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Digestive Enzymes

Digestive Enzymes

Description  

Enzymes are complex protein compounds which speed metabolic processes, in this case, digestion.

Digestion of starches begins in the mouth with saliva, which contains the digestive enzyme ptyalin, an amylase. (The suffix : - ase is a good clue to an enzyme.) In the stomach the gastric juices combine pepsin (hence peptic ulcer) and hydrochloric acid as well as lipase, amylase and gelatinase.

Lipase and amylase are also produced by the pancreas, contributing further to carbohydrate and fat breakdown, respectively. The pancreas also provides 3 major enzymes for protein: trypsin, chymotrypsin and carboxypolypeptidase. The pancreas secretes about 1 1/2 quarts of digestive juices in a day.

In the small intestine (primarily the duodenum hence duodenal ulcer) 4 enzymes form monosaccharides from disaccharides (sucrase, maltase, isomaltase and lactase); lipase continues to breakdwon fats; and peptidases continue the process of protein digestion, into individual amino acids.

The papaya is an organic source of these enzymes, notably: papain.

Method of Action

Enzymes contribute to biochemical reactions during which complex foods are broken down into their constituent parts: carbohydrates, fats and proteins ready for assimilation.

Proteolytic enzymes have also been used to prevent the formulation of bruises in athletes following contact sports (e.g. boxing). This has been controversial and the FDA consider their efficacy not proven. Also controversial but approved by the FDA, is the injection of proteolytic enzymes, usually derived from pineapples (bromelain/chymopapain/papain), into the bulging disk (herniated nucleus pulposas) of a human spine to digest the extruded portion and relieve the pressure on the nerve.

Less than 1 gm of pancreatic enzymes contained in a supplement tablet is claimed to digest: 165 gms protein, 100 gms carbohydrate and 60 gms of fat (a total energy value of 1,600 calories!).

A typical dosage is 500 mg, although several enzymes are usually combined e.g. 500 mg bromelain plus 500 mg papain, perhaps together with herbs, including mint.

 

Therapeutic Approaches

Most enzyme preparations are sold over-the-counter at health food stores, purchased by customers with some form of digestive symptom: that “stuffed full” feeling lingers long after the meal possibly disturbing sleep into the night; meals bring on headaches; sweating follows a meal; “rumbling”, “gurgling” noises from the stomach and flatulence occupy the hours following a meal.

Other health problems may indicate that the gastric acidity is inadequate or abnormal (during reflux episodes) and changes in diet, quantity of foods eaten at a meal, the number of meals eaten in a day, the time intervals between meals etc. may also need to be refined, to accommodate aging, the season or illness.

So far as clinical nutrition is concerned, perhaps the most interesting approach has been developed by Dr. Howard Loomis who has developed a line of enzyme-herbal products to supplement chiropractic adjustments in the treatment of spinal subluxations. Thus, each complex (consisting of several adjoining verterbal levels) is treated with a particular formula consisting of herbs and between 2 and 5 enzymes e.g. amylase, carbohydrase, cellulase and protease. Loomis diagnoses digestive problems via the palpatory diagnostic reflex. Loomis prefers plant enzymes. Many companies use enzymes derived from porcine pancreases which are similar to the human (pigs have also provided insulin for diabetics).
 

Toxicity Factors

It is important that an excessive accumulation of these enzymes (endogenous and/or exogenous) does not activate in the stomach, pancreas, or intestinal tract, overcoming the mucosal protective barrier or inhibitors, in which case gastritis, ulcers or acute pancreatitis could result (during which the pancreas itself is digested in just a few hours, resulting in lethal shock).

The most common sources of such irritation, however, are not enzyme supplements but chronic alcohol or aspirin consumption.

Abstracts

References

Buchler-MW; Binder-M; Friess-H.: Role of somatostatin and its analogues in the treatment of acute and chronic pancreatitis. Gut. 1994; 35(3 Suppl): S15-9

Buchler-MW; Binder-M; Friess-H; Malfertheiner-P: Potential role of somatostatin and octreotide in the management of acute pancreatitis. Digestion. 1994; 55 Suppl 1: 16-9.

DiMagno, E.P.: Medical treatment of pancreatic insufficiency. Mayo Clinic Proceedings, 1979(54):435-42.

Holsclaw, D.S.: Recognition and management of patients with cystic fibrosis. Pediatric Annals 1978(7):1.

Loomis, H.: Clinical nutrition and the chiropractic practice: imbalances in the internal environment and their relationship to nerve irritation and subluxation. The American Chiropractor, 1990(Sept).

Regan, P.T. et al : Comparative effects of antacids, cimetidine and enteric coating on the therapeutic response to oral enzymes in severe pancreatic insufficiency. NEJM 1977 297: 854-8.

Schwachman, H. et al: Studies in cystic fibrosis. Pediatrics 1970,46(3):

Turowski-GA; Rashid-Z; Hong-F; Madri-JA; Basson-MD: Glutamine modulates phenotype and stimulates proliferation in human colon cancer cell lines. Cancer-Res. 1994 Nov 15; 54(22): 5974-80

 

 


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