Hi so happy to see you are feeling better! Wondering which prokinetik you used, or anything specific that helped you. Constipation is my main symptom, as well as burping, indigestion and some nausea. Motil pro was not the best for me, not sure what to try next, very open. Encouraging to see someone is feeling better.
@@lindapelle8738 I used mega guard and HCl. The biggest help was consistently eating enough food, trusting the process and not panicking when I had symptoms. Healing is not linear!
Hi, it's me again. I am a gringo who lives in Mexico. I've been spreading the word about you, your knowledge, your approach to explaining how our bodies work and your resolutions. I'm shocked that you don't have more viewers. Keep up the good work. 😁
You're too, too sweet. Thank you for spreading the word!! Hmmmm... does this make following me a religious experience now? 🤣 But seriously, all jokes aside, thank you 😊
I'm a pescatarian an am healthy for soon to be 70. I fortunately dont suffer these issues butI many gringos here suffer from constipation and motility issues. For this reason I promote you. Keep up the good work
I had excessive belching and trapped gas starting in 2021 almost a full year after the pandemic. The only change I made to my diet was starting to eat Sourdough bread which I made the starter in a home that definitely had mold in it. I’m wondering if that is what instigated IBS C which I am now diagnosed with. I also have gastritis, and what I believe is SIBO(methane dominant). H Pylori test was negative twice on endoscopy testing. I just want to feel better again 😩
I just started taking betain hcl with pepsin. I was under the assumption that I had too much stomach acid. Was wondering why ppi’s and antacids weren’t working. I eat a WFPB diet. It’s what works best for me. But all foods need acid to break it down to usable energy and sustenance. I exercise quite a bit. I’m triple certified in training and post rehabilitative exercises. Despite my clean diet and working out, my gut wouldn’t go down. Bloated like a dang dying fish. I’m here to say that within several days of taking the hcl I’m feeling tremendous relief. The food used to just stay in my stomach for hours. Now it’s digested quicker and exits fairly easily too. Wow. Thanks for the info regarding low stomach acid!
@@gutmicrobiomequeen It would help alot of us struggling daily. Thanks so much. FWIW My husb does data analytics and would be willing to finish it for you to help out. 🙏
Hi Dr, First time here. I'd love to see a video on skin/acne and the gut. Also where should I start with your videos? I haven't done any stool or SIBO tests although I'm sure I had issues with my microbiome due to bloating, indigestion, constipation and gas. Thank you for sharing your knowledge!!!
Great topic! We did talk to someone about those on the IBS Freedom Pod a while back! Here's the channel: youtube.com/@ibsfreedompodcast1245 just FYI, I do think that the woman we interviewed is a bit too gun-ho about kill phases (about both SIBO and H pylori), so take it with a grain of salt if you follow her on social media. We will also have a "start here" episode posting in about two weeks :) So make sure you subscribe to that channel!
@@gutmicrobiomequeen Thanks for the reply, Doc. I'll check that out. I've been watching several of your videos since yesterday. 🤗 Keep up with the good work!
Love your videos. I hope you address chronic idiopathic gastritis (no H. pylori, no NSAIDs, no alcohol, no structural problems such as MALS or ,mesenteric artery syndrome, or gastroduodenal Crohn, etc.) one day. And perhaps how it ties in with SIBO, or at least with what I’d call “gastric bacterial overgrowth” or stomach motility problems. I’m suffering from it and there’s a whole subreddit of around 15000 people suffering from it with which I would be glad to share the potential video with. I’ve seen a testimonial of someone whose duodenal erosions and chronic gastritis were caused by SIBO because they disappeared upon treating with a prokinetic, so I’m sure there’s a causative relation in some cases.
Mine is similar and common: functional dyspepsia. Gastritis often comes with it and misdx (actually FD.) Idiopathic: unknown origin and ‘itis’: inflamed. Medical jargon likes to complicate. 😉 At least redundant or tortuous colon are aptly named.
You noticed!! 🥰 Yes! I know it's just a number, but I'm not gonna lie, I was excited to see it for the first time! And you know what's SUPER weird? I'm 99% sure I crossed the 10k mark WHILE I was on the table getting my ear surgery! I checked it before I powered off my phone and handed it over to my husband and it was like 4 or 5 away. Then, when I checked when I got home it was well past the 10k mark. Cray!
@@gutmicrobiomequeen I do notice. The topic has no limited material. I honestly thing the microbiome research is at the dawn of a golden age. Early curators like yourself will get a deserved following. Been following for a few years now. Best material on the net in its class! Intellectual gold!
@@interestingamerican3100 you're too, too sweet. Thank you for always leaving such nice comments 🥰 Ps. Can you please share your first name so I know how to address you?? I doubt your first name is Interesting and last name is American 😂
I noticed a ton of my classmates at NCSU and my roommate, as well as my wife and I (we met at school) started having issues with SIBO, belching and bloating when we first started going to school there. Pretty sure there's something in the food over at the dining hall. Both my wife and I started having low stomach acid midway thru school and when I graduated I pretty much stopped digesting food for a time. I had TERRIBLE GERD, but realized a couple years ago around the start of Covid it was low stomach acid, so I started doing shots of ACV twice a day, and it made a HUGE difference. I still deal with some SIBO/IBS symptoms which I'm working on as a result of chronic low stomach acid. What an absolute pain. Stress also didn't help - I had started my own business and it almost killed me. Symptoms got way better when I quit and went into a different field... yeah stress absolutely matters. Be careful out there.
Hi burping and belching even happens in the morning when I stand up when I go to the toilet at night.. pretty well all day it’s not particularly just after meals.
My issue is actually burping and belching every time I drink water (I never drink carbonated anything). Any thoughts on that? Would love a video. on it. TY Nicole. :)
@@letsrelaxwithtexts2114 you can also lay on your stomach and lift your right knee up to your chest as high as you can go to burp. If you need to fart, do your left leg. Or I have that backwards haha.
