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The Five Must-Knows for Treating SIBO
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SIBO or Slow Gastric Emptying? Check this Out!

Do you have SIBO or slow gastric emptying? Motility Activator by Integrative Therapeutics is a new prokinetic on the market, that is a must try!

Prokinetics (think  “pro-kinesis”) help to strengthen the lower esophageal sphincter, speed gastric emptying and they strengthen the migrating motor complex (MMC) – which creates house cleaning waves along the small intestine. These waves help move debris down the track. A prokinetic helps amplify these waves, as well as increases their frequency. These waves occur on an empty stomach, between meals. Bile is also released at this time, acting as a detergent, which helps to clean out the small intestine.

To date, supplemental prokinetics included MotilPro by Pure Encapsulations, or high dose ginger. Motilpro contains vitamin B6 6.7 mg (as pyridoxal 5′ phosphate); ginger 1,000 mg. (Zingiber officinale) extract (root) (standardized to contain 5% gingerols) -acetyl-l-carnitine 500mg; 5-hydroxytryptophan 50 mg (5-HTP). At the recommended dosing of 3 capsules 1-2 times daily, a person will ingest 1500-3000 mg of ginger daily. Ginger is a good prokinetic, and it is also an antispasmodic.

Ginger contains a compound called gingerols and when dehydrated, some gingerols form shogaols (similar chemical structure to gingerol). The concentration of shogaols, depends on the type of ginger used. Shogaols are more pungent, and really the main component in ginger that gives it its strong pungent qualities. Ginger can cause heat and irritation in the stomach, especially when taken at 1500-3000mg per day. This also adds 6 capsules per day, when a person (based on the need for a prokinetic) is likely on a robust supplement protocol.

Motility Activator by Integrative Therapeutics, is a proprietary blend, totaling 248 mg per capsule, which includes the following ingredients: Pycrinil® Artichoke (Cynara cardunculus) Leaf Extract; Ginger (Zingiber officinale) Root Extract. The artichoke leaf extract contains higher cyanaropicirins and flavonoids, which leads to more bile production to support MMC cleansing waves. The ginger in Motility Activator contains a  higher total concentration of gingerols (25% to 30% total gingerols)  with a lower shogaols concentration, so people taking this do not feel the ginger ‘heat/ burn.’

Motility Activator is dosed a bit different – start with 1 capsule before dinner and, if well tolerated, add 1 more capsule before bedtime. 1-2 capsules a day, versus 6 capsules a day with MotilPro, is a big advantage! Check it out here: Motility Activator

A clinical study was performed on this exact formulation and the formulation was clinically validated – reduced epigastric fullness, nausea and early satiety and confirmed agent that stimulates the migrating motor complex. Here is the link to the study:

It can help with PPI weaning and it is also helpful for diabetic patients, who often suffer from some level of gastroparesis, and this slow motility effects their ability to malabsorb nutrients and sugar.

At our round table dinner at the SIBO Symposium this year, Allison Siebecker shared her personal and clinical experience with this product – all being favorable. She is personally taking this right now. Clinically I haven’t seen a patient NOT be able to tolerate this and it definitely works to calm and settle down the digestive tract. I highly recommend it!



Angela Pifer, Ms, LN, CN, FMN
Functional Medicine Nutritionist
p 425.747.5282
28 Day Health Solutions Co



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from 10 people

Angela Pifer

You are welcome! This is a long term approach, but I would also go off of symptoms, recovery and work with your practitioner to figure out the right timing. Warmly, Angela

Angela Pifer


Thank you, this product has really helped me. When do I know I have taken it long enough or is this a forever pill.
Thank you.

Jerry White

Angela Pifer

Hi Joshua, Please seek out a good alternative practitioner who can help you with this. Often times, I find that traditional meds fail to fix motility issues. Magnesium can be utilized to get the bowels moving and to stay moving, yet, the goal is also to treat the underlying conditions that set the motility issue up. You do not need to eat only one meal a day to do this. For gastroparesis - lower fat, lower fiber and small frequent meals are best. But, conversely - with constipation - we need fiber to keep us regular - so working with someone to help with this is really key. I realize that there is info out there on the MMC and limiting meal frequency- but we have supplement and meds to support the MMC. Further restricting diet will continue to exacerbate the issue. Warmly, Angela

Angela Pifer


What does one do, like me, when everything that "should" be helpful only makes matters worse? The stagnation and pain of a completely dysfunctional bowel have left me disabled, and these symptoms are even worse with the use of nutritional and/or herbal supplements (like ginger). Though I've already limited myself to one meal each day, the only remaining option I see at this point is to replace food with liquid (which will likely leave me bedridden in weakness). In my current condition, the only way I can be somewhat productive is to completely flush my bowels with magnesium, but that relief is short-lived as hunger, weakness, and the desire for food lead me to eat a meal and "shoot myself in the foot" for another 24-hour period. If nothing else, I thank you for listening ...


Angela Pifer

Hi Ann, many of the probiotics that I work with are listed on my site, under the 'shop' - you may search for 'probiotics' and it will bring them all up. If there are products that you can't see on there, then enter 'SIBO-G' and this will unlock all the products. Please use this list to speak with your doctor/ practitioner, to pick a good probiotic for you. Warmly, Angela

Angela Pifer


Thank you! I am curently taking Xifaxin for SIBO (after 2 failed herbal treatments). I was instructed to take both a prokinetic and a probiotic after I finish the antibiotics. Do you have a recommendation for the probiotic? And diet guidelines?
Thank you in advance for your help!


Angela Pifer

Hi Sue, 1-2 caps before lunch and 1-2 caps before dinner is normal dosing. If your constipation is really stubborn, you may need something stronger. Sometimes the supplement prokinetics are not enough. The dosing on the Motility Activator, is based on the study that proved efficacy and the timing that worked to best support motility. I find that it has worked well around 70% of the time. It doesn't have the ginger burn, which is nice - and it is easy to take. Warmly, Angela

Angela Pifer


Hi Angela,
I have Methane SIBO and have been trying out the Motility Activator taking 1 pill before lunch and dinner, following my practitioner's guidance and as in the product's trial. After 4 days, it hasn't been very effective.
What is the idea behind taking it before dinner and at bedtime? What type of results have you seen?


Angela Pifer

Hi Patty! It has artichoke in it, which may cause an allergic reaction in people who are sensitive to the Asteraceae-Compositae family. As long as your ragweed allergy is not an anaphylactic one, you might want to trial it. I have had other patients do great on this! The other supplement prokinetics are: ginger, MotilPro and, for some, Iberogast (I don't find that this one works that well as a prokinetic). Warmly Angela

Angela Pifer


Hi Angela, I was so excited to try this product after reading your positive review, but when I checked the product label it says not to take it if you are allergic to ragweed. Well, guess what - I'm allergic to ragweed. Do you know if you've had patients tolerate this product even though allergic to ragweed? Can you think of a comparable substitute? Thank you! Patty


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