Digestive enzyme supplements and other approaches for IBS

Jthanmyfitnesspal

I am a woe-is-me broken record on this topic. But, my gut is interfering with my life (and particularly my exercise schedule) and I'm getting desperate to try something new!

Some people tell me to try digestive enzyme supplements. There are lots of articles saying they aren't very helpful unless you really have a deficiency. I more-likely have IBS (which has been previously suggested-- not so much diagnosed, since it is more of a symptomatic assessment).

Here's Harvard saying that the supplements don't do much for IBS:

https://www.health.harvard.edu/staying-healthy/gut-reaction-a-limited-role-for-digestive-enzyme-supplements

Here's Healthline giving a very balanced assessment about enzyme supplements for IBS (basically saying "no one knows if they work"):

https://www.healthline.com/health/digestive-health/digestive-enzymes-for-ibs

I'm interested in comments and suggestions. Have you found any benefit or side effects from digestive enzyme supplements?

cheryldumais

I would try a good probiotic. They have helped me despite others who say they do nothing. I suffered from H-Pylori a while back and perhaps the drugs for that killed my good bacteria. Anyway it's worth a try. Good luck I know it's miserable.

cmriverside

Jthanmyfitnesspal wrote: »

I am a woe-is-me broken record on this topic. But, my gut is interfering with my life (and particularly my exercise schedule) and I'm getting desperate to try something new!

Some people tell me to try digestive enzyme supplements. There are lots of articles saying they aren't very helpful unless you really have a deficiency. I more-likely have IBS (which has been previously suggested-- not so much diagnosed, since it is more of a symptomatic assessment).

Here's Harvard saying that the supplements don't do much for IBS:

https://www.health.harvard.edu/staying-healthy/gut-reaction-a-limited-role-for-digestive-enzyme-supplements

Here's Healthline giving a very balanced assessment about enzyme supplements for IBS (basically saying "no one knows if they work"):

https://www.healthline.com/health/digestive-health/digestive-enzymes-for-ibs

I'm interested in comments and suggestions. Have you found any benefit or side effects from digestive enzyme supplements?

I'm more excited that you made your words red. :flowerforyou:

ElizabethKalmbach

Unless your IBS is being caused by a bacterial overgrowth like h. pylori, I'm not sure *how* digestive enzymes would help. Most people with IBS have normal intestinal structures and enzymes, but poor bowel muscle signalling via the nervous system don't they? Plus, digestive enzymes will mostly do their thing in the stomach, not the large intestine.

Digestive enzymes help me A LOT, but I have achlorhydria (no stomach acid), not IBS.

One of my close friends suffers from IBS, and she's been tracking how much good sleep helps. In her case, nights with poor sleep lead predictably to a bad IBS episode - thus supporting most of what I've read about IBS and a relationship to stress.

I'm sorry there's frustratingly little research to help you with this thing that is causing you pain. That's a miserable place to be.

kshama2001

My mom's IBS is aggravated by stress. During high stress times she has to be more rigid about her diet, for example, eating foods with insoluble fiber after foods with soluble fiber (so salads and some veggies at the end of the meal.)

She finds these sites (same company) to be a good resource and uses their acacia powder daily:

https://www.helpforibs.com/footer/treatments.asp

https://www.heatherstummycare.com/p/suplmts_acacia/tummy-fiber-acacia-senegal-pouch/

Jthanmyfitnesspal

ElizabethKalmbach wrote: »

Most people with IBS have normal intestinal structures and enzymes, but poor bowel muscle signalling via the nervous system don't they? Plus, digestive enzymes will mostly do their thing in the stomach, not the large intestine.

(I'm not an expert, but...)

IBS appears to be a catch-all diagnosis for people with unexplained digestive problems. My problems are livable, so I haven't had extensive tests of any kind. The problem has been aggravated by my new interest in jogging, I think. Or getting old. I really haven't changed my diet much.

Also, apparently, normal digestive enzymes are added by the pancreas, which is at the start of the small intestine just past the stomach. Apparently enzymatic supplements must be coated so they get past the stomach.

ElizabethKalmbach wrote: »

Digestive enzymes help me A LOT, but I have achlorhydria (no stomach acid), not IBS.

