Enzyme therapy for functional bowel disease-like post-prandial distress

Area of Science:

• Gastroenterology
• Digestive Health
• Clinical Nutrition

Background:

• Post-prandial gastrointestinal symptoms like diarrhea, bloating, and flatulence are common but often lack clear causes.
• Digestive enzyme supplements have a historical precedent for alleviating these symptoms, supported by numerous trials.

Purpose of the Study:

• To review studies on multi-digestive enzyme use for symptoms aligning with irritable bowel syndrome (IBS).
• To examine clinical trials, including randomized placebo-controlled studies, focusing on post-prandial diarrhea and IBS-D.

Main Methods:

• Narrative review of clinical trials over the past 60 years.
• Inclusion of double-blinded, randomized, placebo-controlled studies.
• Exclusion of studies focusing solely on disaccharidase or other specific carbohydrate enzyme deficiencies.

Main Results:

• Worldwide studies generally report positive outcomes with multi-enzyme preparations for post-prandial symptoms.
• No studies utilized factorial designs to pinpoint specific effective enzyme subgroups or link symptoms to components.

Conclusions:

• Multi-enzyme preparations have a history of success in managing post-prandial symptoms suggestive of IBS.
• Long-term studies with validated scoring and factorial designs are necessary to confirm efficacy for specific symptoms and components.