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Digestive Enzymes
( Pancreatic Enzymes )

The pancreatic enzymes released from the pancreas are the most common digestive enzymes in the body. They can be placed in three basic classes according to the substrate that they act on. The proteolytic enzymes are enzymes responsible for the digestion of proteins, fats are digested by lipases, and dietary carbohydrates are digested by amylases. Medical doctors may normally prescribe digestive enzymes to promote the absorption of foods, in case a person is affected by several common conditions that cause malabsorption of nutrients, these include problems such as pancreatic insufficiency and cystic fibrosis.

When patients suffer from the physical symptoms of indigestion not attributable to a specific cause, many nutritionally oriented doctors will suggest the supplemental use of pancreatic enzymes with the daily meals to ameliorate the symptoms. The beneficial effects, if any, of such supplementation has still not been worked out in research. Further studies are required before any concrete benefits of such supplements can be proved.

The partially digested proteins can trigger some types of allergies according to one theory, at the same time, proteolytic enzymes are said to reduce the symptoms of allergy in patients with a susceptibility to allergenic reactions. This theory is supported by some scientific evidence but requires more studies. The human body partially absorbs the proteolytic enzymes like trypsin, chymotrypsin, and bromelain. These enzymes start to display anti-inflammatory activities once they are absorbed by the body; some evidence indicates that they even demonstrate possible anti-tumor effects in certain patients. The functioning of the immune system is also boosted by proteolytic enzymes, especially in patients affected by shingles - caused by herpes zoster virus. This line of research still requires verification and is poorly explored. More studies need to be conducted to make sure to confirm this evidence.

Where is it found ?

The normal human diet contains only small amounts of the animal based proteolytic enzymes trypsin and chymotrypsin. These enzymes are synthesized by the pancreas during the process of digestion. Bromelain, which is a plant produced proteolytic enzyme is extracted from pineapples, it is often used in treating digestive disorders. Another plant based enzyme called papain is extracted from unripe papayas; this enzyme is also used in many treatment methodologies. These enzymes are all sold in the form of supplements and can be purchased at most drug stores.

Who is likely to be deficient ?

Supplemental pancreatic enzymes are normally recommended for patients affected by cystic fibrosis and pancreatic insufficiency; these supplements include various lipases and amylases as well as proteolytic enzymes. A deficiency of pancreatic enzymes is also evident to a certain extent in patients affected by celiac disease, Crohn's disease, and some patients with persistent indigestion problems. Plant based enzymes, bromelain and papain, are not produced naturally in the human body and a deficiency of these enzymes is out of the question.

Usual dosage

In supplemental form, it is usual to take the digestive enzymes, such as the lipases and amylases as well as the proteolytic enzymes as a combination. All the three major digestive enzymes are included in a standard supplement called pancreatin; this product has been rated against a standard established by the United States Pharmacopeia - USP, a rating system that enables the comparison of various products sold in the market. This rating system gives a comparison, as an example, a supplement that is "4X pancreatin" will be four times the strength of the USP standard rating. The rating of "X" means that each single X will be equivalent to a content of twenty five USP units of the starch digesting amylase enzyme, two USP units of fat digesting lipase, along with twenty five USP units of protein digesting, proteases or proteolytic enzymes. In some patients suffering from pancreatic insufficiency, a single dose of consisting of three to four grams of 4X pancreatin consumed along with every meal will be helpful, the same effect can be noticed from taking a smaller but more potent dose.

Patients affected by chronic pancreatitis need to discuss the intake or dosage level of supplemental enzyme with a qualified physician, ideally supplements should be taken under medical supervision. Patients with severe illness due to pancreatic insufficiency brought on by pancreatitis are usually given very high dosage levels of supplemental enzymes to improve fat digestion by doctors. This treatment is increasingly the standard treatment for patients and is effective, as results from a successful trial show, in this test, sufficient pancreatin was consumed with each meal to supply slightly over one million USP units of lipase to the patient.

The potency of supplemental enzymes sold in the market that give only the product weight without mentioning the activity units may be weak. Such supplements can be avoided.

Side effects and cautions

The fat digesting enzymes called lipases are usually considered to be the most important digestive enzymes in treating malabsorption diseases. Since all enzymes including lipases are proteins, all proteolytic enzymes will be able to digest the lipases as well. This is one reason to avoid consuming proteolytic enzymes in order to spare lipases; patients with enzyme deficiency disease on supplements must avoid using these supplements together. As the majority of enzyme supplements will contain both types of enzymes, this may not always be possible therefore, all patients affected by malabsorption syndromes may want to consult their doctor and see if they can use enzyme supplements that have the more lipase and a minimum of the proteases - especially if their condition needs to be treated using more lipase.

Consuming a lot of supplemental enzymes could be risky in theory, as excess enzymatic activity along the gastrointestinal cavity can cause irritation because it may even begin to "digest" some parts of the body. This danger of the enzyme digesting the body wall as it moves through the body wall is a possible scenario. The good news is that, at the supplemental amounts used, this potential danger is never realized. The dosage level at which such a scenario might start to come into play has not been determined in research till date.

Supplements of the digestive enzymes must not be consumed along with betaine HCI, or hydrochloric acid, these agents will reduce the activity of the enzymes as they degrade enzymes chemically before they can react with food.

Uses

Cystic fibrosis, Heartburn, Indigestion, Pancreatitis.

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