Digestive enzyme supplements purportedly fix all sorts of abdominal symptoms, including bloating, gas, and bowel irregularity, as well as overall gut health. However, for most people, there's little evidence that they do any good.

Naturally occurring digestive enzymes help break down food so the body can soak up nutrients. Your mouth, stomach, and small intestine make some digestive enzymes.

Still, most come from your pancreas, which floods the small intestine with enzymes when the food arrives there. The main pancreatic enzymes are lipase, which breaks down fats; amylase, which breaks down carbohydrates; and proteases and peptidases, which break down proteins.

Once nutrients are broken into small molecules, they are absorbed through the wall of the small intestine into the blood and then delivered throughout the body. Sometimes the body doesn't make enough digestive enzymes, which can slow digestion and lead to uncomfortable symptoms.

For example, if your small intestine doesn't make enough of the enzyme lactase, you can have difficulty digesting lactose, the sugar in milk and milk-based products.

This can lead to bloating, flatulence, and loose stools. Doctors prescribe special enzyme pills to substitute for the lack of natural enzyme production for people who can't make enough digestive enzymes because of a health condition, like chronic pancreatitis or cystic fibrosis. Histamine intolerance is an emerging area of research, with more to uncover for the digestively troubled.

Research has shown that histamine intolerance often stems from a deficiency in DAO, the enzyme responsible for degrading histamine. While a low-histamine diet is one way to improve things, it can be extremely challenging since histamine occurs in so many foods, from spinach to vinegar to deli meat, and the exact amount is unknown.

Oral supplementation of DAO has been shown to significantly improve reactions to dietary histamine, such as watery diarrhea, severe bloating, and abdominal pain. Note that this product is pork-derived, and therefore not suitable for vegans and vegetarians. The frequency of lactose intolerance, mixed with the popularity of lactose-rich foods, such as milk, ice cream, and fresh mozzarella cheese, makes lactase enzymes a top pick of digestive aid supplements.

In fact, among the digestive enzymes available on the market, lactase has been most widely studied and clinically proven to improve lactose intolerance symptoms such as gas, bloating, nausea, and diarrhea when taken in sufficient doses at the start of a meal.

Each Kirkland lactase caplet contains 9, ALU lactase units , which is about the amount needed to digest the lactose in 4. When taken at the start of eating, the supplement offers a fast hit of lactase to help digest milk sugar that would otherwise be inadequately digested.

Kirkland caplets are a top choice because they do not contain other potential gas-causing ingredients, such as mannitol, which competitor brands often include. Additionally, they are individually wrapped and portable to have on standby for a planned dairy chow-down or surprise lactose-heavy meal.

Active Ingredient: Lactase enzyme Form: Capsules Standard Dosage: 1 capsule 9, ALU. Good for sensitivity to some vegetables, FODMAP sensitivities, IBS, constipation, and active SIBO. Fiber, by definition, is not digested in humans.

We simply lack the enzyme to fully break it down. This is a good thing, in fact, because bacteria in the gut are left to feed on it—a process known as bacterial fermentation—and produce beneficial byproducts.

However, one of these byproducts is gas, and some forms of fiber result in larger amounts of it. Galacto-oligosaccharides GOS , found in foods like beans, chickpeas, broccoli, cauliflower, and lentils, are one type of highly fermentable fiber.

If you eat a lot of these foods, and especially if you have IBS, chronic constipation , or active SIBO, you may notice more digestive distress in response. Research has confirmed that the enzyme alpha-galactosidase, the active ingredient in Bean-zyme, can help break down fiber before it makes its way down to our gut bacteria.

Humans do not produce this unique enzyme, which is derived from a food-grade, plant-derived mold called Aspergillus niger , so external supplementation is the only way to go. If you typically experience uncomfortable bloating or gas from plant-rich meals, have IBS, constipation, or active SIBO, a Bean-zyme tablet at the start of a GOS-rich meal can help prevent the side effects that may otherwise accompany the fermentation party in your intestines.

Active Ingredient: Alpha-galactosidase Form: Tablets Standard Dosage: 1 capsule GalU. Digest Gold Enzymedica contains a proprietary blend of 14 digestive enzymes, including the main pancreatic enzymes needed for digestion—proteases for protein , lipase for fats , and amylase for starch.

