Selena De Vries, RD on Digestive Enzymes for Celiacs: Yay or Nay?
Here’s a question that was submitted to Selena De Vries, RD during a recent Tuesday Instagram Q & A.
Question – What are your thoughts on digestive enzymes?
Answer – Digestive enzymes are made up of proteins that help to degrade different types of molecules – carbohydrates, fats, and proteins. They can be helpful in a few circumstances.
#1 You have been diagnosed with pancreatic insufficiency. This is a condition in which your pancreas does not make enough digestive enzymes to adequately digest your food leading to digestive distress. It is relatively rare but if you have this condition, you will be prescribed enzymes from your gastroenterologist.
#2. You have lactose intolerance. At the beginning of diagnosis, a secondary lactose intolerance can develop and it is common in celiac disease because of small intestinal damage. However, it’s important to understand that lactose intolerance does not mean eliminating all dairy containing foods. Only certain dairy products contain lactose and with lactose intolerance, it is often dose dependent. This means you can have some lactose containing dairy until you hit your unique threshold. Once you pass your threshold, symptoms develop. So, sometimes short term use of an over the counter lactase enzyme taken with food can help so you don’t need to also restrict lactose containing foods from the diet.
#3. You have a FODMAP sensitivity of either of the following: galactans, fructans. FODMAP is a acronym that includes carbohydrates that are highly fermentable and can cause GI distress in susceptible individuals. If you have persistent symptoms, this may be due to an additional diagnosis such as irritable bowel syndrome (IBS). The low FODMAP diet is a short term exclusionary diet that is an evidence based diet to help manage this condition. With celiac disease, there is often a significant shift in the diet towards foods that contain FODMAPs and this is actually a common cause of persistent symptoms in people with celiac. Taking enzyme supplements that are targeted toward the specific FODMAP group that the person is unable to tolerate helps to expand the diet and improve enjoyment of food.
- However, most people wonder about taking just a general over the counter digestive enzyme.
- These won’t do anything to help digestion. It will drain your pocket of money though!
- Your pancreas works just fine if you’ve been diagnosed with celiac. There is no reason to supplement with a general digestive enzyme just because you’ve been diagnosed.
Further to this, even if you have persistent symptoms, they contain such minute amounts of multiple different enzymes, that they don’t contain enough of any one type to be helpful.
And, they are quite costly. Save your money and work with an experienced gut health dietitian, like myself, if you’re struggling with symptoms.
When it comes to enzyme supplementation, it’s all about understanding the person’s symptoms and tailoring the recommendations to the specific individual. Generalized advice isn’t going to help anyone find relief.
I’m Selena – THE CELIAC DIETITIAN
I operate an online private practice specializing in the dietary management of celiac disease and the gluten free diet. And, I’m celiac too.
As the go-to expert on everything gluten free, I help people master the gluten-free diet so they can live gluten free with more ease.
I take the ‘complicated’ out of the gluten free diet, and give you the practical and realistic advice you need so you can still live your life!
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• Media – Work with Selena
‘Q&A Tuesdays on Instagram’
Your chance to submit any questions you may have on nutrition, education or receive downright free advice! Fellow celiac and expert Gluten-Free Dietitian, Selena De Vries, RD, is eager to help! Ask by 4pm Pacific Time and get your answer the same day!
How it works!
1. Visit Selena’s profile at https://www.instagram.com/celiac_dietitian/
2. Click on her profile picture (screenshot 1)
3. Wait until you see the “ask me a question” sticker and then click it and type your question (screenshot 2)
4. Receive your answer by clicking through Selena’s stories i.e. the same spot where you entered your question
- Does it feel like celiac disease is taking over your life?
- Do you want a solution that makes celiac feel less overwhelming and less stressful so you can get back to living and loving your life?
- Are you thinking about celiac from the time you wake up, to the time you go to bed?
- Are you worried about cross contact? ,
- Does eating out feel frustrating?
- Are you experiencing persistent symptoms?
- Does celiac disease often creep into your thoughts?
Well, no more. You’re in the right place now. And, it’s time for this to change!
Selena’s Services
Live Gluten Free with More Ease – Hybrid Group Program – Master the Gluten Free Diet
This online program combines 1:1 support and group coaching support. Sky rocket your knowledge beyond what most healthcare providers know and kick anxiety and stress to the curb. This hybrid program is the ultimate, A-Z, course that will help you live gluten free with more ease.
Learn more
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Eat Out with Confidence – Group Coaching – Become a Celiac Savvy Restaurant Diner
If you find yourself avoiding eating out because of anxiety around cross contact, not knowing the right questions to ask, or not trusting that the staff are taking you seriously, then this online, group coaching course is for you.
Learn more
Apply now
1:1 Individual Coaching – Receive an Individualized Action Plan
This online service is best suited to help people find relief of persistent symptoms such bloat, constipation, reflux, or fatigue. It is also helpful for newly diagnosed and people who prefer to work, solely, in a 1:1 capacity.
Learn more
Apply here