Soft drinks, potato chips, candy, fast food. Tasty, yes. But also high in fat, added sugar and salt. Some researchers believe that a diet high in these types of food, along with a diet of highly processed foods, can be a factor in the development of digestive disorders. Other top factors include smoking, pollution, and genetics.

As consumers become aware that gut health contributes to overall health, demand for digestive health supplements is predicted to increase. Probiotics, prebiotics, enzymes, and fulvic acid are some types of digestive health supplements. Probiotics, prebiotics, and enzymes can also be found in some types of food, food which also contains many beneficial nutrients.

Probiotics are live bacteria and yeasts that are beneficial for the digestive system. They are found in foods such as yogurt,¹ kefir, unpasteurized sauerkraut, and kimchi. Probiotic supplements are used to treat antibiotic-associated diarrhea in adults and infectious diarrhea in infants and children. They are also given to people with Crohn’s disease, ulcerative colitis, and irritable bowel syndrome to help them maintain remission of their disease. Supplements contain various strains of probiotics, depending on the brand. Some popular brands of over-the-counter probiotic supplements that have been tested for use with gastrointestinal disorders include Align (Bifidobacterium infantis 35624), Culturelle (L. rhamnosus GG), and Florastor (Saccharomyces Boulardii).² 

Prebiotics are a type of plant-based fiber that the human body cannot digest. Prebiotics provide food for probiotics; together they maintain a healthy colony of bacteria and microorganisms in a person’s gastrointestinal tract. Prebiotics can be found in fruits, vegetables, and whole grains. Apples, garlic, onions, asparagus, barley, and oats are some foods that contain prebiotics. Most people get enough prebiotics in their diet if they eat a variety of fruits, vegetables, whole grains, and fermented foods, but for those that don’t, prebiotic supplements may be beneficial. Some popular brands of prebiotic supplements include Benefiber, Metamucil, and Fiber Choice.

Digestive enzymes break down food so that a person can absorb its nutrients. A majority of digestive enzymes are manufactured in the pancreas. Lipase breaks down fats. Amylase breaks down carbohydrates. Proteases and peptidases break down proteins. Doctors prescribe digestive enzyme supplements to people with cystic fibrosis, chronic pancreatitis, and pancreatic cancer. These conditions cause a person’s digestive enzyme levels to be low. Over-the-counter digestive enzyme supplements include lactase supplements to break down lactose, the sugar in dairy products, and alpha-galactosidase supplements, to break down the complex carbohydrates in foods such as beans, broccoli, cabbage, and cauliflower. Lactaid and Beano are two popular brands of these types of digestive enzymes, respectively.

Fulvic acid has been used in traditional Indian medicine for 3,000 years. Shilajit, a tar-like substance found in the Himalayas, Caucasus mountains, Altai Mountains and the mountains of Gilgit Baltistan, is created from the decomposition of plants. It contains soil-based organisms and is composed of 15-20% fulvic acid. Some believe that ingesting fulvic acid supplements such as shilajit can improve a person’s gut flora to treat such conditions as small intestinal bacterial overgrowth, irritable bowel syndrome, leaky gut, chronic constipation, and diarrhea. It’s believed that poor gut health caused by oxidative stress leads to chronic inflammatory diseases. As an antioxidant, fulvic acid is thought to counteract the oxidative stress.

Today’s market size shows the total global revenue for digestive health supplements in 2018 and projected for 2025. In Japan, the incidence of ulcerative colitis alone increased from 8 cases per 100,000 people in 1985 to 64 cases per 100,000 in 2005. In the United States, 60-70 million people are afflicted with digestive diseases according to the National Institute of Diabetes and Digestive and Kidney Diseases. The growing prevalence of digestive disorders in Japan, the United States, and several European countries has contributed to the increased demand for digestive health supplements. This is projected to continue through 2025. In the United States, probiotics constitute an overwhelming share of the digestive health supplement market. Currently three-quarters of the supplements sold are in the form of tablets and capsules, however; powdered supplements are expected to gain in popularity in the coming years due to consumer interest in organic ingredients and the convenience of being able to add powdered supplements to the foods they eat. Also, powdered supplements can be absorbed by the body faster. Nearly a third of the supplements sold worldwide in 2018 were manufactured in Italy, Japan, and the United States. Top manufacturers of digestive health supplements include Bayer AG, Amway, Nature’s Bounty Co., and NOW Foods, among others.

Irritable bowel syndrome (IBS) is a chronic disease that affects the large intestine. People with this disease experience cramping, abdominal pain, bloating, gas and diarrhea or constipation, or alternating bouts of diarrhea and constipation. Unlike inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease, IBS does not cause changes in bowel tissue, and sufferers are not at increased risk of contracting colon cancer.

Currently, a precise cause for this disease is not known, but it may be due to be a faulty interaction between the brain, the nervous system, and the gut. An overactive immune system may also be to blame in those sufferers who have increased numbers of immune-system cells in their intestines or those whose IBS developed after a severe bout of gastroenteritis brought on by a bacterial infection or virus.

Globally, 10-15% of the population has this disease, most under the age of 50. Symptoms of IBS can be triggered by stress and certain foods such as wheat, dairy products, cruciferous vegetables, and carbonated drinks. More women than men have IBS; in the United States, 2 out of 3 patients are women. Many women with this disease report worsening of symptoms around the time of their menstrual periods, indicating that hormonal changes may also be a trigger in some people.

In the United States, 25-45 million people suffer from IBS. Because signs and symptoms can indicate many different conditions, doctors have trouble diagnosing this disease. According to a survey by IFFGD,¹ a diagnosis of IBS typically takes more than 6 years after the onset of symptoms. Globally, 40% of patients have mild IBS, 35% a moderate form of the disease, and 25% a severe form. While IBS can affect a person’s emotional, physical, social and financial well-being no matter how mild or severe the symptoms, most patients taking prescription medication for their symptoms have moderate to severe IBS.

Today’s market size shows the worldwide irritable bowel syndrome treatment revenues for 2018 and projected for 2026. Growth in the market is expected over this time period due to a growing prevalence of the disease, especially IBS-C,² and doctors increasingly prescribing medications to treat it. Several new drugs to treat this disease, currently in clinical trials, are expected to come to market in the coming years. Pharmaceutical companies are also expanding their product offerings in several regions of the world. In January 2019, Ironwood Pharmaceuticals and AstraZeneca received approval to market Linzess, a treatment for IBS-C, in China, enabling them to sell their product to potentially tens of millions of more patients. In addition to Linzess, other leading brand-name treatments include Xifaxan, Viberzi, and Amitiza.³ Linzess/Constella⁴ generated the largest revenue in 2018. Some major manufacturers of IBS treatments include Ironwood Pharmaceuticals, Inc.; Allergan; Astellas Pharma, Inc.; Takeda Pharmaceutical Co. Ltd. AstraZeneca; and Sebela Pharmaceuticals Inc.