A double-blind, placebo-controlled study published in the Scandinavian Journal of Gastroenterology (2005; 40(11):1304–1312) examined whether digestive enzyme supplementation could reduce symptoms in patients with celiac disease during controlled gluten exposure.
The study involved 21 patients with biopsy-confirmed celiac disease who were in remission and following a strict gluten-free diet. Participants were randomly assigned to receive either a digestive enzyme supplement or a placebo. Both groups were then challenged with crackers providing 0.9 grams of gluten per day. After a 10-week washout period, the groups were crossed over so that those who initially received placebo received enzymes and vice versa.
Eight of the 21 patients (38%) experienced more than five episodes of moderate to severe symptoms during one or both gluten challenge periods. In this subgroup, symptom scores were significantly lower during the enzyme supplementation phase compared with the placebo phase (p < 0.02). This suggests that digestive enzyme therapy may help reduce symptoms in some individuals with celiac disease who are inadvertently exposed to small amounts of gluten, though it does not replace a gluten-free diet.
