Bitters have been used medicinally since ancient times for digestive ailments and were developed as patent medicines in the 1800s, typically marketed as “tonics” or “stomachics.” The term traditionally refers to alcohol-based extracts of the bark, leaves, roots, or flowers of bitter-tasting plants.
Some examples are gentian, angelica root, bitter orange, cinchona bark, cascarilla bark, and wormwood. As historians point out, however, such “medicines” were really just a guise for selling what in essence were alcoholic drinks to unsuspecting (or suspecting) consumers—until passage of the Pure Food and Drug Act in 1906 required that the alcohol content (and other ingredients) be labeled.
Today bitters are sold as herbal supplements that you take by the dropperful or spoonful or spray into your mouth, with claims being made that they improve all sorts of digestive woes. They’re also popular as flavorings in classic cocktails. You may be familiar with ones like Angostura and Peychaud’s (dating back to the 1800s), Bittermens, or “artisanal bitters” now offered at trendy bars. Just a few drops are added to the drink.
Liqueurs such as Campari, Cynar, Fernet Branca, Jagermeister, and Amaro Montenegro also contain bitter herbs and are consumed around the world as apéritifs or digestifs—that is, supposedly to aid digestion. Bitters are used in cooking, too.
A fix for upset stomachs?
It’s speculated that bitters trigger taste receptors in the mouth, which stimulate secretion of saliva and digestive juices, including stomach and pancreatic enzymes, gastrointestinal hormones, and bile. In Germany, gentian and some other bitters are approved by Commission E (similar to our FDA) for relieving gas and nausea and promoting appetite.
But there isn’t much in the way of clinical studies. Rather, Commission E’s endorsement is based largely on traditional usage, animal research, and the known properties of bitter substances. According to the Natural Medicines Comprehensive Database, which evaluates complementary therapies, there is insufficient evidence that gentian is effective for anything digestion-related.
4 Historical Bits About Bitters
Did you know that bitters have been used since ancient times for digestive ailments? Here are other historical facts about these alcohol-based extracts that are made from bitter-tasting plants.
Even if bitters have the claimed effects, it’s unclear whether healthy people without digestive problems respond to them. And if you have acid reflux, ulcers, or other gastric conditions, stimulating stomach acids is not advisable. It’s also been reported that ingesting large amounts of bitters may actually reduce gastric secretions—for better or worse.
Moreover, bitters may interfere with some medications and have side effects—for instance, there is some concern, at least in theory, that gentian may lower blood pressure. Some formulations contain other ingredients besides bitters—for instance, senna (which has laxative effects) and aloe (which also has laxative properties and has been linked to liver and kidney damage).
Add bitters to drinks (alcoholic or non-alcoholic) if you like the way they taste. But don’t count on supplements to relieve gas and bloating after a large meal—there’s no evidence they help, and they may make things worse. A better bet for occasional gastrointestinal symptoms is to try standard over-the-counter remedies (like simethicone for bloating). If these do not control your symptoms or if you have frequent bouts, you should be evaluated by your health care provider.