4 Prokinetics to Banish Bloat
Did you know between 16-31% of the US population suffers from chronic bloating? That's a staggering statistic, and if you're reading this, you're likely among the many individuals who have experienced the discomfort and frustration of a bloated belly. If you've already tried numerous approaches without a lasting solution, I'd like to introduce you to a powerful tool that can help: prokinetic supplements.
In this blog post, we'll explore the definition of a prokinetic, who can benefit from one, how they work, and we'll dive into four specific prokinetic supplements that can help you on your journey towards a happier, healthier gut.
What is a prokinetic?
To understand prokinetics, you first need to understand a few digestive basics. When you swallow food, it travels through your stomach to the small intestine, and exits your body via the colon. But the food you eat doesn’t just magically make it from Point A to Point B all on its own. Your digestive tract is covered with smooth muscles that periodically contract to propel food forward as you digest and absorb its nutrients.
The muscular contractions responsible for this movement are activated through the coordinated efforts of the smooth muscles in your digestive tract, hormonal signaling, and your nervous system. Collectively, these periodic wave-like contractions are called the Migrating Motor Complex (MMC). The MMC acts on the stomach, the small intestine, and the bowels. (You can learn more about your MMC here!)
Prokinetic supplements act on the hormones or neurotransmitters that control the contractions of your MMC. In doing so, they promote motility in your stomach or small intestine, and help address digestive disturbances such as bloating and constipation.
Prokinetics are not the same as laxatives. Laxatives work by adding bulk to your stool, bringing more water into the bowel, or stimulating the large intestine for a bowel movement. Although prokinetics can help improve bowel regularity, their specific function is not to stimulate a bowel movement – it’s to improve motility.
Who can benefit from a prokinetic?
Anyone who experiences chronic bloating, digestive discomfort, or irregular bowel movements due to slow or impaired motility can potentially benefit from prokinetic supplements.
Prokinetics are also useful in treating the root causes of conditions like small intestinal bacterial overgrowth (SIBO, learn more here). SIBO is a cause for severe, and often chronic, bloating related to too many bacteria living in the wrong neighbourhood of your gut. One causative factor for SIBO is slowed gut motility. This allows for the bacteria from the colon to move into the small intestine where they can cause symptoms of bloating and food intolerances, especially with carbohydrates. Prokinetics can be a useful tool when addressing root causes for SIBO.
How do you know if you have slow motility?
Having a quick look in the toilet bowl after a bowel movement can drop a few clues about your digestive motility. For example, the Bristol Stool Chart is used to classify bowel movements based on consistency. Type I (separate, hard lumps) or type II (sausage-like but lumpy) bowel movements are usually indicative of constipation and indicate slow transit time.
Alternatively, you can also try the beet test. Beets turns your stool a reddish colour which makes this test simple. You consume a large serving size of beets and measure how long it takes for the beets to pass through your system. They should change your stool a reddish-brown colour. More than 24 hours generally indicates a slow transit time. (Click here to read about the beet test.)
Some other signs of slow motility include:
Gas
Bloating
Constipation
Excessive burping
Heartburn/reflux
Excessive fullness after eating
Nausea
Do I need a prokinetic?
Multiple factors can impair or slow motility:
Chronic stress
Nutrient deficiencies
Diets high in refined carbohydrates and sugar
Low fiber diet
High-fat or ketogenic diet
Regular, daily snacking
Medical conditions like diabetes, hypothyroid, or Parkinson’s disease
Emotional/psychological trauma
Concussion/traumatic brain injury
Food poisoning
Side effects of medication
If you've tried various approaches, such as dietary changes, stress management techniques, and gut-healing protocols without finding lasting relief, prokinetics may offer the missing piece to your puzzle. However, it's essential to consult with a qualified healthcare professional or nutritionist, like myself, to determine the right prokinetic supplement and dosage for your specific needs.
How do you know if a prokinetic will be helpful?
Because of how they work, prokinetics can be helpful for individuals with slow transit constipation, irritable bowel syndrome with constipation (IBS-C), small intestinal bacterial overgrowth (SIBO), and gut-brain axis dysregulation.
It’s important to note that there are often many factors that have the potential to impact gut motility. Therefore, it’s essential to make sure you are addressing things like diet, exercise and movement, stress, and sleep before diving headlong into prokinetics. Otherwise, they just end up being a Band-Aid fix rather than a tool to optimize your gut health. This is where it can be useful to work with a trained professional, like a nutritionist or dietician, who can make recommendations for the whole picture.
