Digestive enzymes: Uses, common brands, and safety info

Digestive enzymes are secreted naturally in the body primarily by the pancreas. These enzymes help break down the food we eat into nutrients our bodies can absorb. Due to digestive disorders or other health conditions, some people do not make enough of these enzymes. A deficiency in digestive enzymes can affect the body’s digestive processes and lead to further health issues. Supplementation with digestive enzymes can help support normal digestive processes, which are vital for nutrition and the body’s overall health.

Continue reading to learn more about digestive enzymes, their uses, and their side effects.

Other digestive enzymes

• Ultresa (pancrelipase)

• Lactaid Ultra (lactase)

• Hi-Vegi-Lip (pancreatin)

• Viokase (pancrelipase)

• SureLac (lactase)

• Panocaps (pancrelipase)

• Pangestyme EC (pancrelipase)

• Pan-2400 (pancreatin)

What are digestive enzymes?

Digestive enzymes are proteins that are primarily produced in the pancreas. However, they are also secreted in the mouth, stomach, and small intestines. These enzymes help break down the foods you eat and turn them into the nutrients your body needs. Digestive enzymes break down carbohydrates, fats, and proteins from food sources. When there is a lack of digestive enzymes, food can not be processed into nutrients resulting in poor digestion and malnutrition, which can cause symptoms such as dizziness, fatigue, and weight loss. 

The three main types of digestive enzymes naturally produced by the body include:

• Protease, which breaks down proteins into amino acids

• Lipase, which breaks down fats, or triglycerides, into glycerol and free fatty acids

• Amylase, which breaks down carbohydrates and starches into sugars

Other digestive enzymes can be found in dietary supplements to further support the body’s digestive processes. Cellulase is an enzyme that helps break down cellulose in the plant cell wall, making it a useful supplement for those on a plant-based diet who need help digesting plant fiber. Bromelain is an enzyme extracted from pineapples and papain is an enzyme that comes from papaya. These digestive enzymes are often added to digestive enzyme supplements to help digest proteins. 

How do digestive enzymes work?

In combination with stomach acid and bile from the gallbladder, digestive enzymes help digest food for adequate nutrient absorption. The digestive process starts with amylase released from salivary glands in the mouth, which break down starches while food is still in the mouth. Amylase is also released from the pancreas into the small intestine where it continues to break down carbohydrates and starches into sugars. 

Pancreatic enzymes including pepsin and other protease enzymes break down protein compounds in the stomach and small intestine. Lipase is secreted in the pancreas and small intestines to aid in digesting fat molecules. The digestive process continues throughout the digestive tract as different enzymes are released. When a biological process results in a digestive enzyme deficiency, foods can not be broken down appropriately. Digestive enzyme medications are often given to allow the body to process food. 

Unlike probiotics, which are beneficial bacteria that can balance the gut microbiome, digestive enzymes break down food molecules. However, both probiotics and digestive enzymes have their place in supporting the digestive system and gut health, as well as potentially alleviating digestive issues. 

What are digestive enzymes used for?

Digestive enzyme supplements are used to replace natural enzymes that are deficient as a result of different medical conditions, including digestive health issues. The following conditions require the replacement of digestive enzymes:

• Cystic fibrosis

• Exocrine pancreatic insufficiency (EPI)

• Chronic pancreatitis

• Pancreatic cysts or benign tumors

• Blockage or narrowing of the pancreatic or biliary duct

• Pancreatic cancer

• Crohn’s disease

• Ulcerative colitis

• Irritable bowel syndrome (IBS)

• Liver disease with digestive enzyme deficiency

• Diabetes

• Lactose intolerance

• Bile acid synthesis disorders

• Functional gastric disorder

• Sucrase-Isomaltase deficiency

Types of digestive enzymes

Pancrelipase 

Pancrelipase is supplied in brand-name products such as Creon, Pancreaze, Pertyze, and Viokace. The enzymes lipase, amylase, and protease make up pancrelipase. These enzymes produced by the pancreas aid in the digestion of fats, proteins, and starches.

Lactase

Lactase is supplied in the brand names Lactaid and Lactaid Ultra. This enzyme aids in the breakdown of lactose, or milk sugars, in dairy products.

Alpha-galactosidase

The enzyme alpha-galactosidase, or alpha-d-galactosidase, is found in the brand-name medications Beano and Gas X Prevention. This enzyme is used to digest complex carbohydrates into simple sugars to prevent gas, bloating, and stomach upset. It is useful for digesting certain foods like beans. 

Pancreatin

Pancreatin contains a combination of protease, amylase, and lipase. It supports the digestion of fats, starches, and proteins. It is found in the medications Hi-Vegi-Lip, Pancreatin 4x, Donnazyme, and Digipepsin. 