I have the same problem. I take half a teaspoon of apple cider vinegar in half a glass of water before my meal and it seems to help with my low stomach acid. But check with your doctor first because if you are on any medication it could cause problems
I have serious gut issues all my life.ive tried everything but only herb tea with Senna works. Now I'm worried I'm addicted to it which is supposed to damage my natural reflection to be able to go naturally. Any suggestions would help. Ty
First of all, love the Spirited Away sweater! Next, THANK YOU for posting this!!!! I have been hoping and praying you would talk about burping and today was the day! I have seen 10+ practitioners/doctors and all of them have never seen symptoms like mine before. The gas bubbles up into my stomach and makes loud frog sounds when I breathe. I've even recorded a video on my phone and it has left everyone flabbergasted! 2 questions please: 1) Does this also apply to burping 2 hours after meals/overnight? I am bubbling with gas which gets worse on an empty stomach. 2 hours after meals, I get ravenously hungry, my stomach will fill up with air and burn, then I need to stretch, massage, jump around, and offer a sacrifice to the gods to force burps out. If I can't, it will bubble down and lead to urgent bulky yellow BMs/diarrhea. So does the same principle of improving motility/stomach emptying apply here even though it's worse on an empty stomach? 2) Would prokinetics/HCL be a good idea if the lining is irritated? HCL wouldn't be good with gastritis but would prokinetics be okay? Every time I've tried ginger, it just speeds up the gas bubbling and diarrhea.
Ohh! I'm glad I was able to fulfill your wish today 🥰 I think the same principal still applies, even hours later. When it happened to me, I was belching for what seemed like the entire duration between my meals. God, it was SO annoying!! I would exercise caution taking anything that can irritate an already irritated stomach lining. Betaine HCl is most likely going to be too harsh, but you may be able to use it if you start SUPER low (like... 1/4 of the lowest dose tablet you can find- I use Biotics Research Hydrozyme for situations like this). ACV is also worth considering, too. For a prokinetic, you might try plain artichoke extract. Hope that helps!
@@gutmicrobiomequeen Thank you, and I love you ❤ I have learned so much from you and I will share your channel/podcast to the ends of the earth!! One last follow up question, and perhaps an idea for a future video topic: How does this come into play with rapid gastric emptying or delayed rapid emptying? I feel full after meals but monstrously ravenous 2 hours post-meal and that's when the burping starts and everything bubbles up and down rapidly. Do prokinetics help or hinder in such cases? I've also heard the gallbladder plays a big role in belching issues! Gotta go back and listen to your gallbladder/bile podcast.
@@trixiet hmmmmm. Maybe it's a "dysregulation" thing instead of being slowed down 100% of the time or sped up 100% of the time? In a cases like this, I would think gut-brain axis slash vagus nerve work is best :)
@@gutmicrobiomequeen That is what I'm leaning towards too. It seems to swing from one extreme to the other pretty suddenly. Either full or empty, trapped gas or gas nonstop, quiet gut or bubbling all over rapidly. Thanks for taking the time to write to me and for your insight! :)
Thank you for the great videos! I’ll check out your Prokinetics video, but any advice for someone who can’t swallow capsules (for betaine HCL and stronger digestive enzymes? Do you recommend bitters?
You have a few options :) - Digestive bitters (for digestion/acid support) - Apple cider vinegar (for digestion/acid support) - Ginger tea (as a prokinetic) - Tea made from most any herb in your spice cabinet (many culinary herbs are carminative, which means they help dispel gas and enhance digestion!)
So my burping seems to occur about 4-5 hours after I have eaten something. I just assumed it was the bacteria being fed and releasing their many gasses??
Thanks! I burp major deep dinosaur-burps after water (not guzzling it or swallowing air). The burping is reduced if I take HCL with water but not completely. Would love a video on water burping & bloat as well!
That doesn't matter much, bc the one that worked for me may not work for you! The better question to ask 😉 is how to choose the best prokinetic for YOU! Here's a video I made where I discuss just that 🥰 ruclips.net/video/WEnEnlZDnhA/видео.html
due to acid reflux chest pain for some reason, im on ppi which is creating burping gas due to worse digestion from low acid but hopefully only temporarily to heal the damage
Oh wow this is so interesting! I am dealing with same situation you had with trapped gas and burping right now and it’s been going on for years and it really interferes with my life my eating my energy and even acid reflux and lower GI issues. What pro-kinetic supplement do you recommend with this going on?
What I need is Low Stomach Acid test . I don't drink soda, stopped on January 1, 2013 - present . For each bite, I chew my food slowly 50 times. I will wait one hour before and after eating my meal. And then Ill drink water .
Burps after meals, burps on an empty stomach, burps 9 hours after eating, burps after taking some water, burps, and more burps…with lateral left pain under the edge of the ribs(flank pain), just in the beginning of the descending colon…it is a mystery
It depends on the severity of symptoms and if they have any other health conditions that could worsen with a delay in care. For example, blood I'm stools or prolonged diarrhea always merits a GI appt IMO.
Burping, nausea, fullness after meals (to the point of not having appetite for the next meal) can also be a sign of an active H. Pylori infection (50% of the population is infected). The same bacteria can also give you a "silent acid reflex", which damages your throat and larinx, causing endless sore throat, laryngitis, and dry cough. The H. Pylori itself can colonize the throat/larynx aggravating the sore throat/laryngitis even more. If you take Pepto-Bismol and it reduces drastically your symptoms, it may be H. Pylori.
@@himalay1593 Go to a gastroenterologist to prescribe you 1-2 weeks of eradication regimen: antibiotics, bismuth, and PPI. If the regimen fails, you can suppress it, but not eradicate it with several months of bismuth subcitrate. The Pepto-Bismol is bismuth subsalycilate also may work but is not optimal because it decomposes to aspirin, which is harmful if you have ulcerations.
Hello dr.dinezza, my brother has severe burping after meals . Like 5 times in a single minutes. He saw his physicians many times and passed many tests but never recovered. He is really suffering and I don't know what I can do for him. He is 33 years old. Any advice?
Is there a way to contact you about becoming a client? I'm struggling with gut issues and heart palpitations, but can't find anyone that knows how to treat it
I have functional dyspepsia related to my ENS and redundant colon. Only one motility drug option in Canada. Europe is further ahead for medicine natural and pharma.
Hello, Dr. DiNezza! I take a PPI and have for over 10 years with no problem. Just a few months ago, this constant belching appeared out of nowhere, like you. I also belch in between meals and when drinking even water! Can I take a Prokinetic at the same time as a PPI? I don't want to stop the PPI right now. Thank you!
I get burping hours after meals with gas moving and pulling my intestines....I don't get huge distention but the comfortable moving of gas inside and pulls,pops and growling makes me anxious... mosttimes I feel I am away of my food moving through my tract,all these started after the antibiotics I took for h.pylori.tried betaine and digestive enzymes still no relief please what do you suggest?
