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Larry Newman is the Chief Operating Officer, Technical and Regulatory Affairs of Kirkman Group, Inc. (Kirkman). Contact Kirkman at 1-800-245-8282; 6400 Rosewood St., Lake Oswego, OR.

Tuesday, January 11, 2011

How to Support Digestive Health

By Larry Newman

An Introduction to Digestive Function 

The primary function of the digestive tract is to break down the large particles of food that we eat into small
molecules that can cross over the intestinal lining, enter the bloodstream, and become fuel for the various metabolic processes in the body. In order to accomplish this function, the intestinal tract is involved in four primary activities: digestion, absorption, assimilation, and elimination. 

Digestion/Absorption is where those usable nutrients cross the gut wall and pass from the intestine to the bloodstream.  Assimilation is utilization of the products of digestion for energy and the body’s metabolic processes while elimination is the excretion of the body’s waste products through the intestines and kidneys. is the breakdown of the food particles into usable nutrient forms. 

begins in the mouth with salivary secretions, then continues in the stomach with secretions of hydrochloric acid and pepsin to form a material called chyme.  The pancreas then releases enzymes into the duodenum of the small intestine as the chyme also passes into the duodenum.  Digestion and absorption then continues and is essentially completed in the small intestine.  The final stage of digestion then is completed in the large intestine and colon where waste accumulates and is then eliminated. 

Digestive Enzymes
Digestive function disorders are prevalent in sensitive and special needs individuals, and the majority of these are the result of the stomach not secreting enough hydrochloric acid or the pancreas not releasing enough pancreatic digesting enzymes. When these situations occur (and they often occur together), stomach acidifiers and/or supplemental digestive enzymes are often used to help correct the insufficiencies. The most utilized stomach acidifier is Betaine Hydrochloride which helps make up for the lack of insufficient stomach acid secretion, a condition known as achlorhydria. 

When we talk about supplementing with digestive enzymes we are probably talking about pancreatic enzymes. These are the enzymes which have specific jobs and act only on specific types of food substrates. When digestive enzyme supplementation is called for or recommended by a health professional, it is imperative that the proper combination of enzymes is chosen so as to address the problems at hand. For example, lipase only digests fats, it does not act on protein or sugar. Sucrase only digests sugars. It has no effect on fat or protein. Proteases and peptidases act on protein, casein and gluten. Other enzymes do not.

Digestive Disorder Symptoms
There are many recognizable indicators that digestive disorders due to pancreatic enzyme insufficiency are present in an individual. Some of these can be:
  • Bloating and/or abdominal pain or cramping
  • Irregular bowel habits or abnormal loose or mushy stools
  • Constant constipation or diarrhea
  • Discomfort after eating
  • Excessive gas
  • Extreme sensitivity to dairy and grains
  • Very odorous bowel movements
  • Undigested food in the stool
  • Oily, greasy, and/or floating stools
As discussed earlier, a specific enzyme combination must be selected based on an individual’s specific needs. There are many different enzyme products available including:
  • Lipase which aids fat digestion
  • Lactase to ease lactose intolerance
  • Peptidase/Protease for protein and peptide digestion
  • DPP-IV (Peptidase) which targets casein and gluten
  • Multi-spectrum enzymes which digest all food groups
  • Carbohydrases to aid the digestion of carbohydrates which includes sugars and starches.
Discuss which combinations will work best for your situation with your physician or nutritionist. Kirkman® carries a complete line of digestive enzymes to cover all nutritional requirements and situations.

are generally given at the beginning of every meal. The amount of enzyme supplementation is based on the amount of food consumed at a given meal. A snack would require a smaller dose than a full dinner. If a person’s normal dose for a full meal is one capsule, a snack might only require ½ capsule.

Frequently Asked Questions Regarding Digestion and Digestion Support

Q-What are Digestive Enzymes?

A-Digestive Enzymes are substances produced in the pancreas that aid in food digestion.

Q-Are all digestive enzymes the same?
A-No, there are many different types of digestive enzymes, and each one has a very specific job in the body.  They are substrate specific, in that lipase enzyme only acts on fat, protease only acts on protein, and amylase only acts on starches and carbohydrates.

Q-Why might an individual need to supplement with additional digestive enzymes?
A-Sensitive and special needs individuals often lack sufficient pancreatic enzymes to digest all of their food intake properly, leading to gastrointestinal and digestion issues.

Q-What might be symptoms of insufficient pancreatic enzymes?
A-Bloating or other discomfort after eating, excessive gas, consistent constipation or diarrhea, or undigested food in the stool can be indicators.  Floating stools may indicate incomplete fat digestion. 

