Lipase

Well-established for pancreatic insufficiency (prescription PERT). Over-the-counter lipase supplements for general digestive support have less rigorous evidence.

A rough internal score reflecting quantity, quality, and consistency of human evidence. Not a clinical recommendation.

Pancreatic enzyme replacement therapy (PERT) containing lipase is the standard of care for exocrine pancreatic insufficiency. For general digestive discomfort from high-fat meals, OTC lipase may reduce bloating and steatorrhea. Evidence quality for non-clinical use is lower.

• Essential for managing exocrine pancreatic insufficiency
• May reduce bloating and discomfort from high-fat meals
• Improves fat-soluble vitamin absorption when lipase is deficient

PERT: 25,000-75,000 USP lipase units per meal (prescription). OTC supplements: typically 3,000-10,000 FIP units per meal.

• GI cramps at high doses
• Nausea
• Diarrhea or constipation

High-dose lipase (as PERT) requires medical supervision. Fibrosing colonopathy risk with very high doses in cystic fibrosis patients.

Prescription PERT is well-supported, but OTC digestive enzyme blends with lipase have variable evidence. Individual response depends on degree of lipase insufficiency.

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