Started burping in 2019, when the fish i ate, didn't digest. I took apple cider vinegar, and got excessive vomiting, u can say vomiting for months. Still i burp too much after meals. What do u think, should i take esomeprazole daily? Or any prokinetic? Cz 2019, Dr recommended esomeprazole 40 mg. Still i burp too much after eating, its bizarre 🥺 how to get rid of it?
Yes I have acid reflux and it’s like every time I eat I’m burp and it’s like loud too so I’m trying to see what else I can do for it I have talk to my doctor
Hi, I have this excessive belching problem after eating and in the morning when my stomach is empty. I have really low good bacteria and then a small overgrowth of streptococcus. I also get this need to yawn sensation which i think after researching has to do with LPR? basically my main question is if i have low stomach acid, how can i get lpr or gerd? should i eat foods that are more acidic or alkaline? idk
The more helpful question is "what is the best prokinetic for YOU to take?" It doesn't matter much what worked for me! Check out this video for some ideas when choosing one for yourself: ruclips.net/video/WEnEnlZDnhA/видео.html
Another commenter said taking HCl helps! I also shared that I made a video about bloating from drinking water a couple of months ago. I bet there would be some overlap, if you wanna check that one out!
for me it started 6 years ago with every day heartburn went to the doc got perscribed ppi's then about 6-8 months later had 2 smal ulcers but ever since they healed my stomach acid has been low i know cause i get that heavy feeling after eating some times that you said .the good thing is my other symptoms didn't worse but their not any better. so im stuck now trying to find out what the root cause of the low stomach acid is i tried HCL when this first started but i stopped taking i because i was up to 25 pills and nothing changed. other symptoms are my thyroid changed it's slower now ,mild constapation ,any little thing can set me off , brain fog off and on so any advice and or tips would be great thanks
First see a GI specialist for upper endoscopy and colonoscopy (if you haven’t.) Only way to know for sure what’s going on in your GI system. You may need a motility test. It could be functional dyspepsia incl bouts of gastritis. My specialist isn’t a fan of the idea of adding acid on prob very sensitive guts before a proper DX. Pls be careful. Maybe get a Nutribullet and blend smoothies and simple soups. Avoid high fiber and fats for a few weeks. Our stomach lining turns over every 6-8 wks. Also green juice with turmeric root (thumb size no pepper), cucumber, greens etc but be careful with ginger or lemons for now. Even turmeric spice 1/2 Tsp helps calm stomach. Bites of banana can help and sipping (not gulping) warm water. Stomach massages can help just search YT. All just ideas. Best of luck and stay calm. Stress only makes it all worse. 😊
Doctor, if someone has symptoms of burping for a long time after a meal and a feeling like the food is just sitting there forever, would you recommend digestive enzymes. If so, do I take them just before a meal? How would I coordinate taking betaine hcl with the digestive enzymes as far as timing.
Vagotomy and pyloroplasty. Had the above op in 1971 Vagus nerve was deliberatly severed in order to reduce stomach acid Pylotic Sphincter was widened to allow for rapid stomach emptying. Fortunately PPIs have almost negated any need fir this op currently so rarely performed nowadays. I strongly suspect that after 52 years Im unlikely to find an answer to my problem but the low stomach acid does, as you state, seem to be a significant factor. Love your videos by the way as far as im concerned they are perfectly pitched.
Oh, wow, I'm SO sorry that you had that procedure! It boggles the mind to think that doctors thought this was a good idea in our lifetime. In truth, I don't know if this is something that can be overcome. The only thing I can think of is kind of woo-woo... Joe Dispenza has a "progressive intensive" program (Sort of like meditation? But not exactly?) that has gotten BONKERS results. Like, stage 4 cancer GONE kinda stuff. If anything is going to help your situation, it's something "out there" like Joe's stuff.
Is it ever bad to take BetaineHCI and or Ox Bile? What if one thinks that one needs this but then they take it and they find out that they didn’t need it? Can it make you sick or cause any bad side effects? Thank you
I was at work last night and was covering someone's dinner break. She was complaining about how full she was when she came back. A few seconds later she burped loudly and obviously I asked her if she felt better and she did.
I have a big motility issue that causes this sort of thing, but the burping starts like 4 hours after eating. I have been on Motegrity and it was working great for like 4 months but completely wore off now to where I belch for like 4 hours every night and can only eat one meal. I would be curious to know what other prokenitics you use, as I've had no success with MotiliPro, Motility Activator, and . Limited success with Iberogast and TTFD. Still doing Motegrity as well. I have tried HCL but maybe my dosage is not enough I can try again tomorrow. Digestive enzymes make me feel worse if they have Ox bile, do not really notice a difference with enzymes that do not have Ox bile. Also, I'm curious as to if you've seen vitamin deficiencies cause this as the SIBO has caused my iron/ferritin levels to plummet.
@@Rob__James unfortunately not, though it seems that the root issue is gastroparesis causing contents to not empty. This seems to cause positive SIBO results and the motility issues I've described. Probably going to Cleveland Clinic soon to see what options I have to deal with gastroparesis.
@PianoScottDeBoer people with Gastroparesis usually dont have an appetite & also they get full after just a few bites of a meal. Many gastroparesis sufferers experience stomach pain & nausea/vomiting etc. Do you have those symptoms? I used to think I might have gastroparesis but I don't experience any of those symptoms. I do have excessive burping/belching tho which I'm trying to find a solution for.
@PianoScottDeBoer wow that's hectic! Sorry that you're having to deal with those horrible symptoms! I found an interesting article recently that linked high glyphosate levels in the gut to gastroparesis so once you eliminate the glyphosate then apparently the gastroparesis goes away. You should look into that. Most people get gastroparesis through diabetes, a severe candida infection, damage to vagus nerve & I think there's one other main reason but Glyphosate is another reason that most people don't know about yet so if you didnt get gastroparesis from any of the 4 main ways people get it then it could be due to glyphosate. I'll try to find the article but i dont think we can post links in comments sections of videos. The vagus nerve damage often occurs through surgery gone wrong so if you had some type of surgery before you got the gastroparesis then your vagus nerve couldve been damaged during the surgery.