I like hearing that! Any side effects?

PS I'm lucky to be a good sleeper. Sometimes, too good. Stress is always a factor!

Jthanmyfitnesspal

cmriverside wrote: »

I'm more excited that you made your words red. :flowerforyou:

But, you showed me how to stick in some new emogis! Way cool!

cathipa

I second the probiotics. Make sure they have at least 15 billion CFU per capsule and refrigerate them to prevent degradation. Also diet is key to maintaining healthy gut flora. I work in GI and find most of my patients who have been told they have IBS (I never use this diagnosis) are deficient of fiber. Fiber is the fuel for gut bacteria and the more you consume the more beneficial bacteria proliferate and lead to improved symptoms. The problem is more likely their gut bacteria are out of balance and there are more "bad bacteria" than "good bacteria". The bacteria make most of the hormones and neurotransmitters in our bodies so it is important to have a good balance. Most people find going from a low fiber diet to a high fiber diet leads to gas and bloating and most do not tolerate this so they quit. If you gradually increase (adding 5g daily increasing weekly) there should be less side effects.

AnnPT77

I was diagnosed with IBS/C. (You didn't specify, that I noticed.)

It stays under control better - or so I perceive subjectively - with these strategies, more or less in perceived order of benefit: Sufficient hydration, enough dietary fats, regular exercise that moves the midsection (and reduces stress effects), stress management, probiotic foods and prebiotic foods (I personally strongly prefer foods to supplements, just weird that way), plus avoiding alcohol to excess.

The only reason fiber is not first on that list is that I routinely get lots, as a longtime vegetarian. My doctor had me try a fiber supplement first, when I was more ignorant about my body, and it was a disaster, symptomatically.

Stress management and pro/pre-biotics are a little speculative, but I think they're true for me. The other ones I feel more confident about.

If you have IBS/D or mixed, I dunno.

Hope you find a solution!

ElizabethKalmbach

I take betaine HCl with pepsin. The betaine HCl acidifies my gut temporarily (about an hour or so) and helps me uptake nutrients from my food as well as breaking down proteins. I've titrated my dose of betaine HCl per unit of protein so I know how many tabs to take per meal to avoid poor digestion (too little) or heart burn (too much!). The pepsin helps coat my stomach and protects me from the increased acidity while my stomach does it's thing.

The titration was annoying, but necessary to avoid the primary side effects (for me), being either no effect (not enough acid) or heart burn. When I've done that correctly, my digestion works and my blood tests come back with normal parameters and no vitamin deficiencies. When I skip a lot of doses, I start craving carbs because I'm not digesting protein, I end up with nutritional imbalances (I'm currently getting over a bout of iron anemia, in part, because my compliance to my own plan was half hearted at best.), and well... my food comes out looking pretty much the way it did when it went in. It literally looks like other than chewing, nothing happened to it while it was inside me.

Probably TMI, but there you go. ;-)

camilledaisy

Hi I have IBS and use digestive enzymes especially lactase enzymes and have found they work well for me. I also use a probiotic which also works well, but I have had to try various strains to get the right ‘fit’ for my system. However, the biggest factor in managing my symptoms is controlling my diet. I have issues with several FODMAPs that I mostly avoid.

lgfrie

I have mild IBS and a few food intolerances (lactose, etc.) and digestive enzyme pills have been life-changing for me. I discovered them about two years ago and I find that I'm nearly 100 % asymptomatic as long as I actually take it with meals. It's easy to forget, though, and especially easy to forget when things improve. But if I skip it too much, symptoms come back.

Whether enzymes work for me because they do something about IBS or food intolerances or both, I cannot say. My dr says my food intolerances are probably though not necessarily the trigger for my IBS symptoms. Many other people have idiopathic IBS, meaning without a definite or identifiable cause. So I can't really say whether enzymes would work for IBS distinctly from helping with food intolerances. All I can say is, they do seem to work.

I take a probiotic but I'm not sold that it does anything. I think I'm just taking it out of habit. I feel no different with probiotics.

Jthanmyfitnesspal

I thought I would come back and report that, although I eat plenty of high fiber foods, I'm finding that taking a fiber supplement in the evening is helping.

