When to Use Supplements for Bloating & Gut Health

There are several supplements marketed for gut health and bloating. Some supplements, such as digestive enzymes and probiotics, have reportedly been helpful in certain conditions that can lead to bloat, such as intolerance to foods or gastrointestinal (GI) symptoms.

Bloating isn't always a sign there's something wrong with your health, but it can cause discomfort. The best way to manage bloating is to determine the cause. While supplements may be a beneficial complementary treatment, preventing the underlying cause is key to addressing issues with bloat.

This article reviews the research behind supplements used for gut health and when they may be appropriate to use.

What Causes Bloating?

Gas in your GI tract (or gut) is a normal part of the digestive process. This gas is eliminated in one of three ways, as follows:

• Burping
• Flatulence (passing gas)
• Abdominal bloating

Bloating does not necessarily mean that there is something wrong with your gut. It is simply a result of air getting trapped in the colon or small intestine. Your stomach may feel enlarged and full.

There are several potential causes of abdominal bloating, such as:

• Poor eating habits (eating too fast, overeating)
• Constipation
• Menstruation
• Food intolerance or sensitivities
• GI conditions, such as inflammatory bowel disease (IBD, including Crohn's disease and ulcerative colitis), celiac disease, small intestinal bacterial overgrowth (SIBO), or gastroparesis
  

Digestive Enzymes

Digestive enzymes help break down the food you eat so it can easily be absorbed. Digestive enzymes include:

• Amylase
• Lactase
• Protease
• Lipase
• Maltase
• Sucrase

Enzymes are produced in the body. However, some people with digestive conditions have problems making or using digestive enzymes, which can lead to nutrient deficiencies.

People with exocrine pancreatic insufficiency (EPI) or cystic fibrosis (CF) with secondary malabsorption typically require additional enzymes. This is often referred to as pancreatic enzyme replacement therapy. In this case, a healthcare provider will prescribe the enzymes and the dosage.

People who have lactose intolerance don't make enough lactase. To remedy this, they can either avoid foods with lactose or take lactase with their meals. Since lactose is mostly in dairy foods, special attention should be taken to make sure calcium and vitamin D needs are met from sources other than dairy.

Alpha-galactosidase is an enzyme blend available over the counter (without a prescription) that helps break down beans and legumes. Alpha-galactosidase appears to reduce gas production in people who have trouble digesting beans.

Ginger

Ginger root is a spice used in cooking but is also used in the treatment of various conditions. Ginger appears to have anti-inflammatory and antioxidant properties.

Unscientific reports claim that ginger alleviates abdominal pain and soothes the digestive system. It is commonly used for nausea. However, no research has identified a link between ginger use and bloat relief.

Ginger root is considered safe by the Food and Drug Administration (FDA) as a food flavoring agent. Up to 4 grams (g) of ginger can be safely consumed daily. Exceeding that amount is discouraged, as it is more likely to result in abdominal discomfort.

Peppermint

Peppermint is an herb. Both the leaves and the oil that comes from leaves are used for health and wellness purposes.

Peppermint is marketed for digestive problems, headaches, muscle aches, joint pains, and infections. It is also marketed for use in aromatherapy. However, the research on peppermint has focused on symptoms of irritable bowel syndrome (IBS).

A small, randomized double-blind study provided participants with either two peppermint capsules twice daily for four weeks or a placebo (an intentionally ineffective substance to act as a control group). At the end of four weeks, more people in the peppermint group reported improvements in IBS symptoms.

Another, similar study also found that peppermint oil given three times daily reduced overall symptoms associated with IBS compared to a placebo. Peppermint oil appeared to improve certain symptoms, including stomach pain and bloating.

An older (2014) systematic review of peppermint oil for IBS concluded that peppermint oil is a safe and effective short-term treatment for IBS.

A 2022 systematic review and meta-analysis shared that peppermint oil offered more benefits compared to a placebo in the treatment of IBS. However, side effects were reported with peppermint oil use. Additionally, the quality of evidence for these reviews was low, and larger, well-designed studies are needed.

Peppermint oil taken orally appears to be safe. Possible side effects of taking peppermint oil include:

• Heartburn
• Abdominal pain
• Nausea
• Dry mouth

If using peppermint oil capsules, make sure that the capsules are enteric-coated. This will allow them to pass through the stomach and dissolve in the small intestine. It is recommended to take peppermint oil two hours after antacids. Taking both at the same time may actually increase your risk of heartburn, as it could cause the capsule coating to break down too quickly.

