Digestive Disorders and Enzymes
last updated 8.25.05
Digestive disorders may be a combination of things. By definition they impact digestion. Some may be related to bacteria overgrowth (such as IBD/IBS), or may have auto-immune aspects (Crohn's or colitis), so please see those sections as well.
see Autoimmune/Neuro conditions
The image on this page to the right is an x-ray of a polyp in the colon.
Many actual photos of internal tissue in the digestive tract both healthy and with various disease conditions:
Virtual Hospital Image Library
Image of Crohns in the lower small intestine, ileum
Images of diverticulitis, villi, strictures, colitis
General information on many digestive diseases
Descriptions and images
The following information was provided as a 'Tip of the Day' by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD).
Diagnosing Crohn's Disease
Crohn's disease — a serious condition that causes severe inflammation in the small intestine — is a health concern for many Americans. The most common symptoms of Crohn's disease are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding (often serious and persistent), weight loss, and fever may also occur. In order to diagnose Crohn's disease, a physician will conduct a thorough physical exam and administer a series of tests that may include the following:
- Blood tests. Your doctor may conduct blood tests to check for anemia — a lack of red blood, red blood cells, or hemoglobin — which could indicate bleeding in the intestines. Blood testing may also uncover a high white blood cell count, which is a sign of inflammation somewhere in the body.
- Stool sample. You may be asked for a stool sample, so that your doctor can tell if there is bleeding or infection in the intestines.
- Upper gastrointestinal series. For an upper gastrointestinal series, you would asked to drink barium, a chalky solution that coats the lining of the small intestine, before X-rays are taken. The barium shows up white on X-ray film, revealing inflammation or other abnormalities in the intestine.
- Colonoscopy. During a colonoscopy, the doctor inserts an endoscope — a long, flexible, lighted tube linked to a computer and TV monitor — into the anus to see the inside of the large intestine. The doctor will be able to see any inflammation or bleeding. During the exam, the doctor may do a biopsy, which involves taking a sample of tissue from the lining of the intestine to view with a microscope.
If the results of these tests suggest Crohn's disease, more x-rays of the digestive tract may be necessary to determine how much of it is affected by the disease. Once diagnosed, however, you and your doctor can work on reducing symptoms and distress caused by this disease.
More on Crohn's disease
Enzymes and Gastritis
Question: It is true that you are not suppose to use enzymes if a person has gastritis?
Reply: This is a little tricky. Yes, most places have a disclaimer saying that if you have gastrities, avoid the strong protease formulations. There are some enzyme products with low or no proteases that are for gastritis patients (like Gastro from Enzymedica).
However, there are lots of clinical studies which clearly show that taking proteases significantly speeds up healing of ulcers, gastritis, and wounded tissue. Which looks like you would specifically want proteases with gastritis. So what do you do?
Here is what is going on in the gut:
Proteases help reduce inflammation, clean out debris and infection, and stimulate healing. The can result in clean, yet exposed tissue that is very sensitive.
Think of a sizable infected wound on a skinned knee that just won't heal. The wound is sensitive and inflammed. It's raw. Nerves are exposed. As you attempt to clean it out and remove the cruddy infected tissue, it hurts. The raw nerves are exposed. It might also bleed a little.
As you apply antibiotic, it can really sting badly with sharp pain. But this process is needed to stop the infection and enable the wound to heal.
Now consider this same situation happening in your gut where you can't see what's going on. You might take proteases which are doing the cleaning work. But you experience some stabbing pain, stomach ache, irritation, and might see a little bleeding. All of this is very alarming if you aren't prepared for it. If we didn't know what the antibiotic on the skinned knee was for and why it stung, we might conclude that antibiotics are bad for skinned knees. And thus the warning for people with gastritis taking enzymes.
But proteases might be exactly what you need to really heal. So one strategy is to take an enzyme product with low or no proteases to help the body heal more gently and still get the benefits of enzymes for overall food digestion. (Carbo by Enzymedica, any of the broad-spectrum enzyme products such as Zyme Prime or Thropps). With gastritis I think Carbo or something with very low proteases would be better.
Then dose the proteases separately so you can control how much you are taking in (such as Peptizyde, Purify by Enzymedica, etc). If it is uncomfortable, reduce the dose. The wounded tissue will heal, just at a slower rate. Some people like the quick, tough-it-out method, but I really like to avoid pain when I can. There has been excellent success with this approach of separating out the strong proteases for those with very injured guts.
If you start an enzyme product and have stomachache or pain, the general recommendation is to stop the proteases for 4-5 days, then start again slowly. This allows the clean but raw and exposed tissue to heal up a bit and be less sensitive. Just like allowing a cleaned out skinned knee to form a 'scab' so the healthy but exposed tissue won't hurt as you move around. If the pain persists again, discontinue the proteases for awhile.
Healing doesn't usually occur overnight and some patience and steady persistance may be in order.
Can Enzymes help with reflux or GERD?
In general, yes. My younger son was a chronic refluxer for about 6 years until he started enzymes regularly. It didn't go away overnight, but into the 2 month it was less. In the third month it was less. By the fourth month it had pretty much stopped and didn't come back anymore. that was 3 1/2 years ago. Several older adults have told me the same thing.
