Understanding Bile Acid Diarrhea and Bile Acid Malabsorption
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- Опубліковано 1 кві 2024
- If you’re dealing with BAM, BAD, bile acid diarrhea, bile acid malabsorption, or other bile related troubles, Understanding Bile Acid Diarrhea and Bile Acid Malabsorption can be important to correcting any bile acid diarrhea or bile acid malabsorption problems.
This video will help you understand the underlying cause of bile acid malabsoprtion or bile acid diarrhea and give you insights into steps that can correct this issue. Especially if you’ve been having diarrhea since gallbladder surgery, or if you’re dealing with gallstones or gallbladder symptoms. Learning if you have too much bile or it might be other causes can give you insights into the right steps for you.
➤Data
gut.bmj.com/content/42/2/266
www.sciencedirect.com/topics/....
www.ncbi.nlm.nih.gov/books/NB....
www.ncbi.nlm.nih.gov/pmc/arti....
www.medicinenet.com/what_is_t...
www.ncbi.nlm.nih.gov/pmc/arti...
www.ncbi.nlm.nih.gov/pmc/arti...
www.britannica.com/science/ch...
www.britannica.com/science/ch...
www.ncbi.nlm.nih.gov/pmc/arti...
www.britannica.com/science/bile
➤Videos Mentioned in This Video
How to Adjust Ox Bile Dose and Timing: • How to Adjust Ox Bile ...
6 Steps if You’ve lost Your Gallbladder: • 6 Steps if You’ve Lost...
5 Ways to Improve Bile Flow: • 5 Ways to Improve Bile...
How to Use Ox Bile and Tudca the Right Way
• How to Use Ox Bile and...
10 Signs of Low Stomach Acid: • 10 Signs of Low Stomac...
10 Signs of Poor Bile Flow: • 10 Signs of Poor Bile ...
➤ Register for our TOTALLY FREE 4-Week Online Digestion Course to better understand your unique body chemistry and which aspects of digestion may need a little boost for you. kickitnaturally.com/course
➤ Or download my book, Kick Your Fat in the Nuts for free here: kickitnaturally.com/free/
Chapters 3 & 4 of this book explain the digestive process and how to improve it when aspects aren’t working correctly.
➤ If You’re a Health Professional, download my book, Health Pro Results, for free here: sixfigurehealthpro.com/book
➤ Our Kick It Naturally Podcast episode with T.C. Hale Trouble Improving Bile Flow: kickitnaturally.com/episode363/
➤ TWEET THIS VIDEO: ctt.ac/4VZbY
➤Say hi on social:
Facebook: / kickitinthenuts
Twitter: / kickitinthenuts
UA-cam Video URL: • Understanding Bile Aci...
Disclaimer - T.C. Hale is not a doctor and does not claim to be a doctor or licensed in any type of medical field. Any information found in any of T.C. Hale's books, videos, newsletters, or websites are intended for educational purposes only and should not be used for medical advice. You should contact your doctor for any medical advice.
Comments Section Disclaimer
Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Nothing in the comments section of this video is intended as a substitute for professional medical advice, diagnosis, or treatment. Never disregard or delay seeking professional medical advice because of something you have read or seen in this video or the comments section of this video. No comments or users’ personal opinions found here have been evaluated or approved by the FDA and should not be viewed as medical advice.
Allowing people’s shared comments on this site does not imply our endorsement of, nor any medical claim by us.
People here are simply sharing their own experiences or opinions. If we applaud anyone’s achievements in the comments section we are not saying that we approve of how they did it or that that method is right for you. We are simply celebrating someone’s win. Any results or personal experiences shared should not be considered typical, regardless of the opinion of the one sharing the experience and should not be considered a cure for any disease or medical condition.
If we share a link to other content, we are not saying that this is the answer to your health concern. We are simply sharing other content that may be helpful from an educational standpoint only. If we share steps we use with our clients or methods others have shared with us, that does not mean we are suggesting you follow those steps or methods or providing any type of medical advice in any way. We are simply sharing thoughts and opinions for educational purposes.
Video hashtags: #TCHale #KickItNaturally #bileacidmalabsorption
Helpful videos mentioned in this video and a comment's section disclaimer:
How to Adjust Ox Bile Dose and Timing: ua-cam.com/video/4iuYpaiFT3Y/v-deo.html
6 Steps if You’ve lost Your Gallbladder: ua-cam.com/video/jJ_30UK_G0E/v-deo.html
5 Ways to Improve Bile Flow: ua-cam.com/video/mBdV6ZT9woQ/v-deo.html
Comments Section Disclaimer
Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Nothing in the comments section of this video is intended as a substitute for professional medical advice, diagnosis, or treatment. Never disregard or delay seeking professional medical advice because of something you have read or seen in this video or the comments section of this video. No comments or users’ personal opinions found here have been evaluated or approved by the FDA and should not be viewed as medical advice.
Allowing people’s shared comments on this site does not imply our endorsement of, nor any medical claim by us.
