Can taking enzyme supplements help soothe my bloating?

Q. I often feel uncomfortable and bloated after eating. I have not been able to identify any particular foods that cause it. Would digestive enzyme supplements be helpful?

A. 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. People with known deficiencies get benefit from these drugs.

On the other hand, over-the-counter digestive enzyme supplements — available in health food stores and drugstores or through the Internet — are not medications. The FDA does not regulate them. Therefore, you can't be sure how the pills are made or the amount of enzymes they may contain.

A lactase supplement (such as Lactaid or Lactrase) can help people manage lactose intolerance. An alpha-galactosidase supplement (like Beano or Bean Relief) may reduce gas and bloating if you have difficulty digesting the sugars in beans.

Even though you have not identified specific foods as problematic, it's still likely that dietary changes will help reduce your discomfort. Consider a consultation with a registered dietitian.

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