Read through any online IBS discussion forum and you will be sure to quickly come across a recommendation for the use of digestive enzyme supplements. As with many things IBS-related, research is quite limited. In fact, a review of the literature only turned up two studies:
The first study assessed the effectiveness of prescribing the pancreatic enzyme lipase to patients who suffer from the symptoms of diarrhea predominant IBS (IBS-D) following meals (postpriandal). Lipase is an enzyme that assists with the digestion of fat. The study used a pancralipase formulation known as PEZ.
The study design required participants to identify their own trigger foods and to take either PEZ or a placebo prior to eating meals that contain those triggers. After a brief break in treatment, administration of the PEZ vs. placebo was switched. At the end of both treatment phases, participants were asked as to decide which of the two treatments they preferred. 61% of participants chose PEZ over placebo.
Comparison of PEZ vs. placebo identified that the PEZ was significantly more effective in reducing bloating, borborygmi, cramping, pain, and urgency, as well as decreasing the number of bowel movements and increasing the firmness of stool. The study was limited by the small sample size and a high drop-out rate.
The second study involved a multi-ingredient formulation named Biointol. This supplement contains digestive enzymes along with beta-glucan and inositol. In this small study, 50 IBS patients received the supplement. Their symptoms were compared with a 40 IBS patient no-therapy control group. The results indicated that the supplement reduced abdominal pain, bloating and flatulence. Unfortunately, without a placebo control, there is no way to conclude that the supplement itself was the causative agent for these symptom reductions.
The Bottom Line
Clearly, well-designed research studies are sorely needed before any conclusions can be made about the helpfulness of digestive enzyme supplements in ameliorating the symptoms of IBS. On the other hand, digestive enzymes do not seem to carry any significant risk when taken in recommended dosages and therefore are not likely to do much harm, although they can be costly. Before trying any supplements containing digestive enzymes, it is best to consult with your physician to ensure that the enzymes will not interact negatively with any other medication you may be taking or any other health issues you may be dealing with.
Ciacci, C. et.al. "Effect of beta-Glucan, Inositol and digestive enzymes in GI symptoms of patients with IBS" European Review for Medical and Pharmacological Sciences 2011 15:637-643.
Money, M. et.al. "Pilot study: a randomised, double blind, placebo controlled trial of pancrealipase for the treatment of postprandial irritable bowel syndrome-diarrhoea" Frontline Gastroenterology 2011 2:48-56.
Roxas, M. "The Role of Enzyme Suppplementation in Digestive Disorders" Alternative Medicine Review 2008 13:307-313.
DISCLAIMER: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.