People here are simply sharing their own experiences or opinions. If we applaud anyone’s achievements in the comments section we are not saying that we approve of how they did it or that that method is right for you. We are simply celebrating someone’s win. Any results or personal experiences shared should not be considered typical, regardless of the opinion of the one sharing the experience and should not be considered a cure for any disease or medical condition.
If we share a link to other content, we are not saying that this is the answer to your health concern. We are simply sharing other content that may be helpful from an educational standpoint only. If we share steps we use with our clients or methods others have shared with us, that does not mean we are suggesting you follow those steps or methods or providing any type of medical advice in any way. We are simply sharing thoughts and opinions for educational purposes.
How about making a video of how to prep for a colonoscopy. I'm sure you can make it funny and I can laugh all the while I'm prepping. 😳
I used to drink alot of alcohol mostly on an empty stomach and totally destroyed my gut biome ! Everything you name it and got h- pylori - blocked bile duct - diverticulitis - low stomach acid - gout - low pancreatic enzymes - lost alot if weight from malnutrition and diarrhea ! cut back on drinking - started bile salts - cbd - graviola and a digestive enzyme formula with plenty of fiber ! Back to normal after 2 years of grief !and finally got the will and strength to exercise ! 😊
So glad to hear that you are finding relief.
Did you have erosive esophagus?
In my own opinion, *Stay away from Over the counter medications because you can end up
with H Pylori Again and Gastritis. I feel bad for you with Diverticulitis :( .
My nephew died from Pancreatitis , stay away from alcohol .
How did you fix Malnutrition ?
Way to Go! LOVE to hear stories like this. Similar to mine.
How did you resolve the blocked bile duct, was the blocked bile duct in your liver or was it your gallbladder?
Thanks in advance ❤
Thanks for sharing your experience
TCHal is smarter than the 20 doctors I’ve seen yet. Thank you TC, you are literally a life saver!
I appreciate that. And I saw 23. :) Here's that story. ua-cam.com/video/Ry_mGzS6JU4/v-deo.html
Thank you so much for this detailed explanation. It's crazy how little information there is on this topic on UA-cam. It feels like crickets or the very basics! Thank you again. I appreciate it.
Glad it was helpful! and I agree. :)
I'm dealing with alot of stomach issues acid,bile and a hernia and this has taught me so much and offered more avenues then any actual doctor. Thank you
So glad it was helpful. If you haven't seen our video on fixing a hiatal hernia, that may help too. I had one as well: ua-cam.com/video/J4GICcjT9Tw/v-deo.html
Thank you. I started taking enzymes with ox bile after fatty meals and the diarrhea went away. Thank God!!
I guess I will for the rest of my life
How long after a meal are you taking it?
❤
Hi. Directions say to take after each meal. It also says do not take in empty stomach
Name is Multi Enzyme from Vitamin Shoppe. Cheers
@@Laura-rx9mp thank you❤️
I really enjoy learning from your videos. You are the best!
I appreciate that
It's a sad commentary for the medical profession when a comedian knows more about the digestive process than they do. It's also sad when in the last 35 years of going to 5 different gi docs I've never been asked once: "What have you been eating". It's just a prescription for your symptom game.
agreed. :)
Love your explanations. Your videos break it down so well to be able to comprehend. Thank you so much.
Glad they have been helpful.
You are so helpful and I have learned a lot from your videos. Thanks educating us.
You are so welcome!
Thank you Tony so much I don’t know what I would have done if I didn’t find your videos. I don’t have a gallbladder and you have saved my liver and I think my life.
So glad to hear you're creating improvements! So fun. Keep it up!
Doc, you are the Mentor ❤ we are always our own judges. I still have to figure out how to live without my gallbladder the best way 😞 And you are helping me a lot ❤
Your two latest videos have been about exactly whats going on with myself again, thank you 🙏
I know. I made them just for you. :)
Glad they've been helpful.
@@KickItNaturallyYou are one of my favourite channels, i look forward to new videos :)
I really enjoy your videos and I'm glad I'm getting the notifications on UA-cam again and I try to listen while I'm at work but sometimes it gets overwhelming because of the amount of information at the same time I'm trying to do calculations but I listen to you when I can
TC Hale is a good person and he cares about people.
I watched most of all his videos.
I have recommended Families and Friends throughout The USA, of his videos.
Glad to hear it and thanks for watching.
Your advises with stomach problems are easily the best!!! I I have red articles A LOT. I love you❤. Greetings from Finland
I really appreciate that.
This is interesting. I have to watch it again!
Lots to take in
Everyone should watch this twice@@KickItNaturally
So helpful!
Glad it was helpful!
Another super great, highly informative video. I really appreciate your time and effort. Thank you so much.
Glad it was helpful! I appreciate the note.
Thanks for sharing!
You bet!
Thank you so much.
You bet
TC Hale....I am feeling better since I been taking Betaine HCI, Zinc Carnosine , Slippery Elm, Probiotic .
Have to admit, it took a long while. I haven't feel good for the last 3 1/2 years.
Noticed some symptoms haven't been around for a while.
