Digestive Enzymes Supplement Review

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Digestive Enzymes
  Evaluated for:
Effectiveness Rating Effectiveness Rating
Pain conditions
+1 (Slight Evidence)
Dyspepsia & Reflux
+1 (Slight Evidence)
Pancreatic insufficiency
+1 (Slight Evidence)


  • Digestive enzymes help the body to digest the proteins in food. The enzymes trypsin and chymotrypsin occur naturally in the body, and can be extracted from the pancreas of animals. Or papain and bromelain can be obtained from foods like papaya and pineapple.
  • Digestive enzymes (phlogenzym) have anti-inflammatory and analgesic properties. They seem to reduce pain and improve knee function in patients with osteoarthritis.
  • Digestive enzymes (bromelain) reduce inflammation and swelling, and may be a useful addition to other therapies used for sinusitis (such as antibiotics) due to their ability to reduce inflammation and swelling.
  • Proteolytic enzymes are believed to be quite safe.
  • Digestive enzymes are essentially nontoxic, and seldom cause side effects.


  • Occasional side effects may include mild gastrointestinal distress, diarrhea, or allergic reactions.
  • The digestive enzyme bromelain has possible cross-reactivity and can provoke allergic symptoms in people who are sensitive to wheat, celery, papain, carrot, fennel, cypress pollen, and grass pollen, as well as the plant family that includes ragweed, chrysanthemums, marigolds, daisies, and echinacea. If you are allergic to bromelain, you may find that you are allergic to one or more of these plants, and vice versa.

Combining bromelain and papain with blood thinner medicines may further increase the risk of bruising or bleeding. Some of these include aspirin, clopidogrel (Plavix), enoxaparin (Lovenox), heparin, indomethacin (Indocin), and warfarin (Coumadin). Digestive enzymes should be combined with drugs such as heparin or warfarin (coumadin) only with a doctor's supervision. Some evidence suggests that bromelain may increase the absorption of certain antibiotics, namely amoxicillin and tetracycline. Digestive enzymes may also enhance absorption of sedative medicines such as benzodiazepines, so they should not be mixed with sedatives. There is some evidence that pancreatin may interfere with the absorption of folate, a B vitamin.

DOSAGE:This bromelain combination product seems to be comparable in effect to diclofenac, a prescription-strength, anti-inflammatory medicine.

CONCLUSION:We conclude that while bromelain shows some early promise for treating pain conditions, dyspepsia, reflux and pancreatic insufficiency, there is not yet enough evidence for us to recommend its use. If you do elect to try it, please discuss your decision with your doctor, and observe carefully for any changes in your health.

Proteolytic Enzymes. EBSCO Publishing (2011) 1-8

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