Please help me😢 I burp(even with water) and seem to be gassy and also i have loud stomach sounds _ from different parts of my belly each time _ after eating ( or even drinking water) 😭
I think I have sibo, all the doctors I went to dismissed me by just giving me acidity medicine.. my stool report says "bacteria: significant" I have excessive burping and rumbling in stomach even when I am not hungry, I either have diarrhea or constipation, sometimes acid reflux, I do have hypothyroidism but borderline. It just suddenly started one day and it's been 5 months that I can't eat anything without experiencing gas and burping afterwards, nothing seems to help. Can it be that I have sibo or hpylori please help.
Hello! I'm sorry your doctor's haven't been helpful so far. For what it's worth, you can't diagnose SIBO via a stool test, though. Here's a video where I explain why: ruclips.net/video/fUJhd4wBBus/видео.html I believe you'll find lots of info on this channel and the IBS Freedom Podcast that can help you 🥰 Best of luck! youtube.com/@ibsfreedompodcast1245
@@gutmicrobiomequeen Thankyou so much for replying I hope it will be of help. But can you explain why my report says bacteria: significant, I am really confused
@@gutmicrobiomequeen Thankyou. In this video you talked about prokinetics can you suggest me some also is 'Triphala' a natural prokinetic I heard people talking about those.
@@_cottagecore_9835 yes, Triphala appears to be both a prokinetic and a laxative. So, probably most suited to folks with constipation still. Oh, and it modulates the microbiome!
Mam I have one doubt if we take tpn for 6 months and make our digestive tract to rest.....so the villi will be regenerated and gut issues will fade away....I have this opinion plss clarify me
HELP ME! This does not answer me. I burp, after a teaspoon of food, once only. There is gas being released, almost instantaneously , after 1 to 2 minutes. No time for fermentation. No time for 'lack of mobility' issues. It must be a simple reaction, like acid in the stomach, and bicarbonate in the food. Or vice versa. Clean smelling CO2 burp. Doesn't matter which food. Except of course, the food does not contain bicarbonate, nor does my stomach!...?
My 9 yr old daughter has this problem except she needs to burp after meals but can't and then begins to feel nauseous bc of trapped gas. I have to give her pieces of ginger which always help her burp but she'll often still have some stomach discomfort afterwards. She's seeing the gastroenterologist who's given her several tests but she still hasn't figured it out. Any indication of what you think may be the problem or even just some advice would help tremendously.
All it takes is a meal and a few seconds later my friend turns into a burping machine. Everything gives her indigestion and she burps all the time. Hours after we digested our meal you'll still hear a belch come from her.
Just want to say this is spot on for me and I am now pretty much symptom free thanks to you and Amy, thanks for your work!!!
Ahhhh this makes me so happy to read! This one is becoming the pinned comment for this video 🥰
@@gutmicrobiomequeenyour tshirt is very funny doctor 😃😃😃
Hi so happy to see you are feeling better! Wondering which prokinetik you used, or anything specific that helped you. Constipation is my main symptom, as well as burping, indigestion and some nausea. Motil pro was not the best for me, not sure what to try next, very open. Encouraging to see someone is feeling better.
@@lindapelle8738 I used mega guard and HCl. The biggest help was consistently eating enough food, trusting the process and not panicking when I had symptoms. Healing is not linear!
@@lindapelle8738
Video on prokinetics on this channel. Scan her list or search YT.
Hi, it's me again. I am a gringo who lives in Mexico. I've been spreading the word about you, your knowledge, your approach to explaining how our bodies work and your resolutions. I'm shocked that you don't have more viewers. Keep up the good work. 😁
You're too, too sweet. Thank you for spreading the word!! Hmmmm... does this make following me a religious experience now? 🤣
But seriously, all jokes aside, thank you 😊
I'm a pescatarian an am healthy for soon to be 70. I fortunately dont suffer these issues butI many gringos here suffer from constipation and motility issues. For this reason I promote you. Keep up the good work
@@SG-fz8rz I love that passion for helping others! 🥰
I burp even before I eat any food. After I eat food then the burps just smell like what I just ate. And they are super loud. 🤦🏻♂️🤦🏻♂️
I had excessive belching and trapped gas starting in 2021 almost a full year after the pandemic. The only change I made to my diet was starting to eat Sourdough bread which I made the starter in a home that definitely had mold in it. I’m wondering if that is what instigated IBS C which I am now diagnosed with. I also have gastritis, and what I believe is SIBO(methane dominant). H Pylori test was negative twice on endoscopy testing. I just want to feel better again 😩
@sanctifiedbytruth6048 I feel you as I'm also experiencing the same starting around mid 2021..were you able to find a cure ??
@@akshatkumar9830seems like emf radiation, it all started in 2021 while covid started
Just started watching your videos Dr. I love how detailed (but also easy to understand) your explanations are.
Hello, new internet friend! Thank you for the comment! 🥰🥰🥰
I just started taking betain hcl with pepsin. I was under the assumption that I had too much stomach acid. Was wondering why ppi’s and antacids weren’t working. I eat a WFPB diet. It’s what works best for me. But all foods need acid to break it down to usable energy and sustenance. I exercise quite a bit. I’m triple certified in training and post rehabilitative exercises. Despite my clean diet and working out, my gut wouldn’t go down. Bloated like a dang dying fish. I’m here to say that within several days of taking the hcl I’m feeling tremendous relief. The food used to just stay in my stomach for hours. Now it’s digested quicker and exits fairly easily too. Wow. Thanks for the info regarding low stomach acid!
I’m so looking forward to hearing your prokinetics update!
This is motivation to finish that dang excel spreadsheet 🤣
@@gutmicrobiomequeen 😂😂
@@gutmicrobiomequeen
It would help alot of us struggling daily. Thanks so much. FWIW My husb does data analytics and would be willing to finish it for you to help out. 🙏
Did it work
Great. I was hoping you’d tie this in with motility, which you did! And cool Spirited Away sweater :)
Thank you! We are HUGE Ghibli fans in the DiNezza household 🥰
I definitely get belching from the carbonated water. For prokinetics I use ginger and/or ox bile with tudca. They work great.
Ginger: Queen of the prokinetics!
Hi Dr,
First time here. I'd love to see a video on skin/acne and the gut. Also where should I start with your videos? I haven't done any stool or SIBO tests although I'm sure I had issues with my microbiome due to bloating, indigestion, constipation and gas. Thank you for sharing your knowledge!!!
Great topic! We did talk to someone about those on the IBS Freedom Pod a while back! Here's the channel: youtube.com/@ibsfreedompodcast1245 just FYI, I do think that the woman we interviewed is a bit too gun-ho about kill phases (about both SIBO and H pylori), so take it with a grain of salt if you follow her on social media.