You might want to consider a 'gentler' enzymes product initially. Something like Lacto or V-Gest by Enzymedica. Then, after a bottle of that, go to something with more proteases like Digest Gold or Thropp's Ultra-Zyme Plus (or something similar). Starting with something gentler, particularly in the case of children, initially tends to be better tolerated until a little more healing takes place. With reflux, the main thing seems to be just sticking with the enzymes regularly for a few months.
This first abstract shows how digestive enzymes are effective in helping bowel disease/damage. Note the large number of subjects tested.
Influence of a complementary treatment with oral enzymes on patients with colorectal cancers--an epidemiological retrolective cohort study.
Cancer Chemother Pharmacol 2001 Jul;47 Suppl:S55-63. PMID: 11561874 [PubMed - indexed for MEDLINE]
Popiela T, Kulig J, Hanisch J, Bock PR. First Department of General and Gastroenterological Surgery, Clinic of Gastroenterology, Cracow, Poland.
Purpose: To evaluate the impact of postoperative treatment with an oral enzyme (OE) preparation given complementary to an antineoplastic therapy in patients with all stages of colorectal cancer.
Methods: The design of this epidemiological study was a retrolective cohort analysis with parallel groups. Design and conduct of the study were performed to current standards for prospective, controlled clinical trials. Of a cohort of 1,242 patients with colorectal cancer (documented in 213 centres), 616 had received complementary treatment with OE (182 OE only, 405 other complementary drugs, 29 protocol violators) and 626 had not received OE (368 control only, 229 other complementary drugs, 29 protocol violators). Of 1,162 patients who had undergone primary surgery, 526 received adjuvant chemotherapy and 218 radiotherapy. The median follow-up time for the OE group was 9.2 months and for the control group 6.1 months. The primary test criterion of efficacy for OE treatment was the multivariate effect size of the changes from baseline of the disease- and therapy-associated signs and symptoms (nausea, vomiting, changes in appetite, stomach pain or stomach disorder, tiredness, depression, memory or concentration disorder, sleep disturbance, dizziness, irritability, dyspnoea at rest, dyspnoea during activity, headache, tumour pain, cachexia, skin disorders and infections). Tumour-related events, e.g. death, were evaluated by the number of events observed and time to event. Safety of treatment with OE was analysed in terms of number and severity of adverse events, their duration, treatment and outcome.
Results: A significant reduction in disease-associated signs and symptoms was observed in patients treated with OE alone, but not in those receiving OE in addition to other complementary treatments. Adverse reactions to chemo- and radiotherapy were diminished in all patients receiving OE. Analysis of survival did not demonstrate a reduced number of deaths in the OE group. However, a trend to prolongation of survival was demonstrated, particularly in the patients with disease stage Dukes' D, in the subgroup receiving OE in addition to other complementary treatments. Similar but less-pronounced trends were observed for disease stages Dukes' B and C. In the OE group, 21 of 616 patients (3.4%) experienced OE-associated adverse reactions, all of them mild to moderate gastrointestinal symptoms.
Conclusion: Complementary treatment of colorectal cancer patients with OE improves their quality of life by reducing both the signs and symptoms of the disease and the adverse reactions associated with adjuvant antineoplastic therapies. This epidemiological retrolective cohort analysis provides evidence that patients may also benefit by a prolongation of survival time. OE were generally well tolerated.
Double-blind pilot-study on the efficacy of enzyme therapy in advanced colorectal cancer.
Popiela T, Kulig J, Klek S, Wachol D, Bock PR, Hanisch J. 1st Department of General and Gastrointestinal Surgery, Jagiellonian University, Krakow, Poland. PMID: 11202281 [PubMed - indexed for MEDLINE]
All tested variables showed a tendency in favor for Wobe-Mugos E therapy as addition to standard therapy. Enzymes improve the quality of life by reducing cancer disease typical symptoms, they reduce side effects of chemo-/radiotherapy and they have a potential of prolonging life (preliminary data only).
In Gaucher's disease and in cystic fibrosis, most patients are put on digestive enzymes right away (with Gaucher's it is right after birth) and continue for life. So if enzymes had ill effects or long-term negative consequences, they would have been discovered in this life-long enzyme users.
Here are some more links, but they are more 'commercial' in nature. The general idea is that enzymes help break down food so YOU get the energy and nutrition they contain, and there is little left over to irritate the bowel, or feed bacteria/yeast in the bowel.
How a diet restricting certain foods may work
People who suffer from irritable bowel syndrome may not be sufficiently digesting certain sugars and fibre. When these particular enzymes are not present or insufficient, undigested sugars and carbohydrates remain in the intestines and ferment.
Under normal circumstances when the enzymes are active the sugars and fibre are broken down in the normal course of digestion and flow through the system along with other food that has been digested. Bacteria and yeast that are present and live within the bowel cause the undigested matter to ferment, this, in turn, causes large amounts of gas to be produced.
During this fermentation process other chemicals are produced and as the bowel is a semi-permeable membrane the chemicals can leach through the intestinal wall and enter the body via the bloodstream. This has the potential to stimulate various diseases elsewhere in
It is extremely important, then, that these sugars and fibre are eliminated from your body as soon as possible, which will have a very beneficial affect on your system. You might be able to take the needed enzymes instead of eliminating foods to achieve this as well.