A researcher proposes that supplementing small-intestine brush border enzymes in capsule form could treat multiple carbohydrate malabsorption disorders. Evaluate potential strengths and limitations of this approach for conditions like lactase deficiency and sucrase-isomaltase deficiency.

• A. Oral enzyme supplementation will universally worsen symptoms because exogenous enzymes cause immune reactions in 100% of patients and block all microbial fermentation required for health.
• B. This approach has no potential benefits because all carbohydrate digestion occurs exclusively in the colon where capsules cannot reach, so enzyme supplementation would be ineffective for any malabsorption.
• C. Enzyme capsules would permanently cure genetic enzyme deficiencies by inducing gene expression in the small intestine, solving all carbohydrate malabsorption disorders with a single daily dose.
• D. Strength: targeted enzyme replacement (eg, lactase capsules) can improve digestion of specific disaccharides and relieve symptoms. Limitation: effective delivery to brush border, variability in enzyme stability, timing with meals, and the need for different enzymes for different deficiencies (eg, sucrase-isomaltase deficiency may require a broader enzyme mix) reduce universal applicability; microbial fermentation and secondary effects may still occur if dosing is suboptimal.

Answer: (D)