Prebiotics & Probiotics

Prebiotics are nutrients that are degraded by the microflora in the GI tract to produce short-chain fatty acids. Two common groups of prebiotics are fructooligosaccharides (FOS) and galactooligosaccharides (GOS).

Prebiotics are intended to stimulate the growth of beneficial bacteria in the GI tract. There is not a lot of research to support the use of prebiotics for abdominal bloating.

Probiotics are live microorganisms that can have health benefits when taken appropriately. Probiotics can be found in fermented foods and yogurt. They are also available as supplements in powders or capsules.

Probiotics can be helpful for people with various GI-related health conditions. For example, probiotics given within two days of starting antibiotics may reduce the risk of developing antibiotic-associated diarrhea. Additionally, the use of probiotics may reduce symptoms associated with IBS. Side effects of probiotics can be abdominal discomfort or gas.

There are several, different strains and species of probiotics available. The dose will depend on the strain and product; therefore, it is recommended to check the labels of probiotic supplements purchased before taking them.

Psyllium

Psyllium is a soluble fiber found in some foods (breakfast cereals and bread products) and available as a supplement.

Psyllium works to increase the weight of stool and stimulate bowel movements. It is useful for managing constipation and may provide other health benefits.

A systematic review found moderate evidence to support the use of psyllium in managing chronic constipation. Soluble fiber is known to be an effective treatment for IBS.

However, fiber supplements can also be a cause of bloating. If constipation is what's causing your bloating, adding fiber to your diet is recommended. This can be done by including more high-fiber (soluble) foods or taking psyllium supplements.

To avoid worsening bloating from fiber, consider slowly increasing the amount of fiber over time. Be sure to drink enough water as well.

Vitamin D

Vitamin D is a fat-soluble vitamin found in some foods and available as a supplement. Vitamin D is also made in the body when exposed to sunlight.

Vitamin D deficiency can result from too little intake or poor absorption of nutrients due to GI conditions. Those with lactose intolerance or milk allergy may not get enough vitamin D in their diet.

While there is no research specific to the supplementation of vitamin D for bloating issues, there is some research on its use in IBS. Observational studies have suggested a relationship between vitamin D status and IBS symptoms.

A meta-analysis of vitamin D supplementation in people with IBS found that while improving quality of life, it did not have an effect on symptom severity. In another systematic review, vitamin D supplementation improved both symptom severity and quality of life scores.

Having a GI condition may affect your vitamin D levels. You can get your vitamin D levels checked and take supplements if necessary. However, there is no need to supplement vitamin D beyond treating a deficiency.

Other Ways to Relieve Bloating

To address bloating issues, it's important to understand what could be causing your bloat.

The following, for example, can lead to bloating:

• Swallowing air while eating and eating too fast or too much
• Drinking alcohol
• Smoking
• Consuming carbonated beverages or beverages that are too hot or too cold
• Chewing gum
• Consuming foods high in fructose (e.g., pears, artichokes, artificial sweeteners) or sorbitol (e.g., apples, peaches, artificial sweeteners)

You can prevent bloating by changing these behaviors. Chewing foods well and eating slowly can also give you time to listen to your body's cues for feeling full to prevent overeating.

If bloating is related to your diet, consider working with an RDN to determine which foods are affecting your symptoms. Diets that commonly cause gas include starchy foods (e.g., potatoes, corn), foods that contain lactose (e.g., milk products), and too much fiber.

However, everyone is different and it may be necessary to try different dietary modifications to find what works best for you.

In some cases, certain GI conditions or food sensitivities can also cause bloating. Getting treated for these underlying causes can help with symptom relief. Talk to your healthcare provider if you experience regular bloating and other GI-related problems.

Summary

Bloating can occur for many different reasons. The key to managing bloating is to figure out what is causing it. Certain supplements and dietary choices can also play a role in managing this discomfort.

An RDN can work with you to develop a plan that involves diet and supplement choices for your gut health. It may also be necessary to consult a healthcare provider if your symptoms are persistent and interfere with your daily life.

Seek medical attention if abdominal bloating increases in frequency, duration, or severity or is accompanied by weight loss, persistent abdominal pain, diarrhea, bloody stools, vomiting, or reflux.