The Indian Practitioner

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

A Review of Digestive Enzyme and Probiotic Supplementation for Functional Gastrointestinal Disorders


Affiliations
1 Yatharth Super Speciality Hospital, Greater Noida, India
2 Senior Consultant, Internal Medicine, Bhopal, India
3 Sunflower Medical Centre, Lucknow, India
4 Paras Hospitals, Gurugram, India
5 Medical Affairs, Macleods Pharmaceuticals Ltd., Mumbai, India
6 Centre for Clinical Research and Practice & Research Centre for Diabetes, Hypertension and Obesity, Samastipur, India
     

   Subscribe/Renew Journal


Functional gastrointestinal disorders (FGIDs) also known as disorders of gut-brain interaction are chronic, recurrent disorders with no identifiable underlying pathology. The FGID with upper abdominal pain and discomfort is the hallmark feature of functional dyspepsia. Around 11-30 % prevalence of functional dyspepsia is reported worldwide. One of the unique features of functional dyspepsia is transient deficiency of digestive enzymes in the system. Digestive enzymes are produced and secreted by the gastrointestinal system to break down fats, proteins, and carbohydrates, to accomplish digestion and, afterwards, the absorption of nutrients. Supplementation with digestive enzymes could provide management of disorders caused by impaired digestive function. Various formulations of enzyme supplementation are available commercially in the market, and are currently used in clinical practice for the management of several digestive diseases. Probiotics have multi-faceted role, helping to restore the gut microbiota.

This review elaborates the potential of multi digestive enzymes along with probiotics in the management of digestive diseases and dyspepsia.


Keywords

Digestive enzyme, Probiotics, Functional Dyspepsia, Indigestion.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Stanghellini V. Functional Dyspepsia and Irritable Bowel Syndrome: Beyond Rome IV. Dig Dis 2017; 35 (suppl 1):14-17

  • Chandran S, et al. A review of functional gastrointestinal disorders: A primer for mental health professionals. Arch Ment Health. 2018; 19:70-81.

  • Drossman DA. The Functional Gastrointestinal Disorders and the Rome III Process. Gastroenterology. 2006; 130(5):1377-90.

  • Mearin F, Calleja JL. Defining functional dyspepsia. Rev Esp Enferm Dig. 2011; 103(12):640-7.

  • Talley NJ, Ford AC. Functional Dyspepsia. N Engl J Med. 2015; 373(19):1853-63.

  • Ghoshal UC, Singh R. Functional dyspepsia: the Indian scenario. J Assoc Physicians India. 2012 Mar; 60 Suppl:6-8.

  • Mahadeva S, Goh KL. Epidemiology of functional dyspepsia: A global perspective. World J Gastroenterol. 2006; 12(17):2661-6.

  • Talley NJ et al. Guidelines for the management of dyspepsia. Am J Gastroenterol. 2005 Oct; 100(10):2324-37.

  • GianlucaIaniro et al. Digestive Enzyme Supplementation in Gastrointestinal Diseases. Curr Drug Metab. 2016 Feb; 17(2): 187-193.

  • Swami OC, Shah N. Functional dyspepsia and the role of digestive enzymes supplement in its therapy. Int J Basic Clin Pharmacol. 2017 May; 6(5):1035-1041

  • Laugier R, Bernard JP, Berthezene P, Dupuy P. Changes in pancreatic exocrine secretion with age: pancreatic exocrine secretion does decrease in the elderly. Digestion. 1991; 50(3-4):202-11.

  • Feldman M, Cryer B, McArthur K, Huet BA, Lee E. Effects of aging and gastritis on gastric acid and pepsin secretion in humans: a prospective study. Gastroenterology. 1996; 110(4):1043-52.

  • Madisch A, et al. The Diagnosis and Treatment of Functional Dyspepsia. Dtsch Arztebl Int. 2018 Mar; 115(13): 222-232.

  • Samsom M, Verhagen MA, Van Berge H, Smout AJ. Abnormal clearance of exogenous acid and increased acid sensitivity of the proximal duodenum in dyspeptic patients. Gastroenterology. 1999; 116(3):515-20.

  • Kusunoki H, Haruma K, Manabe N, Imamura H, Kamada T, Shiotani A, et al. Therapeutic efficacy of acotiamide in patients with functional dyspepsia based on enhanced postprandial gastric accommodation and emptying: randomized controlled study evaluation by real-time ultrasonography. Neuro gastroenterol Motil. 2012; 24(6):540-5.