The enzyme doses in Digest Gold are not on par with those in prescription enzymes for pancreatic insufficiency and are therefore not suited for conditions like exogenous pancreatic insufficiency [EPI] or pancreatitis , but this product offers a significantly higher dose than most general enzyme blends on the market.

According to recent research, those with IBS or functional dyspepsia may particularly benefit from supplementing with lipase before consuming fat-rich meals. While studies in humans are small, the higher dose of lipase 4, units may be a helpful remedy if fatty foods tend to provoke your symptoms.

Of note, a subset of people with sucrase-isomaltase deficiency SID may also find a benefit from this product if they are starch intolerant and carefully chewing for extra amylase production is not enough to prevent symptoms caused by starchy foods like grains and potatoes.

Active Ingredient: Proprietary blend of 14 enzymes Form: Capsule Standard Dosage: 1 capsule. If you are experiencing digestive issues, you will only benefit from a digestive enzyme supplement if it contains the enzyme or enzymes that are targeted for your specific condition.

The first step in considering whether or not you need a digestive enzyme and, if so, which type you need is clarifying what is causing your symptoms. In addition to diet assessment, a variety of medical tests can be performed by a gastroenterologist to pinpoint the issue.

A digestive enzyme supplement may be beneficial for the following individuals:. Those with lactose intolerance: Lactase enzyme supplement. Those with fiber-rich diets who experience bloating: Alpha-galactosidase supplement.

Those with active untreated small intestinal bacterial overgrowth SIBO : individual digestive enzymes or FODMAP enzyme cocktail supplement.

Those with histamine intolerance: diamine oxidase DAO supplement. Those with fat sensitivity: possible lipase supplement. Those with functional dyspepsia FD : Potential lipase supplement.

Those unable to restrict their diet: Appropriately selected enzyme for intolerance. If you do not have digestive symptoms, an enzyme supplement is unlikely to provide a noticeable benefit.

Although many products are marketed as improving digestion, there is no evidence for general health or for those who are symptom-free.

Some medical conditions require treatment beyond over-the-counter products. Additionally, certain digestive enzyme supplements may not be safe for:. Some conditions require prescription enzyme replacement therapy. If you have any of the following conditions, work with a healthcare provider to determine the best treatment option:.

In addition, there is no evidence of digestive enzymes to help with the following:. Our team works hard to be transparent about why we recommend certain supplements; you can read more about our dietary supplement methodology here. We support supplements that are evidence-based and rooted in science.

We value certain product attributes that we find to be associated with the highest quality products. It's important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend.

To help develop this list, we also spoke with experts about digestive enzyme supplements. The experts we talked to included:. Digestive enzyme supplements can be formulas containing:.

Over-the-counter digestive enzymes typically come in one of the following physical forms:. There is no research suggesting greater efficacy of one form of the supplement over another; however, keep in mind that some chewable and flavored products may contain additional ingredients, such as sugar alcohols, that can cause extra symptoms.

It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included relative to the recommended daily value of that ingredient. Please bring the supplement label to your healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications you are taking.

Digestive enzymes may be derived from plant or animal sources. If you are vegan, vegetarian, or avoid certain animal products for religious reasons, read product labels carefully. Key ingredients to be aware of:. Some digestive enzyme products may also contain added ingredients such as prebiotics , which can worsen gas and bloating in digestively sensitive people, or sugar alcohols, which can worsen diarrhea.

Chewable supplements are more likely to contain one of these ingredients as a sweetener. Prebiotics avoid for gas and bloating include:. Sugar alcohols avoid for diarrhea include:.

Digestive enzyme dosage is not standardized across products, and many enzymes do not have research-based guidelines. However, of the enzymes that have been studied in human digestion, the following dosages have been shown to improve symptoms:.

Note that products that contain enzyme blends may contain lower amounts of each enzyme compared to products that contain only one type of enzyme. If you have poor digestion of a single nutrient, such as lactose or fructose, you may benefit most from a product that contains only the necessary enzyme.

If you have multiple intolerances e. There are generally no established upper limits for over-the-counter enzymes. Unlike prescription enzymes, there is no standard dosing for commercially available digestive enzymes, and guidelines may vary across different products.

Additionally, many products contain ingredients that have not been studied in human digestion and therefore have unknown health risks. Of the most researched enzyme products, documented side effects include gastrointestinal upset, such as gas, bloating, and nausea.

