Enzymes…The “Workhorse” Of Your Digestive Process

What are digestive enzymes and how can they help when you have gluten sensitivity or intolerance?

Digestive enzymes are absolutely essential to break down the complex molecules found in food into the smaller bits and pieces that our bodies can absorb and utilize for nutrition. Enzymes are complex protein molecules that perform a wide variety of functions, including digestion. Lack of digestive enzymes can cause a variety of symptoms ranging from skin rashes, allergies, abdominal discomfort (such as bloating, diarrhea, gas and constipation), immune depression, fatigue and joint problems.  Some of these symptoms may be the result of poor nutrition—or poor absorption of those nutrients. And, one of the problems people with gluten sensitivities have—especially right after they’ve discovered their sensitivities—is getting the right foods that can be properly absorbed.

After years of not knowing about their gluten sensitivities, often their digestive organs are too inflamed and too weak to absorb nutrients—and have lost their own enzymes. This is where adding digestive enzymes can help—they can “pick up the slack” and help your digestive system heal and ensure that the foods you eat are broken down enough to be absorbed. Using these enzymes can improve absorption of foods in gluten-free diets and can even help in those times we slip—or if we eat something that we don’t think has gluten in it—but does.

Another reason to use digestive enzymes is because cooking and processing destroys the natural enzymes in food. My feeling is this—we evolved along with the other plants and animals on this planet and evolved eating a lot more raw foods, natural herbs, spices and unprocessed foods. The processing that goes into the production of many of the “instant” foods we find on the shelf destroys not only the enzymes, but other nutrients as well, so in a lot of circumstances, it makes sense to replace the enzymes that have been destroyed.

Naturopathic physicians have been recommending digestive enzymes for many years for specific problems, including gluten sensitivity and intolerance. Many conventional physicians are now beginning to recommend digestive enzymes for both pediatric and adult patients, and are beginning to see the positive results that Naturopathic Doctors have seen in the past¹.  For example, in patients with cystic fibrosis, PERT, or Pancreatic Enzyme Replacement Therapy has been used for a number of years with good success.²

There are many different types of digestive enzymes—many of the names of enzymes end in “ase”.  The most important ones for digestion are:

• Lipases³—these break up fats (lipids).  These include pancreatin and pancrelipase.  Ox bile is often included in digestive enzyme formulas because it contains lipases.
• Proteases—these break down proteins and include enzymes such as Bromelain⁴ (from pineapples), papain⁵  (from papayas), pepsin⁶, trypsin/chymptrypsin and dipeptidyl dipeptidase IV (DPP IV), an enzyme that is thought to be particularly important in gluten intolerance.⁷
• Amylases-these break up complex carbohydrates and starch in food. This group includes sucrases (break down table sugar) and Lactases which break up milk sugar.
• Cellulases- these break up the cellulose that makes up the cell wall in plants.

All these enzymes have what is known as optimal pH and temperature ranges where they function best.  Often, betaine HCl is included to ensure the proper acid pH is achieved. Many other digestive enzyme products have various herbs and supplements in their formulations.  Many herbs are included because they are believed to provide an optimal environment for the enzymes as well as working to help decrease the intestinal inflammation.  Many of the supplements are included for similar reasons and because they can function as necessary co-factors for the enzymes.

So, is there a “best” combination of digestive enzymes? No—different brands work better for some than others.  If you have gluten intolerance or sensitivity though, you should get enzymes that contain dipeptidyl dipeptidase IV (DPP IV). This enzyme seems to be particularly important for gluten-sensitive people.⁸  There is some “trial and error” in finding the best form of digestive enzyme for you—but the result is well worth it!  I have used enzymes for other systemic conditions as well, including fibromyalgia and autoimmune disease with good results.

Taking digestive enzyme supplements can help some people with gluten intolerance.  There are ongoing clinical trials to see if there are specific types of enzymes that are better than others.

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References:
1.  Culbert, TP, Banez, GA, Integrative Approaches to Childhood Constipation and Encopresis, – Pediatr Clin North Am – 01-DEC-2007; 54(6): 927-47; xi
2.  Hayek, KM., Medical Nutrition Therapy for Cystic Fibrosis: Beyond Pancreatic Enzyme Replacement Therapy J Am Diet Assoc – 01-AUG-2006; 106(8): 1186-8.
3.  http://www.umm.edu/altmed/articles/lipase-000311.htm
4.  http://www.umm.edu/altmed/articles/bromelain-000289.htm
5.  http://practicalaction.org/docs/technical_information_service/papain.pdf
6.  http://www.pdb.org/pdb/static.do?p=education_discussion/molecule_of_the_month/pdb12_1.html
7. Stepniak, D., Spaenij-Dekking, L. “Highly efficient gluten degradation with a newly identified prolyl endoprotease: implications for celiac disease.”
8.  http://www.enzymestuff.com/rtgluten.htm