This article reviews various forms of
enzyme supplementation used clinically in digestive and absorption disorders.
Enzyme supplementation plays an integral role in the management of various digestive disorders, particularly with regard to
exocrine pancreatic insufficiency. However, application of
enzymes may also be beneficial for other conditions associated with poor digestion including
lactose intolerance. Historically, porcine and bovine pancreatic
enzymes have been the preferred form of supplementation for
exocrine pancreatic insufficiency. Use of microbe-derived
lipase has shown promise with studies indicating benefit similar to pancreatic
enzymes, but at a lower dosage concentration and with a broader pH range. Safety and efficacy of
enzymes derived from microbial species in the treatment of conditions such as malabsorption and
lactose intolerance is promising. Plant-based
enzymes, such as
bromelain from pineapple, serve as effective digestive
aids in the breakdown of
proteins. Synergistic effects have been observed using a combination of animal-based
enzymes and microbe-derived
enzymes or
bromelain.