Research has shown that a diet that is low in fermentable oligo-, di-, monosaccharides and polyols (FODMAPs) helps manage abdominal pain, bloating, and other digestive symptoms in 70-75% of patients with irritable bowel syndrome (IBS). However, the low-FODMAP diet can be challenging and access to registered dietitians (RDs) and other healthcare providers trained in the low-FODMAP diet is limited.
I would know.
I’m an RD with a specialty in gastrointestinal (GI) nutrition, and I provide education and resources on FODMAP intolerances to gastroenterologists (GIs), nurses, RDs and other providers.
I’m also part of the team at Kiwi Biosciences, the biotechnology company behind FODZYME. FODZYME is a novel digestive enzyme blend specifically designed to break down the most common FODMAP triggers: fructan, galacto-oligosaccharides (galactans/GOS) and lactose.
FODZYME’s Founding Story
FODZYME was developed based on personal experience. When Anjie, our cofounder and CEO, was forced to restrict herself from enjoying her favorite foods on an effective (yet frustrating) low-FODMAP diet, she rallied a group of world-class experts in research, medicine and nutrition to create a scientific approach to break down FODMAPs before they cause digestive distress. This novel approach to managing FODMAP intolerance led to the creation of FODZYME and enabled her to put foods like garlic, onion, wheat, chickpeas and more back in her life.
Some patients find the low-FODMAP diet too hard to follow. They may experience cravings, increased food stress and anxiety, development of disordered eating behaviors, nutrient deficiencies and troubling alterations in gut microbiota.
Since day one, our mission with FODZYME has been to provide digestive relief and improve the quality of life for patients with FODMAP issues. We’ve very much valued our partnerships with professional gastroenterology organizations, research institutions, hospitals, clinics and our world-class advisors, including Dr. Bill Chey, chief of the division of gastroenterology and hepatology at Michigan Medicine. Digestive enzymes are increasingly recognized as a highly effective tool for those with FODMAP intolerances to ensure nutritional adequacy, dietary flexibility, symptom relief and quality of life.
The Power of Digestive Enzymes
Broadly speaking, enzymes are specialized proteins (chains of amino acids) folded in particular ways. FODMAP-targeting digestive enzymes are designed to break down FODMAPs in foods before they can trigger symptoms.
There’s a mature body of research supporting the efficacy of digestive-enzyme use for FODMAP intolerance, and their long-term safety is well-recognized. However, I’ve found many healthcare providers rarely utilize this science with patients until they learn about FODZYME.
In fact, guidelines published in the Journal of Neurogastroenterology and Motility on how to implement the low-FODMAP diet into gastroenterological and nutrition practice recommend the use of digestive enzymes for symptom management and to allow for more dietary flexibility during the third personalization phase of the low-FODMAP diet.
Monash University, the leading research institution on FODMAPs and the low-FODMAP diet, also recommends use of digestive enzymes to enable a less restrictive diet long-term while managing symptoms. For example, digestive enzymes allow for increased intake of tofu, peas, legumes, nuts, soy, whole grains, dairy and many other nutrient-rich, high-fiber foods to avoid nutritional deficiencies and their consequences.
Digestive enzymes are also recommended prior to or in lieu of a traditional low-FODMAP diet in patients with bloating, gas and other lower-GI symptoms who are not good candidates for the three-phased diet. Those who already identify high-FODMAP foods as triggers (such as garlic, onion, wheat and beans) can benefit from digestive enzymes right away. Patients at increased risk for disordered eating or with other contraindications for a restrictive diet (e.g., children and the elderly) can use enzymes alongside their existing diet.
A Scientific Approach
FODZYME represents two layers of innovation: a highly efficacious powder format and a proprietary fructan hydrolase enzyme. Let’s dive into both.
The importance of a powder format
It’s crucial to maximize FODMAP-enzyme homogenization as soon as a meal is consumed, which is why FODZYME is a powder. FODMAP-targeting digestive enzymes begin work as soon as they come into contact with FODMAPs and are most effective when they can freely homogenize with food. A powder facilitates greater contact between the enzymes and their target FODMAPs at the post-prandial gastric pH most favorable to FODMAP breakdown, which leads to greater efficacy than a pill or capsule.
In fact, digestive enzymes in capsules or pills are a less efficacious method for delivering carbohydrate-targeting enzymes, as they isolate enzymes from their intended target and may be deactivated in the stomach before coming into contact with FODMAPs. (Note: this is not the case for prescription enzymes; these enzymes are generally encapsulated to delay release until arrival in the small intestine.)
FODZYME’s Novel Fructan Hydrolase Enzyme
FODZYME is a blend of natural enzymes featuring fructan hydrolase, lactase and alpha-galactosidase. FODZYME’s fructan hydrolase adds to the scientific and clinical field with its novel ability to break down the broad spectrum of fructans, including levan, inulin and fructooligosaccharides, which each vary in their chain length and linkages.
Fructans are widely recognized as the most common FODMAP trigger in IBS.
Furthermore, fructans and galactans/GOS provide particular benefits for digestive health by supporting short-chain fatty acid production (SCFA). These fibers are also in many high FODMAP foods that patients may have trouble tolerating. We’ve conducted extensive peer-reviewed research, published in the journal Gastro Hep Advances, to confirm that FODZYME administration with prebiotic fiber reduces but does not deplete SCFA production, suggesting that use of digestive enzymes with prebiotic-rich foods is favorable to overall colonic health than avoiding FODMAPs altogether.
