Can Enzyme Therapy Help IBS?

In my early 20s when I was scrambling to find a longer-term solution to managing my IBS, was when I first stumbled upon the concept of taking supplemental enzymes as a potential treatment.

I did try them for a while, but couldn't parse out the difference between whether they helped me, compared to the other treatments I had integrated into my daily routine, that included dietary tweaks, taking supplemental soluble fiber, and a high-quality probiotic. Additionally, I am not sure if it was my imagination or not, but some of the enzymes seemed to make me feel bloated (or perhaps it was a coincidence, I certainly didn't experience relief from bloating).

That being said, I've decided to give enzymes another go, more to treat my GERD than my IBS, with the hopes it will benefit both (or at least not aggravate either).

What are digestive enzymes?

Digestive enzymes are substances produced by our own bodies to help us to digest food, including certain proteins, carbohydrates, and fats. Since those of us with certain digestive disorders--like IBS and/or GERD--may be deficient in some of these enzymes, it reasons that supplementing them could help alleviate some of our symptoms. The most common enzyme people might be familiar with is lactase--which helps breakdown lactose found in milk and other dairy products. Some people take lactase tablets before they have ice cream, for instance. Other enzymes include lipase, maltase, proteases (which has several subtypes)

What does the science say?

There hasn't been a ton of research into enzymes, especially as related to its impacts on IBS. What's been done has been somewhat promising, though.

A study published 2010 of 49 patient (including 14 men, and 35 women), with IBS-D symptoms took either an enzyme combination known as pancrealipase (PEZ) or a placebo. The group taking PEZ did better compared to the placebo group with the former demonstrating improvement in all of their IBS-D-related symptoms including cramping, bloating, urge to defecate, abdominal pain and decreased incidences of defecation. However, this was a very small study and the improvements were in a small subset of the population studied.¹

Another study from 2011 compared 50 people taking a supplemental formula called Biointo (a combination of beta-glucan, inositol and digestive enzymes) to 50 people receiving no such supplement or any other treatment. It found that those taking Biointo had significant alleviation of certain IBS symptoms such as bloating, flatulence and abdominal pain; however, those taking it also experienced a slight increase in urgency for bowel movements.²

Overall, it seems that enzymes can be promising in treating some IBS symptoms, though may not be a silver bullet by any means. There is little risk to taking enzymes as directed (other than expense of buying them), so for most, it's a fairly innocuous thing to try and see if it helps. As always, you should consult with your doctor first. As for me, so far taking the formula I am taking, I have noticed some benefits for my GERD and it hasn't triggered any IBS issues (no bloating this time around).

What about you--do you take enzymes to help manage IBS? If so, what has been your experience?