Sacrosidase

Sacrosidase is a yeast-based enzyme that aids in the digestion of sucrose (sugar). It is recommended in people who lack the enzyme sucrase and cannot break down sucrose in their bodies. It is found in the product Sucraid.

Invertase

Invertase is a digestive enzyme that breaks down sucrose into fructose and glucose. It is a natural enzyme found in foods like honey. 

Maltase

Maltase is an enzyme that breaks down malt sugars. It is typically secreted by the intestine to convert maltose into glucose. Maltase is a natural digestive enzyme found in bacteria, plants, yeast, and humans. 

Cholic acid

Although not technically a digestive enzyme, colic plays an important role in digestion along with digestive enzymes. Cholic acid is a bile acid that aids in the digestion of fats. Cholbam is a medication that contains cholic acid. It is used to treat bile acid synthesis disorders caused by single enzyme defects (SEDs). 

Who can take digestive enzymes?

Adults

Adults with pancreatic insufficiency caused by cystic fibrosis or pancreatic disorders are typically prescribed pancrelipase products. Doses are given with meals and gradually adjusted to control symptoms. Digestive enzymes should be swallowed whole and taken with a generous amount of liquid. Crushing or chewing the supplement may irritate the lining of the mouth and throat. 

Viokace tablets are not enteric-coated and should be given with a proton pump inhibitor to prevent the drug from breaking down in the stomach. 

Lactase is given to adults with lactose intolerance. It should be taken with the first few bites of dairy-containing food. 

Sucraid is given to adults with sucrase-isomaltase deficiency. It is taken with each meal or snack. Sucraid is formulated in a liquid and should be diluted in 60 to 120 mL of a liquid that is served cold or at room temperature. Avoid mixing it in a warm or hot liquid, as this may decrease the potency. 

Beano is available in a chewable or meltaway form. It is taken with a meal, and the dose may be adjusted to control symptoms. 

Children

Children with pancreatic insufficiency caused by cystic fibrosis can safely take pancrelipase products. Doses are given with meals and adjusted for the weight of the child. Digestive enzymes should be swallowed whole and taken with a generous amount of liquid to prevent irritation of the mouth and throat. If necessary, capsules may be opened and sprinkled on acidic food such as applesauce. The contents of the capsule should not be chewed or crushed but swallowed whole. 

Children aged 4 years and older may take lactase for symptoms of lactose intolerance. It is dosed in the same manner as for adults. 

Sucraid is given to children with sucrase-isomaltase deficiency. It is dosed based on the child’s weight and given with each meal or snack. Sucraid is formulated in a liquid and should be diluted with water, milk, or formula. Avoid mixing in juice, as the acidity can reduce enzyme activity. Do not mix in warm or hot liquids as this may decrease the potency of the enzyme product. 

Children can take Beano. It should be given with the first bite of food, and either the chewable or meltaway form can be given. 

Seniors

Seniors may safely take all digestive enzymes. The same instructions as adults applied for seniors. No dose adjustments are required.

Are digestive enzymes safe?

In general, digestive enzymes are safe. However, a few groups of people should not take digestive enzymes. 

Tell your healthcare provider if any of the following apply to you before taking a digestive enzyme:

• You have allergies to foods or medications

• You are currently taking other medications, including over-the-counter medications and dietary supplements

• You are pregnant, planning to become pregnant, or breastfeeding. 

Digestive enzyme recalls

There are no current digestive enzyme recalls. 

Digestive enzyme restrictions

Pancrelipase products are formulated from pork pancreatic glands and can not be taken by anyone with a pork allergy. Patients with gout or hyperuricemia who take pancrelipase may develop an increase in uric acid, which could lead to a gout flare-up. 

Viokace contains lactose and may not be tolerated by those with lactose intolerance. 

Can you take digestive enzymes while pregnant or breastfeeding?

Digestive enzymes are generally considered safe to take while pregnant and during breastfeeding. 

Are digestive enzymes controlled substances?

No. Digestive enzymes are not controlled substances. 

Common digestive enzymes side effects

The most common side effects of digestive enzymes include:

• Diarrhea

• Stomach cramps

• Nausea

• Headache

• Congestion

• Neck pain

• Rash

• Dizziness

More severe but rare side effects include:

• Severe stomach pain, bloating, constipation, nausea, or vomiting

• Joint pain

• Mouth ulcers

• Allergic reactions

This list of side effects is not comprehensive. Speaking with a healthcare professional is the best way to get a complete list of side effects and determine whether taking digestive enzymes is suitable for you.

How much do digestive enzymes cost?

Digestive enzymes are available in brand-name and generic formulas. Medicare plans will cover specific formulations, and most insurance plans will cover digestive enzymes. Costs will vary depending on your insurance plan. Without insurance, the price can vary widely depending on the medication and quantity of medication prescribed. However, using a prescription discount card from SingleCare may help reduce the cost of digestive enzymes.