Prokinetic supplements
As mentioned, prokinetics work through various mechanisms to support the function of your MMC. This can improve gastrointestinal motility in your stomach and small intestine. Let's explore four options and how they work.
Ginger:
Ginger is a versatile herb known for its medicinal properties and it has been used for centuries in traditional medicine. It contains active compounds, such as gingerols and shogaols, which have been shown to promote digestive health.
Ginger has been shown to increase motility in the stomach during periods of fasting and after eating a meal. Because its action is on the stomach, rather than the intestines, ginger is often useful for individuals who have upper digestive complaints such as excessive burping, upper abdominal bloating or fullness, indigestion, and acid reflux.
How to use it: For mild symptoms, sip on warm ginger tea during or after meals to promote gastric motility. You can also supplement with ginger capsules, 100 to 500mg of ginger extract before meals. A combination of ginger and artichoke (see below) has been well studied for improved symptoms of upper abdominal pain, fullness, nausea, and bloating.
Artichoke:
Artichoke is well known in both traditional and modern medicine as a plant ally that supports digestion. It contains compounds like cynarine and luteolin, which stimulate bile production and enhance bile flow.
In a randomized placebo-controlled double-blind cross-over study was conducted with 20 participants who were administered a single dose of artichoke extract. Thirty minutes after administration there was an increase of bile by 127.3%; 60 minutes, 151% increase in bile secretion; and after another 60 minutes, there was an increase of 94% in bile secretion when compared to baseline.
Although it is not well understood how artichoke extract improves motility, it is thought to do so through its action on bile because bile is well known for increasing motility in the small and large intestine. Because of these properties, artichoke extract has the potential to have the most benefit for individuals who experience lower abdominal bloating, constipation, and excessive gas.
How to use it: Artichoke extract can be taken as a supplement as a capsule or tincture. Taking 320mg of plant extract twice daily was indicated in the above study to have beneficial results.
5-HTP:
5-HTP (5-Hydroxytryptophan) is the natural precursor to serotonin that can be taken as an amino acid supplement. This results in increased serotonin levels in the brain and gut. Serotonin is one of the most important hormones for the gut, and about 95% of your body’s serotonin is stored in specialized cells in the gut walls. Serotonin is one of the main hormones that controls activity of the MMC in your small intestine and colon.
Low serotonin levels in the gut have been associated with slowed intestinal MMC. By increasing serotonin availability, 5-HTP has the potential to support improved transit time, regular bowel movements, and alleviate symptoms of lower abdominal bloating.
How to use it*: Some individuals may be sensitive to 5-HTP due to its influence on serotonin in the body. Start slow (e.g., 50-100mg) and gradually increase your dose to see how you respond. Generally, it’s safe to take 150 to 300mg in divided doses per day. 5-HTP should be taken on an empty stomach for best results.
Acetyl-L-Carnitine:
Acetyl-L-carnitine is a precursor in the synthesis of acetylcholine, a neurotransmitter that regulates various physiological processes, including gut motility. By increasing acetylcholine levels, acetyl-L-carnitine enhances communication between nerve cells and smooth muscle cells in the digestive tract, promoting more efficient contractions and improving gut motility. This can lead to alleviation of slow gut motility symptoms, such as bloating and constipation, and support overall digestive health.
How to use it*: Acetyl-L-carnitine is often found in combined supplements that support gut motility, such as Cyto-Matrix’s GI Motility Matrix and Apex Energetics Acetyl-CH Active. It can also be taken as an individual supplement. Take as directed on the supplement packaging.
*IMPORTANT NOTE: 5-HTP and acetyl-L-carnitine may interfere with serotonin-enhancing drugs and other medications. Check with your doctor or pharmacist before taking these supplements.
Chronic bloating can be a frustrating and uncomfortable experience, but it doesn't have to be a lifelong struggle. By exploring the world of prokinetic supplements and incorporating them into your holistic approach, you can support your body's natural digestive processes and find lasting relief from bloating. Remember, it's important to consult with a qualified healthcare professional or nutritionist, like myself, to determine the most suitable prokinetic supplement and dosage for your unique needs.
If prokinetics sound like they could be a good fit for you, click here for a special 10% discount off of Cyto-Matrix’s GI Motility Matrix, which combines all four of these prokinetic supplements in one complete formula. (Note: You’ll have to create a FullScript profile to access the deal.)
If you're ready to transform your bloated belly into a happy gut with lasting results, I invite you to reach out for 1:1 nutrition coaching. Together, we can create a personalized plan that incorporates prokinetics and other effective strategies to support your digestive health and overall well-being. Say goodbye to Band-Aid solutions and hello to your vibrant, bloat-free life!
