When should digestive enzymes not be used?

The article was professionally consulted by Doctor Department of Gastroenterology - Endoscopy, Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital.

Digestive enzymes are the common name for a group of drugs that play a similar role to enzymes in the human intestinal tract. They are essential to aid digestion in people with pathological or physiological enzyme deficiencies. Like other drugs, the use of digestive enzymes needs to be strictly prescribed. However, how to use digestive enzymes properly, in which cases should not use digestive enzymes ... not everyone understands.

Digestive enzymes are chemicals secreted by the body into the intestinal tract, which play a role in breaking down food into small, easily absorbed molecules. Experts often refer to it as an enzyme. Each different enzyme will be produced by different organs, which have the effect of metabolizing each specific chemical in the food. The basic substances are carbohydrates (glucid), proteins (proteins), fats (lipids), which are metabolized by the digestive enzyme system from the salivary glands, the first gateway of this pathway, next. followed by liver, pancreas and intestinal juices.
One thing to clearly distinguish is that digestive enzymes are completely different from probiotics. Probiotics are symbiotic beneficial bacteria spores in the intestinal tract, produced freeze-dried, which, when ingested, enrich the resident microflora, while digestive enzymes are actual chemical compounds. artificially synthesized.

The core function of enzymes is to break down food into corresponding chemical molecules, from which they are easily absorbed through the intestinal wall, into the bloodstream and fed to the body. Therefore, no matter what type, digestive enzymes produced in the medical field also have a common function to restore that function when the digestive system can no longer guarantee this role.
Specifically, powdered sugar from rice, flour, bread, and noodles will be broken down by enzymes into simple sugar molecules; Likewise, proteins in meat, fish, eggs, and milk are converted into amino acids, and fats into fatty acids for easy absorption by the body. Thus, if there is no replacement of artificial digestive enzymes, the body's ability to absorb essential nutrients will no longer be guaranteed. The body will become emaciated, weak and susceptible to disease.

First of all, it is necessary to confirm that digestive enzymes are also a drug, the use of digestive enzymes should comply with separate indications for adults and children, and depending on specific diseases. . Therefore, the cases of using digestive enzymes incorrectly indicated may not bring better results but can also be harmful.
In particular, the most basic thing is not to use digestive enzymes in patients with acute intestinal diseases such as peptic ulcer disease, pancreatitis. Because, these patients have absolutely no enzyme deficiency to have to supplement from the outside, but even have the phenomenon of excessive enzyme secretion, damaging the intestinal parenchyma of the body. The use of digestive enzymes with people who are suffering from increased gastric acid secretion, acute pancreatitis will definitely make the disease worse. In fact, in these cases, patients need to fast or eat easily digestible foods, treat with drugs that inhibit intestinal secretion, help the digestive system temporarily rest, and minimize damage.
Besides, the participation of digestive enzymes is to support the breakdown of food, so it doesn't make sense if we take digestive enzymes but fast or skip meals, diet too much. level. At this time, when there is no presence of food particles in the intestinal tract, but the enzyme system has been activated, they will digest their own body. Specifically, the concentration of acid in the gastric lumen, liver enzymes, and pancreatic enzymes in the duodenal lumen is excessively high, exceeding the self-protective capacity of the intestinal wall, which will quickly lead to inflammatory and erosive lesions. Over a long period of time, the lesion will gradually progress to ulceration and perforation, causing severe surgical abdominal pain, requiring the patient to go to the hospital and sometimes requiring emergency surgical intervention.
Therefore, when taking digestive enzymes, absolutely do not drink before meals, nor should they be used too late after meals. At the same time, the prolonged use of digestive enzymes in the absence of evidence of a decline in the enzyme levels of the organ systems is a warning.

With that said, digestive enzymes will be needed in subjects with evidence of intestinal enzyme deficiencies. In which, especially suitable are patients with fibrosis or permanent damage to the salivary glands, cirrhosis of the liver, cholecystectomy, chronic pancreatitis, short bowel syndrome... digestive enzyme preparations in the form of pills or ampoules, containing artificially synthesized enzyme components, simulating similar physiological digestive activities in reality. From there, digestive enzymes brought in from the outside will help the patient increase the rate of food consumption, absorb many nutrients, and also help partly improve flatulence, anorexia, slow digestion, malnutrition. .. Note that when supplementing with digestive enzyme preparations, it should be taken after a main meal, with a variety of foods, rich in nutrients. If so, the digestive enzymes will have the best chance of being effective.
All subjects with digestive enzyme dysfunction as mentioned above, including children, can use digestive enzymes. However, absolutely do not abuse but always need to consult a doctor. Sometimes a patient only needs a specific enzyme instead of a whole system of enzymes with many different types, or sometimes the patient only needs support for a while while waiting for the organ to recover or need to be replaced all the time. life.
Therefore, digestive enzymes should only be used when absolutely necessary to avoid dependence and in a sufficient dose, neither lack nor excess. If gastrointestinal enzymes are used arbitrarily for a long time, the ability of the glands to secrete endogenous digestive enzymes will be inhibited or the enzyme concentration is too high, which can easily damage the organs. Normally, the duration of using digestive enzymes should not exceed 10-15 days.
In short, digestive enzymes are additional synthetic enzymes from outside that work to support food metabolism. Because this is also a form of medicine, do not arbitrarily use it without a doctor's opinion, to avoid unfortunate side effects. It is necessary to understand the subjects should and should not use, how to use digestive enzymes properly so that this product really has a good effect, helping the body absorb nutrients from daily meals.