I used to be a big fan of Citrucel. Being methyl-cellulose, it is biologically inert, so it won't give you gas. But, it's expensive and a bit harder to find (Amazon still has it). Also, it is a slightly weird thing to consume. (It's not "food.")

Benefiber is much more pleasant to take. It is processed wheat dextrin and is totally flavorless-- I put it in herb tea this time of year. It is actually not fiber, but seems to stimulate bacterial action to good effect. (It's method of action is somewhat mysterious, I think, but it seems to work.)

youngmomtaz

ElizabethKalmbach wrote: »

Unless your IBS is being caused by a bacterial overgrowth like h. pylori, I'm not sure *how* digestive enzymes would help. Most people with IBS have normal intestinal structures and enzymes, but poor bowel muscle signalling via the nervous system don't they? Plus, digestive enzymes will mostly do their thing in the stomach, not the large intestine.

Digestive enzymes help me A LOT, but I have achlorhydria (no stomach acid), not IBS.

One of my close friends suffers from IBS, and she's been tracking how much good sleep helps. In her case, nights with poor sleep lead predictably to a bad IBS episode - thus supporting most of what I've read about IBS and a relationship to stress.

I'm sorry there's frustratingly little research to help you with this thing that is causing you pain. That's a miserable place to be.

Could you tell me what brand you use?? My thyroid levels have been stable for a while now but the low stomach acid, and digestive issues common to hypothyroidism are still a problem for me.

naomi8888

Are you tracking what you're eating and noting the symptoms?
I went through an elimination diet with a naturopath to identify trigger foods. It's a pain to get through but is very much worth it (IMO). I avoid certain high FODMAP foods and that's helped a lot. Unfortunately stress is also a major factor and harder to control.

ElizabethKalmbach

youngmomtaz wrote: »

Could you tell me what brand you use?? My thyroid levels have been stable for a while now but the low stomach acid, and digestive issues common to hypothyroidism are still a problem for me.

I take betaine HCL with pepsin, which I calibrated over time with a protocol I found online, as my doctor was initially rather unhelpful in sorting this out. (I have since changed doctors and the new doc has actually taken the time to READ the articles I asked about and has added my discoveries and the protocols that are working to my records.) I need a fairly high dose to get ideal acidification, so I've gone with Solaray 650mg tabs, so that I only have to take three per meal to get the dose I need to digest my food. There have been a number of different brands I've tried with different dosages/pill. They all seemed to work equally well as long as I hit the target of 1800-2000mg per meal, but some of the brands were only providing 250mg per tablet, which is A LOT of tablets to swallow before eating.

youngmomtaz

ElizabethKalmbach wrote: »

youngmomtaz wrote: »

Could you tell me what brand you use?? My thyroid levels have been stable for a while now but the low stomach acid, and digestive issues common to hypothyroidism are still a problem for me.

I take betaine HCL with pepsin, which I calibrated over time with a protocol I found online, as my doctor was initially rather unhelpful in sorting this out. (I have since changed doctors and the new doc has actually taken the time to READ the articles I asked about and has added my discoveries and the protocols that are working to my records.) I need a fairly high dose to get ideal acidification, so I've gone with Solaray 650mg tabs, so that I only have to take three per meal to get the dose I need to digest my food. There have been a number of different brands I've tried with different dosages/pill. They all seemed to work equally well as long as I hit the target of 1800-2000mg per meal, but some of the brands were only providing 250mg per tablet, which is A LOT of tablets to swallow before eating.

Interesting! Thank you! I will do some looking.

Siobhan256

I’ve just finished 10 days on a product by ATP called Gut Right. Oh my goodness - it’s great! I’ve been constantly bloated and digestion really is something I’m trying to get right and this stuff has been great. It has also made me slightly more aware of foods that could cause me bloating because there’s a list of food to keep clear of for the 10 days. I’m down 1kg in 10 days (54 to 53 kg so it’s not like I had loads to lose). I’m not bloated. I was taking 5g 3 times a day with food. The tub costs AUD$70 and I’m now going to get another one to do another 30 days of maintenance which is 1 scoop per day. I’d recommend checking it out. It’s helped me so much.