We will also have a "start here" episode posting in about two weeks :) So make sure you subscribe to that channel!
@@gutmicrobiomequeen Thanks for the reply, Doc. I'll check that out. I've been watching several of your videos since yesterday. 🤗 Keep up with the good work!
This! Rosacea?
Love your videos. I hope you address chronic idiopathic gastritis (no H. pylori, no NSAIDs, no alcohol, no structural problems such as MALS or ,mesenteric artery syndrome, or gastroduodenal Crohn, etc.) one day. And perhaps how it ties in with SIBO, or at least with what I’d call “gastric bacterial overgrowth” or stomach motility problems. I’m suffering from it and there’s a whole subreddit of around 15000 people suffering from it with which I would be glad to share the potential video with. I’ve seen a testimonial of someone whose duodenal erosions and chronic gastritis were caused by SIBO because they disappeared upon treating with a prokinetic, so I’m sure there’s a causative relation in some cases.
That is a great video topic, Victor! I'll add it to the line-up for 2023!
Which prokinetic do you use?
Mine is similar and common: functional dyspepsia. Gastritis often comes with it and misdx (actually FD.) Idiopathic: unknown origin and ‘itis’: inflamed. Medical jargon likes to complicate. 😉 At least redundant or tortuous colon are aptly named.
10k followers, goin on 100k! Thank you for your videos!
You noticed!! 🥰 Yes! I know it's just a number, but I'm not gonna lie, I was excited to see it for the first time! And you know what's SUPER weird? I'm 99% sure I crossed the 10k mark WHILE I was on the table getting my ear surgery! I checked it before I powered off my phone and handed it over to my husband and it was like 4 or 5 away. Then, when I checked when I got home it was well past the 10k mark. Cray!
@@gutmicrobiomequeen I do notice. The topic has no limited material. I honestly thing the microbiome research is at the dawn of a golden age. Early curators like yourself will get a deserved following. Been following for a few years now. Best material on the net in its class! Intellectual gold!
@@interestingamerican3100 you're too, too sweet. Thank you for always leaving such nice comments 🥰
Ps. Can you please share your first name so I know how to address you?? I doubt your first name is Interesting and last name is American 😂
@@gutmicrobiomequeen Amed.
@@interestingamerican3100 🥰🥰🥰🥰 I'll remember for future exchanges. Thank you Amed!
I noticed a ton of my classmates at NCSU and my roommate, as well as my wife and I (we met at school) started having issues with SIBO, belching and bloating when we first started going to school there. Pretty sure there's something in the food over at the dining hall. Both my wife and I started having low stomach acid midway thru school and when I graduated I pretty much stopped digesting food for a time. I had TERRIBLE GERD, but realized a couple years ago around the start of Covid it was low stomach acid, so I started doing shots of ACV twice a day, and it made a HUGE difference. I still deal with some SIBO/IBS symptoms which I'm working on as a result of chronic low stomach acid. What an absolute pain. Stress also didn't help - I had started my own business and it almost killed me. Symptoms got way better when I quit and went into a different field... yeah stress absolutely matters. Be careful out there.
Hi burping and belching even happens in the morning when I stand up when I go to the toilet at night.. pretty well all day it’s not particularly just after meals.
My issue is actually burping and belching every time I drink water (I never drink carbonated anything). Any thoughts on that? Would love a video. on it. TY Nicole. :)
Look into sifo which is a fungal overgrowth. I read that one of the symptoms is burping after drinking water
Thats totally not what I expected to find when I made my research. Good thing I just found a digestive system class...
This is great info.
Thanks for sharing.
Leaning (physically) far to the left (standing or sitting) will help get burps out. It's quite effective.
Thank you so much
@@letsrelaxwithtexts2114 you can also lay on your stomach and lift your right knee up to your chest as high as you can go to burp. If you need to fart, do your left leg. Or I have that backwards haha.
Please talk about excess flatulence 😔
I'll add that to the line-up if I think I have enough good/useful info to share :)
Thia is destroying my life. 4 years with this non stop burping. 😢
I have the same problem. I take half a teaspoon of apple cider vinegar in half a glass of water before my meal and it seems to help with my low stomach acid. But check with your doctor first because if you are on any medication it could cause problems
Me too😢
Lol. Me too
You're not alone 😔.. I ve had this for 13 years
@@wellbeing6198 I can't stop laughing, how old are you
Just noticed that your sweater is a character Kaonashi (no-face) from the movie Spirited Away!!
I took allithimine 100mg bd for 1 week and my motility and stomach sphincters work so well...vit b1 and magnesium saved my day...
Hi Dr. Dinezza! Is it ok to take ox bile with meals? or since bile is alkaline will it interfere with stomach acid production?
After meals as per dr berg
That spirited away sweater is awesome 😍
I loooooove your sweater!!!
Can’t wait for the updated prokinectic video
I need to get around to emailing my FODMAP Freedom students to get their feedback/results! Once I do that, my updated spreadsheet will be ready 🤩
Is that top you wearing , spirited away? What a great movie.
Great video, my herbal prokinetic has helped so much on my SIBO journey.
Sure is! We're HUGE Ghibli fans in the DiNezza household 🥰
More Apple cider vinegar, HELP 😁😁😁
I have serious gut issues all my life.ive tried everything but only herb tea with Senna works. Now I'm worried I'm addicted to it which is supposed to damage my natural reflection to be able to go naturally. Any suggestions would help. Ty
I’m into a year of this, I haven’t ate more than maybe 15 small bites of solids since June 1 last year. I’ve lost so much weight, I will try these!
Thank you for this video.
What about burping and belching before meals? I get this and stops once I eat.
Hmmmm let me think about that one.
@@gutmicrobiomequeen Thank you!
I used to get this in my teens when I was hungry. I called them empty stomach burps
First of all, love the Spirited Away sweater! Next, THANK YOU for posting this!!!! I have been hoping and praying you would talk about burping and today was the day! I have seen 10+ practitioners/doctors and all of them have never seen symptoms like mine before. The gas bubbles up into my stomach and makes loud frog sounds when I breathe. I've even recorded a video on my phone and it has left everyone flabbergasted! 2 questions please:
1) Does this also apply to burping 2 hours after meals/overnight? I am bubbling with gas which gets worse on an empty stomach. 2 hours after meals, I get ravenously hungry, my stomach will fill up with air and burn, then I need to stretch, massage, jump around, and offer a sacrifice to the gods to force burps out. If I can't, it will bubble down and lead to urgent bulky yellow BMs/diarrhea. So does the same principle of improving motility/stomach emptying apply here even though it's worse on an empty stomach?
