health

Digestive enzyme supplement for heartburn?

Heidi Godman
 
My romance with spicy food came to a tragic end a couple of years ago. Age — and I’m guessing too many jalapenos — have left me susceptible to heartburn if I eat meals with a fiery flare. My doctor says there’s no underlying condition causing the matter and advises me to avoid the foods that appear to trigger symptoms. But that’s tricky sometimes. Digestive enzyme.

So I used to be particularly interested when a lover suggested that an over-the-counter (OTC) digestive enzyme supplement might help. I learned pretty quickly that there are many ads for the pills and powders. It’s a booming business, with sales for OTC digestive enzymes of all types expected to succeed in $1.6 billion by 2025.

About the supplement touted for heartburn relief

OTC digestive enzymes claim they will assist you break down food, a bit like digestive enzymes your own body makes (mostly within the pancreas). for instance , there’s

lipase, which breaks down fats
amylase, which breaks down carbohydrates
proteases and peptidases, which break down proteins.
The supplement versions of those enzymes come from plants and animals. Plant sources include bromelain, derived from pineapples; papain, derived from papayas; and lactase that’s obtained from purified yeasts or fungi. Animal sources include enzymes from the pancreases of pigs, cows, or lambs.

But there’s no thanks to know what’s really in supplements. The FDA doesn’t regulate them, therefore you can’t make certain what the pills are really made from or the precise amounts of enzymes they’ll contain. “It’s buyer beware,” warns Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital.

Do supplements help heartburn?

Sometimes the body doesn’t make enough digestive enzymes. This can slow the digestion process and lead to uncomfortable symptoms.

Would a digestive enzyme supplement help treat the symptoms of occasional heartburn, caused by acid reflux, slow stomach emptying, or an unknown reason (like I have)? The answer is that we don’t know. “Unfortunately, there is little evidence that OTC digestive enzymes are helpful for heartburn,” says Dr. Staller.

But we do know that OTC digestive enzymes can help manage other conditions. For example, if you don’t make enough of the enzyme alpha-galactosidase, needed to digest the sugar in beans, you may benefit from taking an alpha-galactosidase supplement (Beano, Bean Relief).

Or if you don’t make enough of the enzyme lactase, needed to digest lactose — the sugar in milk and milk-based products — you may benefit by taking a lactase supplement (Lactaid, Lactase). “If you don’t have lactase, the undigested lactose goes to the colon, which leads to more fluid entering the colon and more gas produced by bacteria in the colon. That creates bloating, flatulence, and diarrhea,” explains Dr. Staller. “A supplement might help.”

What about prescription enzymes?

Sometimes doctors recommend taking prescription-strength digestive enzymes. These could also be necessary when digestion enzyme levels are low due to a health condition like chronic pancreatitis or CF .

Taking prescription digestive enzyme medications helps bring levels back to normal. “People with known deficiencies clearly get a benefit,” says Dr. Staller.

But these medications aren’t appropriate treatments for heartburn.

The rest of my story

Because I’m persistent, I asked if it might hurt to undertake an OTC digestive enzyme for infrequent heartburn. Both my doctor and Dr. Staller had an equivalent answer: “In most cases, it’s unlikely to be harmful. But don’t spend tons of cash on them,” Dr. Staller advised. In other words, it won’t hurt, but we don’t know if it’ll help. So don’t make an enormous investment within the treatment. supplement

With that dubious green light and tons of curiosity, I attempted an OTC enzyme made up of papaya. And guess what — it helped! But as a health reporter, I do know that this might are the results of my very own personal hope (the placebo effect) or simply a cheerful coincidence.

I also know that ignoring my doctor’s orders to avoid spicy foods (which is my heartburn trigger but might not be someone else’s) would be foolish, and will cause damage to my esophagus. So I might use digestive enzymes as a crutch to eat anything I would like.

The lesson on behalf of me is that the OTC digestive enzyme supplement is there if i want it during a pinch which it’d or won’t work.

But I won’t make a habit of using it. I’ll keep the spice factor dialed right down to a lower heat, and I’ll just need to learn to like being symptom-free the way I once loved those jalapenos.

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