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Digestive enzymes are made in the pancreas, small intestine and stomach, according toJohns Hopkins Medicine. The main enzymes produced by the pancreas are amylase, which breaks down complex carbohydrates; lipase, which digests fats; and proteases, which break down fats. The enzymes lactase and sucrase, made in the small intestine, break down dairy sugar and sugar, respectively. Pepsin, made in the stomach, isthe main enzymeinvolved in the digestion of protein.

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But there are some plant-based alternatives, such as bromelain from pineapple or papain from papaya, and enzymes extracted from various microbes or yeast, Cohen added.

Despite the body’s ability to produce digestive enzymes, research has shown the market for these products is booming, estimated at nearly$700 millionin 2021 and expected to hit $1.6 billion by 2031, said Dr. Akash Goel, a clinical assistant professor of medicine at Weill Cornell Medicine in New York City.

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But over-the-counter supplements are regulated as food, so “there is much less standardization and quality control in terms of ingredients,” Goel said.

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“That’s the issue with supplements and digestive enzymes,” she added. “(Brands) can say whatever they want on TV ads, on magazine ads or on (social media) … and it’s perfectly legal. But whether or not it’s true is a whole different story.”

Because supplements don’t undergo FDA approval, those that have been tested by a third party are safer bets, experts said. These couldinclude the NSF— which says it holds the only national standard that establishes requirements for the ingredients in dietary and nutritional supplements — the US Pharmacopeia or ConsumerLab.com.

“Enteric coating protects the enzymes, which are proteins, from being digested by the acid contained in, and secreted by, the stomach,” Cohen said, so “the enzyme can safely get to the small intestine where it does its main work.”

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On its own, the body should produce levels of digestive enzymes sufficient for assimilation of nutrients, Goel said. But when it doesn’t, due to deficiencies evidenced by a stool test a doctor performs, prescription digestive enzymes are the primary treatment.

“Prescription enzymes are used primarily by individuals diagnosed with cystic fibrosis and exocrine pancreatic insufficiency,” Cohen said. Cystic fibrosisis a diseasethat damages the lungs, digestive tract and other organs, whileexocrine pancreatic insufficiencyis a condition in which the small intestine can’t thoroughly digest food due to problems with pancreatic enzymes.

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People with those diagnoses are really the only people with a clinical or legitimate need for digestive enzyme products, Cohen said — particularly prescribed ones as, again, those are more likely to have the precise dose needed.

“If there are no medical issues or established food intolerances, then digestive enzyme supplements are not required,” Tuck said.

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But if you’re consuming them for digestive issues you’re experiencing on a regular basis, you should see a gastroenterologist or your doctor since you may be masking symptoms and delaying a diagnosis in need of supervised treatment, experts said.

If you have enzyme deficiencies, nothing can be done to improve levels naturally, Cohen said. Consequently, the only options are to take prescription digestive enzymes or avoid the foods you can’t digest because of your deficiencies.

But if you’re a healthy person, you can improve your digestive health overall, including by not eating meals that are so taxing on your system.

“Something we registered dietitian nutritionists hear a lot is ‘I have trouble digesting food’ or ‘I have slow digestion’ when what they actually have is constipation,” Cohen said. “Digestive enzymes will not help with constipation.”

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Goel also recommended meetingthe national exercise guidelinesand theguidelines for fiber intakeas well as regularly getting restful sleep, being exposed to nature and spending time with loved ones.

“Stress managementthrough various practices that could include meditation, but also recreational activities that bring one joy,” he added, “is key.”

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