  • Du LJ, Chen BR, Kim JJ, Shen JH, Dai N. Helicobacter pylori eradication therapy for functional dyspepsia: Systematic review and meta-analysis. World J Gastroenterol. 2016; 22(12):3486-95.

  • Banka N, Sawant P, Vartak M, Pawar D. Efficacy and Tolerability of Unienzyme MPS-A Multienzyme Preparation with Simethicone in Patients with Nonulcer, Dyspepsia. Indian Medical Gazette. 2001; 135(7):294-305.

  • Khandke DA, Shirsath PA, Jain SK. Post-Marketing Surveillance Study to Assess the Efficacy and Tolerability of Al5zyme-A Multienzyme Preparation in Patients with Functional Dyspepsia. Indian Medical Gazette. 2013; 181-91.

  • O’Toole PW, Cooney JC. Probiotic bacteria influence the composition and function of the intestinal microbiota. Interdiscip Perspect Infect Dis. 2008; 2008():175-285.

  • Hemarajata P, Versalovic J. Effects of probiotics on gut microbiota: mechanisms of intestinal immunomodulation and neuromodulation. Therap Adv Gastroenterol. 2013 Jan; 6(1): 39-51.

  • GianlucaIaniro et al. Digestive Enzyme Supplementation in Gastrointestinal Diseases. Curr Drug Metab. 2016 Feb; 17(2): 187-193.

  • Gut reaction: A limited role for digestive enzyme supplements. Available on: https://www.health.harvard.edu/staying-healthy/gut-reaction-a-limited-role-for-digestive-enzyme-supplements

  • Pawar D. Efficacy and Tolerability of Unienzyme MPS-A Multienzyme Preparation with Simethicone in Patients with Non-ulcer, Dyspepsia. Indian Medical Gazette. 2001; 135(7):294-305.

  • Khandke D et al. Post-Marketing Surveillance Study to Assess the Efficacy and Tolerability of Al5zyme-A Multienzyme Preparation in Patients with Functional Dyspepsia. Indian Medical Gazette. 2013; 181-91.

  • Ahyani T. Lactobacillus probiotics for treating functional dyspepsia in children. Paediatrica Indonesiana. 2016; 56(1):37-42.


Abstract Views: 586

PDF Views: 1




  • A Review of Digestive Enzyme and Probiotic Supplementation for Functional Gastrointestinal Disorders

Abstract Views: 586  |  PDF Views: 1

Authors

N. K. Soni
Yatharth Super Speciality Hospital, Greater Noida, India
H. H. Trivedi
Senior Consultant, Internal Medicine, Bhopal, India
Sanjay Kumar
Sunflower Medical Centre, Lucknow, India
Anukalp Prakash
Paras Hospitals, Gurugram, India
Soumen Roy
Medical Affairs, Macleods Pharmaceuticals Ltd., Mumbai, India
Amit Qamra
Medical Affairs, Macleods Pharmaceuticals Ltd., Mumbai, India
Supriyo Mukherjee
Centre for Clinical Research and Practice & Research Centre for Diabetes, Hypertension and Obesity, Samastipur, India

Abstract


Functional gastrointestinal disorders (FGIDs) also known as disorders of gut-brain interaction are chronic, recurrent disorders with no identifiable underlying pathology. The FGID with upper abdominal pain and discomfort is the hallmark feature of functional dyspepsia. Around 11-30 % prevalence of functional dyspepsia is reported worldwide. One of the unique features of functional dyspepsia is transient deficiency of digestive enzymes in the system. Digestive enzymes are produced and secreted by the gastrointestinal system to break down fats, proteins, and carbohydrates, to accomplish digestion and, afterwards, the absorption of nutrients. Supplementation with digestive enzymes could provide management of disorders caused by impaired digestive function. Various formulations of enzyme supplementation are available commercially in the market, and are currently used in clinical practice for the management of several digestive diseases. Probiotics have multi-faceted role, helping to restore the gut microbiota.

This review elaborates the potential of multi digestive enzymes along with probiotics in the management of digestive diseases and dyspepsia.


Keywords


Digestive enzyme, Probiotics, Functional Dyspepsia, Indigestion.

References