2) Would prokinetics/HCL be a good idea if the lining is irritated? HCL wouldn't be good with gastritis but would prokinetics be okay? Every time I've tried ginger, it just speeds up the gas bubbling and diarrhea.
Ohh! I'm glad I was able to fulfill your wish today 🥰
I think the same principal still applies, even hours later. When it happened to me, I was belching for what seemed like the entire duration between my meals. God, it was SO annoying!!
I would exercise caution taking anything that can irritate an already irritated stomach lining. Betaine HCl is most likely going to be too harsh, but you may be able to use it if you start SUPER low (like... 1/4 of the lowest dose tablet you can find- I use Biotics Research Hydrozyme for situations like this). ACV is also worth considering, too. For a prokinetic, you might try plain artichoke extract. Hope that helps!
@@gutmicrobiomequeen Thank you, and I love you ❤ I have learned so much from you and I will share your channel/podcast to the ends of the earth!!
One last follow up question, and perhaps an idea for a future video topic: How does this come into play with rapid gastric emptying or delayed rapid emptying? I feel full after meals but monstrously ravenous 2 hours post-meal and that's when the burping starts and everything bubbles up and down rapidly. Do prokinetics help or hinder in such cases? I've also heard the gallbladder plays a big role in belching issues! Gotta go back and listen to your gallbladder/bile podcast.
@@trixiet hmmmmm. Maybe it's a "dysregulation" thing instead of being slowed down 100% of the time or sped up 100% of the time?
In a cases like this, I would think gut-brain axis slash vagus nerve work is best :)
@@gutmicrobiomequeen That is what I'm leaning towards too. It seems to swing from one extreme to the other pretty suddenly. Either full or empty, trapped gas or gas nonstop, quiet gut or bubbling all over rapidly. Thanks for taking the time to write to me and for your insight! :)
@@trixiet you're very welcome :)
Thank you for the great videos! I’ll check out your Prokinetics video, but any advice for someone who can’t swallow capsules (for betaine HCL and stronger digestive enzymes? Do you recommend bitters?
You have a few options :)
- Digestive bitters (for digestion/acid support)
- Apple cider vinegar (for digestion/acid support)
- Ginger tea (as a prokinetic)
- Tea made from most any herb in your spice cabinet (many culinary herbs are carminative, which means they help dispel gas and enhance digestion!)
So my burping seems to occur about 4-5 hours after I have eaten something. I just assumed it was the bacteria being fed and releasing their many gasses??
I m going through the same, are you OK now ??
Thanks! I burp major deep dinosaur-burps after water (not guzzling it or swallowing air). The burping is reduced if I take HCL with water but not completely. Would love a video on water burping & bloat as well!
I made a video about bloating after water a couple of months ago- I bet there would be overlap! 🥰
@@gutmicrobiomequeen Can't find this video. A link to it would help.
or drink apple cider vinegar
Nice video! Which prokinetic did you use to get rid of this problem?
That doesn't matter much, bc the one that worked for me may not work for you! The better question to ask 😉 is how to choose the best prokinetic for YOU! Here's a video I made where I discuss just that 🥰 ruclips.net/video/WEnEnlZDnhA/видео.html
Can you go over aerophagia and how to get rid/stop doing it?
due to acid reflux chest pain for some reason, im on ppi which is creating burping gas due to worse digestion from low acid but hopefully only temporarily to heal the damage
Oh wow this is so interesting! I am dealing with same situation you had with trapped gas and burping right now and it’s been going on for years and it really interferes with my life my eating my energy and even acid reflux and lower GI issues. What pro-kinetic supplement do you recommend with this going on?
Depends on the person! Here's a video where I talk all about choosing herbal prokinetics: ruclips.net/video/WEnEnlZDnhA/видео.html
What I need is Low Stomach Acid test .
I don't drink soda, stopped on January 1, 2013 - present .
For each bite, I chew my food slowly 50 times.
I will wait one hour before and after eating my meal. And then Ill drink water .
Burps after meals, burps on an empty stomach, burps 9 hours after eating, burps after taking some water, burps, and more burps…with lateral left pain under the edge of the ribs(flank pain), just in the beginning of the descending colon…it is a mystery
What do you recommend a patient to start with in general ? to go see a GI Doctor for a diagnostic ?
It depends on the severity of symptoms and if they have any other health conditions that could worsen with a delay in care. For example, blood I'm stools or prolonged diarrhea always merits a GI appt IMO.
Burping, nausea, fullness after meals (to the point of not having appetite for the next meal) can also be a sign of an active H. Pylori infection (50% of the population is infected). The same bacteria can also give you a "silent acid reflex", which damages your throat and larinx, causing endless sore throat, laryngitis, and dry cough. The H. Pylori itself can colonize the throat/larynx aggravating the sore throat/laryngitis even more. If you take Pepto-Bismol and it reduces drastically your symptoms, it may be H. Pylori.
Bro i have same problem with h pylori how did u cured it? Plz help me😢
@@himalay1593 Go to a gastroenterologist to prescribe you 1-2 weeks of eradication regimen: antibiotics, bismuth, and PPI. If the regimen fails, you can suppress it, but not eradicate it with several months of bismuth subcitrate. The Pepto-Bismol is bismuth subsalycilate also may work but is not optimal because it decomposes to aspirin, which is harmful if you have ulcerations.
Hello dr.dinezza, my brother has severe burping after meals . Like 5 times in a single minutes. He saw his physicians many times and passed many tests but never recovered. He is really suffering and I don't know what I can do for him. He is 33 years old. Any advice?
I have hot lemon and ginger drink every morning (strong lemon and ginger juice) would this stop my stomach producing enough acid ..?
Doctor, I need your help. I’m in NYS though. How can I be your patient?
Is there a way to contact you about becoming a client? I'm struggling with gut issues and heart palpitations, but can't find anyone that knows how to treat it
I have functional dyspepsia related to my ENS and redundant colon. Only one motility drug option in Canada. Europe is further ahead for medicine natural and pharma.
Why does a bad gallbladder cause excessive burping after eating?
