Digestive enzyme supplements for heartburn?

Illustration from acid reflux or heartburn, Cartoon vector, Concept with internal health


My love affair with spicy food came to a sad end a few years ago. Age — and I’m guessing too many jalapenos — have left me prone to heartburn if I eat meals with a fiery flare. My doctor says there’s no underlying condition causing the problem, and advises me to avoid the foods that seem to trigger symptoms. But that’s tricky sometimes.

So I was particularly interested when a friend suggested that an over-the-counter (OTC) digestive enzyme supplement might help. I learned pretty quickly that there are lots of ads for the pills and powders. It’s a booming business, with sales for OTC digestive enzymes of all kinds expected to reach $1.6 billion by 2025.

About the supplements touted for heartburn relief

OTC digestive enzymes claim they can help you break down food, just like digestive enzymes your own body makes (mostly in the pancreas). For example, there’s

  • lipase, which breaks down fats
  • amylase, which breaks down carbohydrates
  • proteases and peptidases, which break down proteins.

The supplement versions of these enzymes come from plants and animals. Plant sources include bromelain, derived from pineapples; papain, derived from papayas; and lactase that’s obtained from purified yeasts or fungi. Animal sources include enzymes from the pancreases of pigs, cows, or lambs.

But there’s no way to know what’s really in supplements. The FDA does not regulate them, therefore you can’t be sure what the pills are really made of or the exact amounts of enzymes they may contain. “It’s buyer beware,” warns Dr. Kyle Staller, a gastroenterologist at Harvard-affiliated Massachusetts General Hospital.

Do supplements help heartburn?

Stop the burn!

End the distress—and damage—of heartburn, GERD, and acid reflux

Sometimes the body doesn’t make enough digestive enzymes. This can slow the digestion process and lead to uncomfortable symptoms.

Would a digestive enzyme supplement help treat the symptoms of occasional heartburn, caused by acid reflux, slow stomach emptying, or an unknown reason (like I have)? The answer is that we don’t know. “Unfortunately, there is little evidence that OTC digestive enzymes are helpful for heartburn,” says Dr. Staller.

But we do know that OTC digestive enzymes can help manage other conditions. For example, if you don’t make enough of the enzyme alpha-galactosidase, needed to digest the sugar in beans, you may benefit from taking an alpha-galactosidase supplement (Beano, Bean Relief).

Or if you don’t make enough of the enzyme lactase, needed to digest lactose — the sugar in milk and milk-based products — you may benefit by taking a lactase supplement (Lactaid, Lactrase). “If you don’t have lactase, the undigested lactose goes to the colon, which leads to more fluid entering the colon and more gas produced by bacteria in the colon. That creates bloating, flatulence, and diarrhea,” explains Dr. Staller. “A supplement might help.”

What about prescription enzymes?

Sometimes doctors recommend taking prescription-strength digestive enzymes. These may be necessary when digestion enzyme levels are low because of a health condition such as chronic pancreatitis or cystic fibrosis.

Taking prescription digestive enzyme medications helps bring levels back to normal. “People with known deficiencies clearly get a benefit,” says Dr. Staller.

But these medications are not appropriate treatments for heartburn.

The rest of my story

Because I am persistent, I asked if it would hurt to try an OTC digestive enzyme for occasional heartburn. Both my doctor and Dr. Staller had the same answer: “In most cases, it’s unlikely to be harmful. But don’t spend a lot of money on them,” Dr. Staller advised. In other words, it won’t hurt, but we don’t know if it will help. So don’t make a big investment in the treatment.

With that dubious green light and a lot of curiosity, I tried an OTC enzyme made from papaya. And guess what — it helped! But as a health reporter I know that this could have been the result of my own personal hope (the placebo effect) or just a happy coincidence.

I also know that ignoring my doctor’s orders to avoid spicy foods (which is my heartburn trigger, but may not be someone else’s) would be foolish, and could cause damage to my esophagus. So would using digestive enzymes as a crutch to eat anything I want.

The lesson for me is that the OTC digestive enzyme supplement is there if I need it in a pinch, and that it might or might not work.

But I won’t make a habit of using it. I’ll keep the spice factor dialed down to a lower heat, and l’ll just have to learn to love being symptom-free the way I once loved those jalapenos.

Related Information: The Sensitive Gut

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

Psalm 38:3 There is no soundness in my flesh because of Your indignation; There is no health in my bones because of my sin.

Matthew 9:12-13 But when Jesus heard this, He said, “It is not those who are healthy who need a physician, but those who are sick. “But go and learn what this means: ‘I DESIRE COMPASSION, AND NOT SACRIFICE,’ for I did not come to call the righteous, but sinners.”

Luke 5:31-32 And Jesus answered and said to them, “It is not those who are well who need a physician, but those who are sick. “I have not come to call the righteous but sinners to repentance.”

Exodus 15:2 “The LORD is my strength and song, And He has become my salvation; This is my God, and I will praise Him; My father’s God, and I will extol Him.

Acts 3:16 “And on the basis of faith in His name, it is the name of Jesus which has strengthened this man whom you see and know; and the faith which comes through Him has given him this perfect health in the presence of you all.

Exodus 23:25 “But you shall serve the LORD your God, and He will bless your bread and your water; and I will remove sickness from your midst. Philippians 4:6-7

Be anxious for nothing, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.

Psalm 32:4-5 For day and night Your hand was heavy upon me; My vitality was drained away as with the fever heat of summer. Selah. I acknowledged my sin to You, And my iniquity I did not hide; I said, “I will confess my transgressions to the LORD”; And You forgave the guilt of my sin. Selah.

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