Q-Where do digestive enzymes come from to put in enzyme supplements?
A-They can come from cows, pigs or certain living plant type organisms such as molds.

Q-Where do Kirkman’s enzymes come from?
A-Kirkman only uses plant based enzymes which come from various species of the Aspergillus organism.

Q-If I am sensitive to mold, could I react to plant based enzymes?
A-The enzymes are purified and should have no traces of mold left in them, but caution is advised in that situation.  Use only a minute amount of the enzyme initially to check for sensitivity.

Q-How do I know which enzyme product to use?
A-For most individuals, a multi spectrum enzyme which helps digest all food groups is effective.  Examples would be Kirkman’s Enzyme Complete Products or our Maximum Spectrum product.  If, however, your physician has isolated a particular enzyme need such as lipase, lactase, or protease, then an individual enzyme product could work such as Kirkman’s Peptidase Complete or Bio-Core Dairy.

Q-What if I only have difficulty with carbohydrate metabolism?
A-Kirkman has a specialty enzyme called Carb Digest™ for this purpose.

Q-What is unique about Kirkman’s enzyme supplements?
A-Kirkman’s newest most comprehensive products feature a specialty enzyme called Isogest™ which is not available in any other brand of commercially available enzymes.

Q-What does Isogest™ do?
A-Isogest is Kirkman’s specialty enzyme for isomaltase activity.  No other brand of enzymes currently utilize an enzyme for isomaltase activity.

Q-Why is isomaltase activity important?
A-There is an enzyme in the body called sucrase/isomaltase.  Sucrase is available in many enzyme products, but only Kirkman enzymes also have isomaltase activity.  Many complex carbohydrates that we eat, including potatoes, contain isomaltose or palatinose which require isomaltase to completely digest those complex starches properly.

Q-How do we know that enzyme activity is often lacking in sensitive and special needs individuals?
A-A study done at Massachusetts General Hospital in 2004 by R. Kushak, Ph. D. and T. Buie, MD confirmed that  25-40% of a special needs group exhibited certain enzyme deficiencies including isomaltase/palatinase. 

Q-Has Isogest™ been tested?
A-Yes, before marketing enzymes with Isogest®, Kirkman asked 12 DAN! Physicians to do a clinical evaluation of the products Enzyme Complete II/Isogest™ and Carb Digest.  The doctors and parents of the evaluated patients were polled as to the effects of the new products.  Results were outstanding and side effects virtually non-existent.

Q-Which of Kirkman’s enzyme products contain Isogest™?
A-Enzyme Complete II/Isogest™ formula, Carb Digest, and the Maximum Spectrum product all contain Isogest™.

Q-When  do I supplement with Digestive Enzymes?
A-At the beginning of each meal or snack is the suggested dosage time.

Q-Do I always take the same amount of extra enzymes?
A-Not necessarily.  Snacks or very small meals usually require only ½ the dosage taken with full meals.

Q-How long will it take me to know digestive enzymes are working?
A-For many individuals results are very fast, as soon as a few days.  Others may take longer, but certainly within three weeks.  If after three weeks no noticeable improvements are evident, supplementation may be discontinued and a physician should be consulted for further evaluation.

Q-Why do Kirkman’s enzyme labels warn not to get enzyme powder on the skin or in the eyes?
A-Enzymes are very powerful substances.  The proteases present in enzymes can literally begin to digest skin and mucous membranes causing severe irritations.  This is why the warnings are present.

Q-Will there be any side effects from digestive enzyme supplementation?
A-Generally, there will not be any side effects.  Rarely diarrhea or nausea can occur on initial supplementation.  This usually disappears after the body gets used to the supplements.

Q-I have heard that I can’t take enzymes and probiotics together.  Is this true?
A-This is a much debated issue.  Kirkman and our consulting experts, believe that enzymes and probiotics should be separated by a short time frame.  Our recommendation is to take the enzyme right at the beginning of the meal, and follow with the probiotic about ½ hour later or halfway through the meal.  That way, the enzyme has passed through the stomach before the probiotic arrives.

Q-Can digestive enzymes that contain protease and peptidase be substituted for the GF/CF diet since they digest casein and gluten?
A-Kirkman and the physicians we work closely with do not recommend using enzymes in place of the GF/CF diet.  There is a limit to how much casein and gluten can be digested fully by proteases and peptidases and this has never been measured.  It is possible that enzymes can limit the effects of certain GF/CF diet infractions where very small amounts of casein and/or gluten are consumed, but the diet itself has proven to be too important to compromise on.