Would low stomach acid and motility issues cause nausea in addition to burping after eating?
Can you recommend the name of medicine to relieve from burping just after eating any food everytime also a trap gas to release please 🙏
I have trap gas. Feeling dizzy when i didnt burp. I have hiatal hernia and gastritis
thank you Doc.. Do you suggest celery juicing to increase acid?
Apple cider vinegar will help increase acid in the stomach.
Hello, Dr. DiNezza! I take a PPI and have for over 10 years with no problem. Just a few months ago, this constant belching appeared out of nowhere, like you. I also belch in between meals and when drinking even water! Can I take a Prokinetic at the same time as a PPI? I don't want to stop the PPI right now. Thank you!
I burp after drinking water
Hey I have excessive burping what can take to help out
I get burping hours after meals with gas moving and pulling my intestines....I don't get huge distention but the comfortable moving of gas inside and pulls,pops and growling makes me anxious... mosttimes I feel I am away of my food moving through my tract,all these started after the antibiotics I took for h.pylori.tried betaine and digestive enzymes still no relief please what do you suggest?
Started burping in 2019, when the fish i ate, didn't digest. I took apple cider vinegar, and got excessive vomiting, u can say vomiting for months. Still i burp too much after meals. What do u think, should i take esomeprazole daily? Or any prokinetic? Cz 2019, Dr recommended esomeprazole 40 mg.
Still i burp too much after eating, its bizarre 🥺 how to get rid of it?
I have a GERD, acid reflux issue, too. Right now
Gone through endoscopy. It was okay.
@@DiversifiedDigestso your stomach is okay,what did the doctor say about the burping then
Propkinetics and Vagus nerve? I need to learn about those. Thanks for info .Will check into those subjects.
Hugely huge, my friend! I have loads of videos about those topics here as well as over on the IBS Freedom Pod! 🥰 youtube.com/@ibsfreedompodcast1245
@@gutmicrobiomequeen thanks
Yes I have acid reflux and it’s like every time I eat I’m burp and it’s like loud too so I’m trying to see what else I can do for it I have talk to my doctor
Hi, I have this excessive belching problem after eating and in the morning when my stomach is empty. I have really low good bacteria and then a small overgrowth of streptococcus. I also get this need to yawn sensation which i think after researching has to do with LPR?
basically my main question is if i have low stomach acid, how can i get lpr or gerd? should i eat foods that are more acidic or alkaline? idk
This is me but I also have erosive gastritis so I have to be careful about upping my acid (even though I need to do it!)...what do I do???
Does kombucha count as carbonated drink?
Great video thank you. What pro kinetic did you take ? Should you take hcl if you have sibo-c?
The more helpful question is "what is the best prokinetic for YOU to take?" It doesn't matter much what worked for me! Check out this video for some ideas when choosing one for yourself: ruclips.net/video/WEnEnlZDnhA/видео.html
(That being said, the one I happened to have a partial bottle of and decided to try was Mega-Guard)
Also! Perhaps? Certainly if you have symptoms of low stomach acid.
@@gutmicrobiomequeen Thank you for answering. Doesn't hcl feed some types of sibo?
@@scaramouche8244 Nope! Here's a video explaining and debunking that rumor: ruclips.net/video/XfNWSlDyNBs/видео.html
Im so tired of this belching, it’s exhausting and disturbs my sleep. I do drink a lot of coke 😮
What about belching after drinking water? Thanks for this video!
Another commenter said taking HCl helps! I also shared that I made a video about bloating from drinking water a couple of months ago. I bet there would be some overlap, if you wanna check that one out!
for me it started 6 years ago with every day heartburn went to the doc got perscribed ppi's then about 6-8 months later had 2 smal ulcers but ever since they healed my stomach acid has been low i know cause i get that heavy feeling after eating some times that you said .the good thing is my other symptoms didn't worse but their not any better. so im stuck now trying to find out what the root cause of the low stomach acid is i tried HCL when this first started but i stopped taking i because i was up to 25 pills and nothing changed. other symptoms are my thyroid changed it's slower now ,mild constapation ,any little thing can set me off , brain fog off and on so any advice and or tips would be great thanks
First see a GI specialist for upper endoscopy and colonoscopy (if you haven’t.) Only way to know for sure what’s going on in your GI system. You may need a motility test. It could be functional dyspepsia incl bouts of gastritis. My specialist isn’t a fan of the idea of adding acid on prob very sensitive guts before a proper DX. Pls be careful. Maybe get a Nutribullet and blend smoothies and simple soups. Avoid high fiber and fats for a few weeks. Our stomach lining turns over every 6-8 wks. Also green juice with turmeric root (thumb size no pepper), cucumber, greens etc but be careful with ginger or lemons for now. Even turmeric spice 1/2 Tsp helps calm stomach. Bites of banana can help and sipping (not gulping) warm water. Stomach massages can help just search YT. All just ideas. Best of luck and stay calm. Stress only makes it all worse. 😊
Please doctor could tell me which are the best prokentics for burping i been burping so much after meals
Doctor, if someone has symptoms of burping for a long time after a meal and a feeling like the food is just sitting there forever, would you recommend digestive enzymes. If so, do I take them just before a meal? How would I coordinate taking betaine hcl with the digestive enzymes as far as timing.
Vagotomy and pyloroplasty.
Had the above op in 1971
Vagus nerve was deliberatly severed in order to reduce stomach acid
Pylotic Sphincter was widened to allow for rapid stomach emptying.
Fortunately PPIs have almost negated any need fir this op currently so rarely performed nowadays.
I strongly suspect that after 52 years Im unlikely to find an answer to my problem but the low stomach acid does, as you state, seem to be a significant factor.
Love your videos by the way as far as im concerned they are perfectly pitched.
Oh, wow, I'm SO sorry that you had that procedure! It boggles the mind to think that doctors thought this was a good idea in our lifetime.
In truth, I don't know if this is something that can be overcome. The only thing I can think of is kind of woo-woo... Joe Dispenza has a "progressive intensive" program (Sort of like meditation? But not exactly?) that has gotten BONKERS results. Like, stage 4 cancer GONE kinda stuff. If anything is going to help your situation, it's something "out there" like Joe's stuff.
Is it ever bad to take BetaineHCI and or Ox Bile? What if one thinks that one needs this but then they take it and they find out that they didn’t need it? Can it make you sick or cause any bad side effects? Thank you
Hello, you have the weirdest sweatshirt ever😮
Is hcl safer to use than acv when gastritis is present? Does prokinetics cause depression in some cases?
