Digestive Enzymes for Bloating
Digestive enzymes help only when matched to a specific trigger sugar: lactase for lactose and alpha-galactosidase for beans can ease the related gas, but the generic multi-enzyme blends most people buy for everyday bloating have little reliable evidence behind them.
Why this grade7-layer evidence engine
The grade is weak because the evidence splits sharply by enzyme. Targeted, substrate-specific enzymes have niche support: in lactose-intolerant patients, lactase cut cumulative breath hydrogen by about 55% and improved symptom scores (PMID 33490624), and alpha-galactosidase reduced bean-related gas and breath hydrogen (PMID 17151807), even cutting days of moderate-to-severe bloating in a small pediatric trial (PMID 24063420).
But the effect is mostly on flatulence, not bloating itself, and it does not generalize. The 1994 Beano trial reduced gas frequency yet found no significant change in bloating or pain (PMID 7964541), the pediatric study showed no effect on distension (PMID 24063420), and a 2021 crossover in IBS patients was outright negative (PMID 33619835). All trials are small (n=8 to 120), and no meta-analysis exists for bloating as a standalone symptom.
Crucially, the generic multi-enzyme blends sold for nonspecific bloating rest only on small functional-dyspepsia trials that did not enroll bloating patients or isolate bloating as an endpoint, one of which tested the maker's own product (PMID 37976892; PMID 30156436, industry-funded). Regulators (FDA, NHS, WHO) endorse only prescription pancreatic enzymes for diagnosed pancreatic insufficiency, a different drug and condition, and Mayo Clinic stays cautious about broad use, so the popular over-the-counter claim earns only a weak, warning-flagged rating.
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditable▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.472
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 無高階證據可裁決
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status