Role of Digestive Enzymes in Symptom Management of Irritable Bowel Syndrome and Lactose Intolerance: A Cross-Sectional Study
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Abstract
Background: Irritable bowel syndrome and lactose intolerance commonly present with overlapping gastrointestinal symptoms, including bloating, abdominal pain, flatulence, diarrhea, constipation, and post-meal discomfort. In settings where dairy products, milk tea, pulses, beans, and heavy mixed meals are frequently consumed, digestive enzyme supplementation may offer symptom-specific supportive benefit. Objective: To assess the association between digestive enzyme use and patient-reported symptom relief among adults with IBS-like and lactose intolerance-related gastrointestinal symptoms in Quetta, Pakistan. Methods: This cross-sectional observational study included 250 adults aged 18–60 years presenting with symptoms suggestive of IBS, lactose intolerance, or overlapping features. Data were collected using a structured questionnaire covering demographic characteristics, symptom patterns, dietary triggers, digestive enzyme use, and perceived symptom relief. Digestive enzyme users and non-users were described, and symptom-specific improvement among enzyme users was analyzed using frequencies, percentages, confidence intervals, and p-values. Results: Of 250 participants, 138 were female and 112 were male, with a mean age of 34.8 ± 10.6 years. IBS-only symptoms were reported by 96 participants, lactose intolerance-only symptoms by 58, and overlapping symptoms by 96. Digestive enzyme use was reported by 142 participants. Improvement was highest for bloating (79.6%), flatulence/gas (73.9%), and diarrhea after dairy intake (68.4%), followed by post-meal heaviness (64.1%) and abdominal pain (60.6%). Constipation showed the weakest improvement (37.3%). Conclusion: Digestive enzyme supplementation was associated with greater patient-reported relief of gas-related and dairy-associated symptoms than constipation-predominant complaints, supporting phenotype-directed use as an adjunctive symptom-management strategy.
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