In other words, with digestive enzymes, patients can more readily follow a high-fiber diet and benefit from fiber’s protective role against many gastrointestinal diseases, such as colon cancer.
Ongoing Research
Our team and research partners are regulars at the top nutrition and GI conferences, where we frequently exhibit and present. In 2022, we presented our findings at Digestive Disease Week (DDW) on FODZYME’s in-vitro efficacy.
We recently presented three abstracts on our clinical work at conferences including the Food & Nutrition Conference & Expo (FNCE), the American College of Gastroenterology (ACG) and North American Society for Pediatric Gastroenterology and Nutrition (NASPGHAN). Findings from these studies showed that after four weeks of FODZYME use, patients reported significantly less bloating, diarrhea, constipation and abdominal pain. While I cannot reveal too much here, we anticipate having additional publications on our clinical research to share in 2025.
Furthermore, our R&D on additional ways to develop products that support those with digestive issues continues. In our pipeline are novel approaches to tackle additional FODMAPs groups, like polyols such as mannitol and sorbitol.
Supporting Providers
Standard training for healthcare providers rarely covers in any depth how to integrate digestive enzymes into patient care. The educational programming I run aims to change that.
Our resources for healthcare providers include training on how to manage FODMAP intolerances while minimizing the impact of dietary restriction. We offer dozens of free trainings and materials for the clinicians, such as:
- Webinars: Presented by expert GI clinicians, our free continuing-education webinars cover a wide-range of GI nutrition topics.
- Educational handouts: Our free handouts for patients provide accessible, practical education on FODMAPs and how to effectively use digestive enzymes. The library also includes time-saving resources for providers to reference in their practice.
- Clinic trainings: As an RD with deep expertise in FODMAPs and digestive enzymes, I often present on clinical application of enzymes and how to integrate them into the patient-care process.
- 1:1 Calls: Providers come to me with specific questions on complex cases, counseling approaches and our research, and I welcome the opportunity to share my knowledge with them.
It’s a privilege to support the diverse community of healthcare providers in our network. All these resources are available on demand on our website, fodzyme.com/partners.
Beyond background on FODMAPs, the benefits and potential cons of a low-FODMAP diet and the science of FODMAP-targeting enzymes, points I emphasize are:
How to identify FODMAP intolerances
FODMAPs tend to cause trouble 4-8 hours after a meal, which is when they generally reach the colon and trigger gas, bloating, diarrhea, constipation and abdominal pain. This can be a very helpful clue to watch for when helping patients get to the root of what may be driving symptoms. This also means that when using FODMAP-targeting enzymes, patients should expect to see a benefit roughly 4-8 hours after a high-FODMAP meal.
The pathogenesis of FODMAP intolerance
Except for lactase, the body does not produce enzymes for FODMAPs. Rather, FODMAP intolerances arise from alterations in the gut microbiota (dysbiosis), increased sensitivity to digestive processes (visceral hypersensitivity), their osmotic effect, and other miscommunications between the gut-brain-axis, although research remains ongoing.
Contraindications for the low-FODMAP diet
Restrictive diets must be implemented with extreme sensitivity in many groups, such as children, the elderly, pregnant women and other populations with additional energy and nutrient needs or challenges meeting them. Patients with low interest or ability to implement a low FODMAP diet are also less likely to find symptom relief if they do try to follow one. These patients are better suited to a simplified FODMAP approach or alternative interventions.
Safety profile of digestive enzymes
Over-the-counter digestive enzymes work on food (not the body). The enzymes will be metabolized like any other dietary protein if they do not break down in contact with FODMAPs, and their byproducts are excreted. They can be safely used as frequently as, and for as long as, FODMAP intolerances persist.
FODMAP Freedom
I’m passionate about educating on how digestive enzymes provide benefits beyond symptomatic relief by enabling a more nutrient- dense, diverse diet. The many providers using FODZYME with their patients support us in our mission, as well. The most rewarding moments are when I hear success stories about how their patients are enjoying the foods they love without worry or pain.
“The best compliment I get from my patients is when they finally have freedom to eat what they love. FODZYME is so small [and] easy to use and now my patients can go out to their favorite restaurants. My patients have been enjoying high-fiber meals that are painless and make them feel good.”
— Dr. Kumkum Patel, M.D., board-certified gastroenterologist specializing in IBS
Dietary freedom also means patients can enjoy the integral cultural and social role food plays. From feeling free to join a communal family meal, to having the confidence to enjoy a catered meal at a friend’s wedding, patients who have been reluctant to expand their diet due to food fears or anxiety gain invaluable psychological benefits from digestive enzymes.
“This has been life-changing. I’m able to dine out without worry. I no longer have excessive bloat after those meals.”
— Jennifer, FODZYME user of three years
Conclusion
For those with IBS, digestive enzymes allow for a tailored, nutritionally robust diet. Dietary flexibility and inclusion of delicious, high- FODMAP foods is possible with digestive enzymes, even among the most FODMAP sensitive.
Our commitment at FODZYME is to educate healthcare providers on dietary and non-dietary lifestyle strategies to manage digestive symptoms. We all know IBS is a chronic condition that requires lifelong management. This makes it especially vital that providers can ensure their patients achieve adequate nutritional intake and can enjoy the many psychosocial pleasures of food with a plan that is sustainable on the long-term.
Foods FODZYME Helps Patients Tolerate:
