Digestive Enzymes for Indigestion (Functional Dyspepsia)
Over-the-counter digestive enzymes are not a proven treatment for indigestion (functional dyspepsia). A handful of small trials report symptom relief, but the studies are low quality and major guidelines do not recommend enzymes for this condition.
Why this grade7-layer evidence engine
The evidence rests on just three small, short randomized trials, all reporting benefit but all flawed. A 2023 placebo-controlled trial (PMID 37976892, n=120, 8 weeks) found significant gains in dyspepsia quality-of-life, pain and sleep scores, but it was single-center with undisclosed funding. The most positive trial (DigeZyme, PMID 30156436, n=40) was run by the manufacturer's own founders and employees, a serious conflict of interest, and a 203-patient Chinese trial (PMID 25622633) had no placebo arm, so a true effect cannot be isolated.
No systematic review or meta-analysis supports enzymes for this use, and a 2023 review of functional dyspepsia therapy (PMID 36588474) does not mention them at all. Guideline-backed first-line care is H. pylori test-and-treat, acid suppression, prokinetics and neuromodulators. Mayo Clinic, Cleveland Clinic and Harvard all treat OTC enzymes for indigestion as unproven, noting supplements are largely untested and unregulated for dose and ingredient content.
Regulators like the FDA, NHS and WHO do endorse prescription pancreatic enzyme replacement therapy, but only for diagnosed exocrine pancreatic insufficiency, a separate disease, not ordinary indigestion. Borrowing that legitimacy for OTC products is misleading. The overall picture is a coherent weak (C) grade: a few small, mostly industry-tinged positive trials with no high-quality synthesis or guideline endorsement.
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 = 0.448
- 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