Products should be used under the guidance of a healthcare provider to minimize the risk of excessive use. High-dose lipase intake, in particular, has been shown to cause damage to the colon walls. Numerous digestive products advertise enzymes derived from raw fruits and vegetables, as well as some from animal sources, for digestion enhancement.

Although these ingredients may facilitate a chemical reaction breakdown outside of the human body, the following enzymes lack evidence as digestive remedies in humans:. The supplement company NOW released the results from a recent study looking at the potency of 19 different bromelain supplements sold on Amazon.

Bromelain, an enzyme found in pineapple plants, in particular, has become expensive to source, which may be leading to companies cutting corners. While there are some biases to consider in this study, given NOW is a market competitor of other brands sold on Amazon, it raises the warning that the limited regulation of the supplement industry can lead to misrepresentations of what the product actually contains.

For this reason, Verywell Health recommends supplements that have proven efficacy from science-backed research and products from reputable brands that do internal and third-party testing. Digestive enzymes require specific conditions to do their job.

A product is most likely to be effective with the following considerations:. Probiotics are live microorganisms that live in the human gut and can offer specific health benefits.

Digestive enzymes are nonliving proteins made by the body to break down food components into digestible building blocks. Probiotics and enzymes are both found in our digestive tract and can be taken in supplement form.

While consuming probiotics through food or supplements can help to support a healthy gut microbiome which may improve digestion , they are not directly involved in the chemical breakdown of food like digestive enzymes.

If you have a digestive enzyme deficiency or dietary intolerance, probiotic supplements or probiotics added to digestive enzyme supplements are not known to be an effective remedy. Prescription enzymes differ from over-the-counter products in that they offer much higher doses of enzymes that are standardized precisely controlled and regulated by the FDA.

If you have a condition called pancreatic insufficiency, in which the pancreas doesn't produce enough of the key digestive enzymes lipase, protease, and amylase , a prescription enzyme regimen known as pancreatic enzyme replacement therapy or PERT is advised.

Although some over-the-counter digestive enzymes offer the same enzymes found in the prescription formula, the dosage is significantly lower and typically insufficient for improving digestion.

Similarly, if your digestive symptoms stem from sucrose intolerance—a diagnosable condition known as a sucrase-isomaltase deficiency or CSID—enzymes bought at a store will not meet your needs. A digestive enzyme called sacrosidase Sucraid is available by prescription only. It comes in a liquid form that needs to be refrigerated, and there is currently no over-the-counter substitute.

Digestive enzymes are objectively important for good digestion, though the effect of an enzyme supplement depends on the ingredients it contains and whether it is appropriate for your digestive issue.

If you have digestive symptoms due to an enzyme deficiency or intolerance, supplementing with the particular enzyme responsible for the nutrient you are malabsorbing can improve symptoms.

Digestive enzymes are not intended to treat constipation. However, if you have an enzyme deficiency or dietary intolerance, you may notice changes in your bowel movements. Poor digestion of nutrients most often results in gas, bloating, or diarrhea, though constipation may be experienced in some cases as well.

Digestive enzymes are most effective when matched to the appropriate issue. A random blend of enzymes may not be an effective digestive aid. Although many products are marketed with broad claims for digestion and health, proven benefits are limited to certain conditions.

For those with lactase deficiency, fructose intolerance, or galacto-oligosaccharide sensitivity, supplementing with adequate doses and appropriate timing of the target enzyme has been clinically shown to improve symptoms.

There are few risks associated with enzyme supplementation. Known side effects include gastrointestinal discomfort, particularly with increased dosage. As with any commercially available supplement, digestive enzyme products are minimally regulated and can include contaminants and doses that do not match the label or vary across brands.

Products with ox and bovine ingredients may present risk of disease transition, including bovine spongiform encephalopathy aka mad cow disease. Additionally, some digestive enzymes can cause adverse side effects when taken in excess.

For example, papain can cause esophageal perforation at high doses. Those that are pregnant, lactating, have a preexisting medical condition or those taking any medications should consult a healthcare professional before taking any digestive enzymes.

Suzie Finkel, MS, RD, CDN , is a nutrition consultant specializing in the nutritional management of digestive problems. As a GI dietitian, she provides evidence-based nutrition services for a wide array of conditions, including enzyme deficiencies.

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