Sendawa/ atob sehabis makan😂
So what the hell
Is a pro kinetic
I need that sweater 🙃
It's from Box Lunch! Box Lunch and Etsy are my kryptonite 😂
What is prokenitic?
I was taking 80mg daily o epmrazol anti acid for 2 month!!!!! And I'm only 21 years old. Now i think i have low acid stomach hard.
Dr which vid do i need to view to see the procktin stuff?
Her shirts abit creepy..
I was at work last night and was covering someone's dinner break. She was complaining about how full she was when she came back. A few seconds later she burped loudly and obviously I asked her if she felt better and she did.
Hello.. What did you take?!?
Is a prokinetic the same as a PPI?
Maybe tight clothing. Me!
I always burp on an empty stomach. After I eat I stop burping. What do I have ?
Might be an ulcer.
I have a big motility issue that causes this sort of thing, but the burping starts like 4 hours after eating. I have been on Motegrity and it was working great for like 4 months but completely wore off now to where I belch for like 4 hours every night and can only eat one meal. I would be curious to know what other prokenitics you use, as I've had no success with MotiliPro, Motility Activator, and . Limited success with Iberogast and TTFD. Still doing Motegrity as well. I have tried HCL but maybe my dosage is not enough I can try again tomorrow. Digestive enzymes make me feel worse if they have Ox bile, do not really notice a difference with enzymes that do not have Ox bile.
Also, I'm curious as to if you've seen vitamin deficiencies cause this as the SIBO has caused my iron/ferritin levels to plummet.
Did u find a solution?
@@Rob__James unfortunately not, though it seems that the root issue is gastroparesis causing contents to not empty. This seems to cause positive SIBO results and the motility issues I've described. Probably going to Cleveland Clinic soon to see what options I have to deal with gastroparesis.
@PianoScottDeBoer people with Gastroparesis usually dont have an appetite & also they get full after just a few bites of a meal. Many gastroparesis sufferers experience stomach pain & nausea/vomiting etc. Do you have those symptoms?
I used to think I might have gastroparesis but I don't experience any of those symptoms. I do have excessive burping/belching tho which I'm trying to find a solution for.
@@Rob__James I vomit every day for a few hours per day, constantly feel full and am belching all the time. Also have some malnutrition symptoms.
@PianoScottDeBoer wow that's hectic! Sorry that you're having to deal with those horrible symptoms! I found an interesting article recently that linked high glyphosate levels in the gut to gastroparesis so once you eliminate the glyphosate then apparently the gastroparesis goes away. You should look into that. Most people get gastroparesis through diabetes, a severe candida infection, damage to vagus nerve & I think there's one other main reason but Glyphosate is another reason that most people don't know about yet so if you didnt get gastroparesis from any of the 4 main ways people get it then it could be due to glyphosate. I'll try to find the article but i dont think we can post links in comments sections of videos.
The vagus nerve damage often occurs through surgery gone wrong so if you had some type of surgery before you got the gastroparesis then your vagus nerve couldve been damaged during the surgery.
Please help me😢
I burp(even with water) and seem to be gassy and also i have loud stomach sounds _ from different parts of my belly each time _ after eating ( or even drinking water) 😭
I m going through the same,what did u do for that? Are u OK now?
Did you figure out the problem ?
try aloe capsuls for burping it works for me but maybe not you
I think I have sibo, all the doctors I went to dismissed me by just giving me acidity medicine.. my stool report says "bacteria: significant" I have excessive burping and rumbling in stomach even when I am not hungry, I either have diarrhea or constipation, sometimes acid reflux, I do have hypothyroidism but borderline. It just suddenly started one day and it's been 5 months that I can't eat anything without experiencing gas and burping afterwards, nothing seems to help. Can it be that I have sibo or hpylori please help.
Hello! I'm sorry your doctor's haven't been helpful so far. For what it's worth, you can't diagnose SIBO via a stool test, though. Here's a video where I explain why: ruclips.net/video/fUJhd4wBBus/видео.html
I believe you'll find lots of info on this channel and the IBS Freedom Podcast that can help you 🥰 Best of luck! youtube.com/@ibsfreedompodcast1245
@@gutmicrobiomequeen Thankyou so much for replying I hope it will be of help. But can you explain why my report says bacteria: significant, I am really confused
@@_cottagecore_9835 it's hard to say without seeing it myself. Honestly, a lot of stool tests are utter rubbish, so who knows what they mean by that.
@@gutmicrobiomequeen Thankyou. In this video you talked about prokinetics can you suggest me some also is 'Triphala' a natural prokinetic I heard people talking about those.
@@_cottagecore_9835 yes, Triphala appears to be both a prokinetic and a laxative. So, probably most suited to folks with constipation still. Oh, and it modulates the microbiome!
Will Apply cider vinegar work
Not if you have peptic ulcers, which are caused by the Helicobacter Pylori bacterium.
Mam I have one doubt if we take tpn for 6 months and make our digestive tract to rest.....so the villi will be regenerated and gut issues will fade away....I have this opinion plss clarify me
Burping and coughing after eating sometimes after 2 hours
HELP ME! This does not answer me. I burp, after a teaspoon of food, once only. There is gas being released, almost instantaneously , after 1 to 2 minutes. No time for fermentation. No time for 'lack of mobility' issues. It must be a simple reaction, like acid in the stomach, and bicarbonate in the food. Or vice versa. Clean smelling CO2 burp. Doesn't matter which food. Except of course, the food does not contain bicarbonate, nor does my stomach!...?
Same issue. Burp as soon as anything goes down. ANYTHING.
@@sofiaroz4685 has any doctor given you an explaination?
Any updates?
Can you link the prokinetic please
Prokinetic?
My 9 yr old daughter has this problem except she needs to burp after meals but can't and then begins to feel nauseous bc of trapped gas. I have to give her pieces of ginger which always help her burp but she'll often still have some stomach discomfort afterwards. She's seeing the gastroenterologist who's given her several tests but she still hasn't figured it out. Any indication of what you think may be the problem or even just some advice would help tremendously.
How is she now?
How is she now im 21 have suffered with this since one
Soda water junkie 👋😑
All it takes is a meal and a few seconds later my friend turns into a burping machine. Everything gives her indigestion and she burps all the time. Hours after we digested our meal you'll still hear a belch come from her.