the disease. Elastase in feces most reliably reflects exocrine pancreatic insufficiency, because unlike other enzymes, it is not inactivated during transit through the intestines. The standard elastase coprology test contains monoclonal antibodies to human pancratic elastase. Tolerability and side effects
Side effects when using enzyme preparations are extremely rare (less than 1%) and are most often dose-dependent. Increased levels of uric acid may be observed in the urine of patients using high doses of pancreatic enzymes. Hyperuricosuria promotes the precipitation of uric acid in the tubular apparatus of the kidney, creating conditions for the development of urolithiasis. Patients with cystic fibrosis who use high doses of pancreatic enzymes for a long time may develop interstitial fibrosis. With celiac disease, against the background of atrophy of the mucous membrane of the small intestine, the exchange of purine bases in the blood of patients changes sharply with the accumulation of high concentrations of uric acid and an increase in its excretion. Enzyme preparations are used with caution in patients with gout. In some cases, patients taking enzymes may experience diarrhea, constipation, discomfort in the stomach, nausea, and irritation of the perianal area. The main contraindications for prescribing enzyme preparations containing bile components are acute and chronic pancreatitis, acute and severe chronic liver diseases, diarrhea, inflammatory bowel diseases, a history of allergic reactions to pork or beef.

Thus, therapy with enzyme preparations should be carried out differentiatedly, taking into account the mechanism of development of the disease underlying the digestive disorder. The availability of highly active microtablets and microgranular preparations at the doctor’s disposal can significantly increase the effectiveness of enzyme treatment.

Literature:

1. Grebenev A.L., Myagkova L.P. Intestinal diseases. M., 1994.- 397 p. 2. Grigoriev P.Ya., Yakovenko A.V. Reference Guide to Gastroenterology. M., 1997.- 476 p. 3. Zlatkina A.R., Belousova E.A., Nikitina N.Yu., Sileverstova T.R. Modern enzyme therapy of chronic pancreatitis. Ross. journal of gastroenterol., hepatol., coloproctol., 1997.- No. 7 (5).- P. 109-111. 4. Ivashkin V.T., Minasyan G.A. Treatment of chronic pancreatitis. Ross. journal of gastroenterol., hepatol., coloproctol., 1996.- No. 5 (4) - pp. 10-17. 5. Kokueva O.V. Treatment of chronic pancreatitis. - Krasnodar, 2000. - 48 p. 6. Yakovenko E.P. Enzyme preparations in clinical practice // Klin. Pharmacol.1998, V.7 No. 1.- P.1-5.

Risks and side effects

Can Digestive Enzymes Be Dangerous? If you suffer from chronic diseases, we recommend that you consult a doctor who can select the most suitable enzymes for you.

Depending on your health condition, a specialist will be able to prescribe the safest medications. If you have suffered or are suffering from liver or gallbladder diseases, or ulcers, be sure to consult your doctor before taking supplements.

Despite all the benefits, digestive enzymes can cause side effects, including:

• nausea
• diarrhea
• cramps in the abdomen
• gases
• headache
• edema
• dizziness
• changes in blood sugar levels
• allergic reaction
• change in stool

If you notice these symptoms, stop taking enzymes and consult your doctor.

Most often, undesirable consequences occur when the dosage is too high or the drug is taken incorrectly. For this reason, it is important to read the instructions before use.