ENZYMES: Clinical Considerations in IBS, SIBO, Dysbiosis, and the Leaky Gut

Transcription

1 ENZYMES: Clinical Considerations in IBS, SIBO, Dysbiosis, and the Leaky Gut Michael T. Murray, N.D. AllHealth BeginsintheGut Hippocrates

2 Key Objectives To provide an overview of the key role digestive enzymes play in the intestinal environment Examine the role of digestive enzymes in functional GI disorders such as IBS, SIBO, leaky gut, and on the microbiome Use of digestive enzymes in food intolerance Provide practical guidance on selection, dosage, and applications of digestive enzymes

3 Endocrine System Inflammatory Support Digestion Mental Health The gut is the central Gut 101hub to all functions of the human body Immune Function Circulation 70% of the immune system is found in the gut. 90% of all neurotransmitters are produced within the GI tract. We have 10 times more microbes living in our digestive tract than human cells in our entire body. The digestive tract itself is the largest and most complex organ of the endocrine system. While gut flora is crucial to the functioning of the GI tract, enzymes offer specialized and unique benefits to this important system.

4 Functional Gastrointestinal Disorders G.I. Symptoms not attributable to anatomic or biochemical defects: Occasional heartburn Functional dyspepsia (bloating, belching, pain, nausea) Irritable bowel syndrome Constipation Are the symptoms really due to unknown factors..

5 Pancreatic Enzyme Insufficiency Characteristic symptoms include a combination of: Bloating/belching/flatulence minutes after eating Malabsorption and passage of undigested food Abdominal distension Food intolerance Constipation or diarrhea Symptoms of IBS, candidiasis or SIBO

6 Irritable Bowel Syndrome (IBS) Characteristic symptoms include a combination of: abdominal pain and distension more frequent bowel movements pain during bowel movements or relief of abdominal pain with movements constipation or diarrhea excessive production of mucus in the colon flatulence, nausea, loss of appetite anxiety and/or depression

7 Small Intestinal Bacterial Overgrowth (SIBO) IBS plus other associated symptoms such as: Brain fogginess Fatigue Joint pain Skin issues: acne, eczema, rashes or rosacea Weight loss

8 Dysbiosis in IBS

9 What Causes the Dysbiosisin IBS? Complex interactions that include: History of antibiotics Xenobiotic exposure Numerous dietary factors Lack of digestive secretions Immune dysregulation Infection and/or inflammation

10 Abnormal Fecal Markers in IBS?

11 Questions Related to Digestive Enzyme Insufficiency Is it more prevalent than reported? Does fecal pancreatic elastase reflect enzyme activity? What are some factors that can lead to inactivation of digestive enzymes? Xenobiotic exposure Genetic variations Dietary factors Microbial interactions

12 Digestive Enzymes as Food Supplements Digestive enzyme supplements can be derived from yeast, bacteria, animals, and plant sources. As dietary supplements, digestive enzymes can eliminate gastrointestinal discomfort by promoting the proper breakdown of food.

13 What are Digestive Enzymes? THE ROLE of DIGESTIVE ENZYMES

14 Why are enzymes necessary? Naturally produced in the body, but decline as we age Enzyme deficiencies also caused by diet, lifestyle or genetics Help stop discomfort such as occasional gas, bloating, indigestion and irregularity before it starts, by addressing the root cause Provide fast-acting relief of digestive issues versus probiotics, which may take longer to provide a noticeable effect Multiple enzyme combos are more effective vs. single enzyme Complete digestion of all major food groups: carbohydrates, protein, fiber, fat Vegetarian enzymes more effective as they work in a broader ph range versus other sources total GI system coverage Greater nutrient assimilation = increased energy utilization

15 Digestive Enzymes vs. Probiotics? DIGESTIVE ENZYMES Work across the entire GI system: stomach, small and large intestine Initiate digestive process by breaking-down food into smaller particles Digest multiple food groups based on selection of particular variants Provide significant support for food intolerance PROBIOTICS Live, friendly micro-organisms that confer a health benefit Work in the small (immune health) & large intestine (digestive health) Influence health and growth of beneficial bacteria in the GI system Don t actually digest food, but help resident microflora improve nutrient utilization Both are indispensable to digestive health

16 Are Supplemental Enzymes Effective in Pancreatic Insufficiency? Well-recognized clinical treatment Fungal enzyme preparations vs. pancreatin Better results -why? Acid-stable Broader range of enzymes More variants within enzyme classification Is there clinical evidence beyond PI? Other digestive complaints (IBS, SIBO, Leaky Gut, etc.) Food intolerance

17 Pancreatic Enzymes: Limited by Stability and ph

18 Review Article

19 Review Article Conclusion As reviewed in this paper, enzyme supplementation therapy may play an important role in several digestive and malabsorption disorders, such as EPI and lactose intolerance. Currently, the animal-derived enzymes represent an established standard of care, however the growing study of plant-based and microbe-derived enzymes offers great promise in the advancement of digestive enzyme therapy. Furthermore, a tailored probiotic addition to the enzyme supplement.seems to offer an advantage to the therapeutic management of such disorders.

