Still Bloated After Cutting Dairy and Gluten? What Digestive Enzyme Trials Actually Show

If you have already cut dairy and gluten and still feel bloated after meals, it is reasonable to ask whether a digestive enzyme could help. The honest answer depends on which enzyme, which food, and what is behind your bloating. Some enzymes have been tested against specific foods in controlled trials; others have mostly been studied in people with indigestion rather than bloating as such. Here is what the published trials report, and where they stop.

This article is for general education and is not medical advice. Persistent or worsening bloating should be checked by a doctor, and you should talk to your doctor before starting a supplement, especially if you take medication or have a diagnosed condition.

Why some meals cause gas

Carbohydrates that are not broken down and absorbed in the small intestine travel on to the colon, where bacteria ferment them and produce gas. Two well-known examples are lactose (the sugar in milk), in people who make little lactase, and the alpha-galactoside sugars in beans and some vegetables, which people lack the enzyme to digest. That is the logic behind taking an enzyme with the meal: break the carbohydrate down before it reaches the colon.^[1]

Alpha-galactosidase: beans and gas

Di Stefano and colleagues gave eight healthy volunteers a test meal of 420 g of cooked beans with 300 or 1,200 GalU of alpha-galactosidase or a placebo, in a randomised, double-blind design. The 1,200 GalU dose significantly reduced breath hydrogen (a marker of colonic fermentation) and the severity of flatulence, and both doses reduced the total symptom score.^[1]

In an older double-blind crossover study, Ganiats and colleagues fed 19 people a meatless chili meal with either alpha-galactosidase drops or placebo. Flatulence events per hour were lower with the enzyme, but the researchers found no difference in bloating or pain after the meal.^[2]

Results in irritable bowel syndrome (IBS) have been less encouraging. Hillilä and colleagues gave 125 people with IBS and bloating or flatulence alpha-galactosidase or placebo with meals for 12 weeks. They found no evidence to support routine use in IBS, and more people withdrew from the enzyme group than the placebo group.^[3]

The takeaway: alpha-galactosidase is best supported for what it was designed for, reducing gas from bean-type meals. It has not been shown to resolve bloating in general, and the evidence in IBS is not supportive.

Lactase: if dairy is the trigger

If you have cut dairy and feel better, lactose may have been part of the problem. In a randomised, double-blind, placebo-controlled crossover trial in 47 adults with lactose intolerance confirmed by breath test, Baijal and colleagues found that lactase tablets improved symptom scores and reduced breath hydrogen compared with placebo.^[4]

A broader systematic review by Shaukat and colleagues for the Annals of Internal Medicine is a useful counterweight: it concluded that most people with presumed lactose intolerance can tolerate 12 to 15 g of lactose (roughly a cup of milk), and that more studies are needed to establish how well the various treatments work.^[5] In practice, lactase may help some people enjoy dairy again, but it will not help bloating that has nothing to do with lactose.

Gluten-digesting enzymes: early evidence only

Ido and colleagues tested a mixture of protein-digesting enzymes from microbial and papaya sources in people with non-coeliac gluten sensitivity, using a single-blind crossover gluten challenge. The enzyme mixture reduced the rise in symptom scores after gluten compared with placebo.^[6] This is a single small study of one specific blend, and enzymes are not a substitute for a gluten-free diet in coeliac disease. If you suspect coeliac disease, get tested before changing your diet.

Multi-enzyme blends and indigestion

Several placebo-controlled trials have tested broad enzyme blends in functional dyspepsia (recurring upper-abdominal discomfort without an obvious cause):

• Ullah and colleagues randomised 120 adults to a fungal multi-enzyme blend or placebo for two months and reported improvements in dyspepsia-related quality of life, pain severity and sleep quality, without side effects.^[7]
• Majeed and colleagues randomised 40 patients to a multi-enzyme complex or placebo for 60 days and reported significant improvements across their dyspepsia measures, with no product-related adverse events.^[8]
• In a multicentre crossover trial in 151 patients, Ran and colleagues found that two weeks of an enzyme preparation reduced dyspepsia symptom severity compared with placebo; abdominal distension was among the individual symptoms that improved.^[9]

Each of these tested a particular formula in a particular group of people, so the results cannot be transferred directly to any other product. They do show that enzyme blends have been studied in controlled trials and were generally well tolerated in them.

How to use these findings

• Match the enzyme to the food. Lactase for dairy, alpha-galactosidase for beans and similar foods. Trials tested the enzyme alongside the meal it was meant to act on.
• Take it with the meal. Enzymes act on food that is present; in the trials above they were given with the test meal.
• Do not use enzymes to mask symptoms that need investigating. Ongoing bloating, weight loss, blood in the stool, or bloating that wakes you at night are reasons to see a doctor.

Where The Vital Co. fits

Vital Digestive Enzyme Pro Blend includes both of the enzymes discussed above: lactase (600 LACU) and alpha-galactosidase (300 GALU) per capsule, alongside bromelain, papain, fungal lipase and the Makzyme-Pro™ protease blend. It is designed to be taken at the start of a meal. The trials above tested other formulas, not this product, so they describe what those enzymes have been shown to do rather than promise a result.

If you also want to support the gut bacteria side of digestion, the De-Bloat & Digest Stack pairs Vital Digestive Enzyme Pro Blend with Vital Gut Restore, a 13-strain, 20 billion CFU probiotic.

References

1. Di Stefano M, et al. The effect of oral alpha-galactosidase on intestinal gas production and gas-related symptoms. Digestive Diseases and Sciences. 2007. DOI: 10.1007/s10620-006-9296-9 (PMID 17151807)
2. Ganiats TG, et al. Does Beano prevent gas? A double-blind crossover study of oral alpha-galactosidase to treat dietary oligosaccharide intolerance. Journal of Family Practice. 1994. PMID 7964541
3. Hillilä M, et al. Does oral α-galactosidase relieve irritable bowel symptoms? Scandinavian Journal of Gastroenterology. 2016. DOI: 10.3109/00365521.2015.1063156 (PMID 26133538)
4. Baijal R, et al. Effect of lactase on symptoms and hydrogen breath levels in lactose intolerance: A crossover placebo-controlled study. JGH Open. 2021. DOI: 10.1002/jgh3.12463 (PMID 33490624)
5. Shaukat A, et al. Systematic review: effective management strategies for lactose intolerance. Annals of Internal Medicine. 2010. DOI: 10.7326/0003-4819-152-12-201006150-00241 (PMID 20404262)
6. Ido H, et al. Combination of Gluten-Digesting Enzymes Improved Symptoms of Non-Celiac Gluten Sensitivity: A Randomized Single-blind, Placebo-controlled Crossover Study. Clinical and Translational Gastroenterology. 2018. DOI: 10.1038/s41424-018-0052-1 (PMID 30228265)
7. Ullah H, et al. Efficacy of digestive enzyme supplementation in functional dyspepsia: A monocentric, randomized, double-blind, placebo-controlled, clinical trial. Biomedicine & Pharmacotherapy. 2023. DOI: 10.1016/j.biopha.2023.115858 (PMID 37976892)
8. Majeed M, et al. Evaluation of the Safety and Efficacy of a Multienzyme Complex in Patients with Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study. Journal of Medicinal Food. 2018. DOI: 10.1089/jmf.2017.4172 (PMID 30156436)
9. Ran ZH, et al. The efficacy of Combizym in the treatment of Chinese patients with dyspepsia: a multicenter, randomized, placebo-controlled and cross-over study. Journal of Digestive Diseases. 2009. DOI: 10.1111/j.1751-2980.2008.00361.x (PMID 19236546)