• Source: June 2020 Q&A with Dr. Allison Siebecker 
• Time in Video: 00:02:06

Dr. Allison Siebecker: Well, first of all… I guess I have three thoughts. One is that most people get their worst bloating towards the end of the day, like in the evening or at night. And that’s just a typical pattern in SIBO bloating because more and more gases are accumulating as we keep eating (like our various meals throughout the day). So, the dinner meal is just more gas being made on top of the other gases. And then, it takes time for gas to be made. It keeps being made and made and made. So the gas from dinner might start being made an hour or two after dinner, but it’s continuing to be made. I think she said it was five to seven hours or something like that. That makes sense. At the end of the day, and then the dinner, and then it’s more gas and more gas. 

Now, a second thought would be there could be something going on in the large intestine, an overgrowth there, LIBO; or also, there can be yeast overgrowth potentially in the large intestine. And so then that might kick in even later. And then, more gas is being made later. Maybe that’s more like the seven-hour mark or the five-hour mark. It depends on a person’s transit time and anatomy. 

And then, the third thought I have is lying down in terms of the burping. When you lie down, the gas can shift and move around. And it might then want to come out the top. 

So, when we stand out, we can get upper gas out better and burp better when we’re standing up. And another position that’s good for that is actually lying on the stomach. It does something to the positioning of the actual physical stomach (lying on the abdomen) that can help facilitate gas to come out. 

So, those are my thoughts. It could be a combination of all of them. But I know a lot of people have bad symptoms at night while sleeping. And that’s just terrible because then your sleep is disrupted and everything. 

But I also think it could have something to do with lying down. I mean, we don’t know what position she sleeps in. What if she sleeps on her abdomen? I don’t know if that would help or hurt. I just think lying down can move the gas. And it can maybe encourage burping. I’ve heard that from more than one person. 

And so, another thing you could think to do just to help it would be to try charcoal before bed to help absorb some of the gas; or potentially, a prokinetic could help whether it’s up or down. Usually, prokinetics will push the gas down. 

I mean, I don’t know that she feels this. But if she felt like she might be able to burp sooner, then a little carbonated water sometimes helps encourage burping, like an hour after dinner or something. 

But otherwise, I would say… I’m sorry, I don’t remember the person’s name. What was her name? 

Shivan Sarna: Marilyn. 

Dr. Allison Siebecker: Marilyn! Marilyn, I don’t know if you’ve taken a look at the Symptomatic Relief Suggestions Handout that is included and the classes on that, the lessons we have on it, but I go over all of these things in depth—the charcoal, the Iberogast and all the things you can do. So, take a look at the sections or that handout on bloating particularly. 

But those are my first thoughts… prokinetic and charcoal before bed.

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