Patients with irritable bowel syndrome, or IBS, suffer recurrent episodes of abdominal pain accompanied by diarrhea, constipation or alternating bouts of each. Treatment for IBS begins with avoiding dietary triggers such as fatty foods, milk products, chocolate, alcohol, caffeine and carbonated beverages. Some triggers---such as legumes and many vegetables---are difficult to avoid in a healthy diet. Digestive enzymes can help.
Lactase
According to the National Institutes of Health, milk products trigger IBS symptoms in many people. After the age of 2, the intestine starts to produce progressively less lactase, the enzyme that digests the sugars in milk. Lactase levels fall even further after an injury or infection in the intestine, at least until healing is complete. IBS patients who are unable or unwilling to eliminate milk products from their diets sometimes find that their symptoms subside with over-the-counter lactase supplements.
Beta-Glycosidase
Legumes, which are dried beans and peas, and vegetables such as cabbage, Brussels sprouts, broccoli and asparagus, contain a non-digestible carbohydrate called raffinose. Patients with IBS---and many who do not have IBS---experience gas pain and bloating when they eat these foods. Over-the-counter beta-glycosidase supplements such as Beano digest raffinose. According to gastroenterologist Dr. Chung Owyang in the 2008 edition of "Harrison's Principles of Internal Medicine", however, these products provide only incomplete relief, reducing rectal passage of gas without improving bloating or gas-related pain.
Pancrelipase
Many patients with IBS experience worsening symptoms with large or fatty meals. A 2010 study in the journal "Clinical Gastroenterology and Hepatology" concluded that most of these patients suffered from mild deficiencies in pancreatic enzyme production. Prescription pancreatic enzyme supplements such as creon and pancrease have long been used to treat pancreatic insufficiency due to diseases such as cystic fibrosis. They also appear to benefit patients with IBS.
References
- "Harrison's Principles of Internal Medicine, 19th edition"; Irritable Bowel Syndrome (Chapter); C. Owyang; A.S. Fauci, E. Braunwald, D.L. Kasper et al. (eds); 2008
- NIH: What I Need to Know about Irritable Bowel Syndrome
- NIH: Gas in the Digestive Tract
- "Clinical Gastroenterology and Hepatology;" Some Patients with Irritable Bowel Syndrome May Have Exocrine Pancreatic Insufficiency; J.S. Leeds, A.D. Hopper, R. Sidhu et al.; May 2010
- MedlinePlus: Pancrelipase