20 The Low FODMAP Diet FODMAP is an acronym for: Fermentable fermentable foods (e.g., prebiotics) Oligosaccharides Beans and various vegetables. Disaccharides e.g., sucrose, lactose, etc. Monosaccharides primarily fructose And Polyols these are sugar alcohols often used as sweeteners. Some examples are xylitol, maltitol, and erythritol

21 The Low FODMAP Diet Excludes the following foods: Vegetables: Artichokes, asparagus, broccoli, beetroot, Brussels sprouts, cabbage, cauliflower, garlic, fennel, leaks, mushrooms, okra, onions, peas, shallots. Fruit:Apples, applesauce, apricots, blackberries, boysenberries, cherries, canned fruit, dates, figs, pears, peaches, watermelon. Dairy products: Milk (from cows, goats and sheep), ice cream, most yogurts, sour cream, soft and fresh cheeses (cottage, ricotta, etc). Legumes: Beans, chickpeas, lentils, red kidney beans, baked beans, soybeans. Wheat, barley and rye: bread, pasta, most breakfast cereals, tortillas, waffles, pancakes, crackers, biscuits. Beverages: Beer, fortified wines, soft drinks with high fructose corn syrup, milk, soy milk, fruit juices. Sweeteners: Fructose, honey, high fructose corn syrup, xylitol, mannitol, maltitol, sorbitol.

22 The Low FODMAP Diet A low FODMAP diet as a 7 to 10 day treatment is often effective for IBS, SIBO and other Functional Gastrointestinal Disorder (FGID) Certain auto-immune conditions/diseases like (potentially) rheumatoid arthritis, multiple sclerosis or eczema Fibromyalgia or other health issues that are triggered by certain foods Frequent migraines that appear to be triggered after certain meals

23 Is the FODMAP Diet Necessary?

24 Blends of Enzymes Broadest ph Range ENZYME SCIENCE: The Power of Thera-Blend

25 CRITICAL DIGESTION 3-in-1 Digestive Health Support Highest Potency Thera-blend Enzyme Formulation (Break More Bonds 3X stronger 6X faster) Proteases Amylases Lipases Cellulases Alpha Galactosidase DPPIV and More 1 Billion CFU Supportive Probiotics ATPro Blend 3 in 1 Per Capsule One Capsule with the First Bite of Food Supports Nutrient Absorption More Energy for Metabolic Function No. 1 Seller To Healthcare Professionals

26 COMPLETE DIGESTION Full Spectrum Daily Formula 1/2 the Potency of Critical Digestion Great Place To Start with New Patients One Capsule with the First Bite of Food Affordable 30 Count Bottle Therablend Enzyme Formulation (Break More Bonds 3X stronger 6X faster) 125 Million CFU Probiotic ATPro Blend Smaller Meals

27 Food Intolerance is a MAJOR cause of Digestive Disturbance Digestive Enzyme Supplements can help: Provide a solution for food intolerance Support against cross-contamination Address a spectrum of intolerances, or target a single, specific intolerance, like: Dairy Gluten Beans Carbohydrates

28 INTOLERANCE COMPLEX Targeted Enzyme Support Powerful blend to support Food Intolerances* Gluten Casein Lactose Phenols Bean & Veggie

29 Discovery of The Human Microbiome 29

30 What Influences the Microbiome?

31 A Quick Summary of Microbiome Research Advanced gene sequencing techniques have fueled an explosion of research Many key microbiota are not able to be cultured Microbial diversity is an important factor in health Dietary fiber, polyphenols, and other phytochemicals are critical The microbiome is influenced by MANY factors

32 Alterations in the Microbiome Links: Functional BD IBS GI infections Celiac disease Allergies Autism Metabolic diseases Obesity Malignancy Type 1 and 2 Diabetes NASH Depression

33 The connection between the gut microbiota and energy homeostasis and inflammation and its role in the pathogenesis of obesity-related disorders are increasingly recognized. The role of the Western diet, antibiotics and lifestyle in promoting an obesogenic microbiota is increasingly clear.

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35 A Dietary Fiber-Deprived Gut Microbiota Degrades the Colonic Mucus Barrier and Enhances Pathogen Susceptibility

36 The Leaky Gut Syndrome Higher antigenic load from the gastrointestinal tract leads to increased lymphocytes and ASDassociated cytokines, such as interleukin-1β (IL-1β), IL-6, interferon-γ (IFN-γ), and tumor necrosis factor-a (TNF-α), are present in the circulation and cross the blood-brain barrier (BBB).

37 Summary of the Gut Connection in ASD 70% of autistic children have significant GI symptoms Leaky gut in 36.7% of patients with ASD; <5% in controls Intestinal dysbiosis. Most, but not all, studies show significant disturbance Antibiotic-resistant, propionic acid producing bacteria increased in ASD Candida is two times more abundant in ASD individuals than in other individuals Clinical data show positive effects with: Probiotics, prebiotics, gluten and casein-free diets, and fecal matter transplants

38 Enzymes are Part of the Solution Practical guidelines: Selection of best formulation Application Patient profile Dosage recommendations Timing, potency, and gauging individual needs Side effects and interactions Answers to some common questions

39 Summary Digestive enzymes are critically important to the intestinal environment Digestive enzymes can provide significant benefit in functional GI disorders such as IBS, SIBO, leaky gut, and in the microbiome Digestive enzymes can directly and indirectly impact the gut-brain axis For best clinical response choose the right enzyme product and use at an appropriate dosage

40 Q & A Time Webinar Sponsored by TMC Ventures Europe/Enzyme Science UK Enzyme Science is a Practitioner Only range of Enzyme Food Supplements