I have a M.D check up next week, every 6 months.
Way to go Debbie! Love to hear about your improvements.
What is the cause for the epidemic of people 40 and over to have a low stomach acid issue ?
Wonderful
this was super informative. thank you
Glad it was helpful!
Thanks for all the videos about bile. Its soooo helpful. Could you also talk about bile induced constipation and bile reflux?:)
Here is our video about bile reflux: ua-cam.com/video/FyRL1_xSK3s/v-deo.html
I like the bile induced constipation topic. I'll put that down.
Very informative
Glad it was helpful!
“ when we poop like a champion” 😂😂🎉
I remember when I had a 14 day fasting, after the 7th I had an urge to poop and then I’ve got out several balls of something that took like fatty eggs! I guess that was lumps of bile! Before that in the veinings I drank every evening 2to 3 spoons of vinegar and the juice of half of lemon mixed with little water! I felt I had a really good sleep and also some movement in to the liver area. Was it wrong of me doing that? I like learning about metabolism! And I hope some day I can buy your book from audible! Reading them in the evening would have put me to sleep fast
Very well explained!
I appreciate that
Great learning video
I appreciate that.
Taking down notes!
Hope it helps
Great video, much appreciated! Thank you💫
I started taking Tudca; I had to adjust my dose, by trial & error… found the right dose! Works great for me🎉
Thanks for sharing that.
What dose you are taking? Tudca is giving me diarrhea. I take it twice with meals.
Hi, when do you take it and at what dosage?
Lots of good information 👍🏻👍🏻👍🏻
I apreciate that
Excellent video! If people fixed these issues they may absorb more nutrients and they will be less sick.
Totally agree!
Great, Thanks
You bet
Doctor, I have been prescribed cholestyramine as I have lighter stool, belly cramps and diarrhea.... Also found some gallstones but gallbladder not removed.
Feel much better now and your video makes sense! Thank you
Glad it was helpful. With all those factors, your best bet could be to go through our totally free digestion course because that will walk you through figuring out which aspects of digestion are not working correctly and what steps will help you the most. You can find that free course here: kickitnaturally.com/course
Come back and let us know how it goes.
Lifesaver
:)
OMG ...you are hysterical!!!
Everything you're saying is true. :)
I appreciate that.
@@KickItNaturally hahahaha!!
He is making a critical lesson entertaining and fun - underated channel.
@@VisionCapitalist He sure does a great job at it! Always keeps me interested in wanting to learn from him! And yes, definitely underrated! I have learned so much from him more so than anyone else!
Before having gall bladder and stones removed, I never realized how important it is, to SAVE it !!!
For those who recently had their gall bladder removed, no doubt they are stressing out and if they
have other health issues and can't figure it out . I felt every emotion a person feels Overwhelmed ,etcc.
I truly feel bad for the person.
Thanks for sharing this Debbie.
I've been doing everything to save mine. My gallbladder is fine, is what the tests say, it's Fatty liver, but I was already making changes to eat healthy
If i have foul smelling floating stools how would i knw if its lack of bile or enzymes?
Great video - thank you! What does a high blood bilirubin level mean in the context of bile issues?
Hi bilirubin in the urine can be used as a possible marker for poor bile flow. It's not diagnostic, but when bile is flowing correctly, you usually won't see it in a urine test.
Thank you for your reply 😊
That sounds awful. Glad we can now correct it!
true
Any insight for my situation would be greatly appreciated. Born with a congenital birth defect. First surgery at 24 hrs old. 130+ surgeries since. At age five, they accidentally squashed the gallbladder and removed it at that time. During these many reconstruction surgeries they used the Iliosical tissue to reconstruct the ureters. This last major surgery the removed more upper bowel and the Iliosical valve to redo the ureters again giving me my second urinostomy. I've had diarrhea for the last seven years.
I can't give advice on specific situations like that in video comments. But if you go through our free digestion course, it will help you understand how digestion is supposed to work, and give you insights into tweaks you can test out for yourself. You can find that free course here: kickitnaturally.com/course
Come back and let us know how it goes.
My wife had her gallbladder removed and had the same symptoms for years. Her triggers were sugar so she cut it from her diet. Helped but still had ibs w pain and bloating and then diarrhea. This was going on for years so we went to a GI surgeon and he recommended benefiber (without the sugar) with probiotics and taking 2 tablespoons daily in the morning. He said that it works like a binder like the medication this doc mentions. It’s been about two weeks now and she no longer has any of the symptoms however still watches her diet. Try it and see if it helps
What product did you say helped her?
@@user-pl9ll2dc7s Benefiber (without sugar) w probiotics (should be a green container and can buy it at any store: CVS, Walgreens, etc). She still is careful what she eats, she cant have sugar because it’s a major trigger (so we read a lot of labels), no more processed foods like pastas, breads, tortillas(sourdough bread seems to be ok), and be careful with steak because it’s hard for her body to process. Hopefully it helps you. It’s not a cure but it has helped her. She normally puts it in her hot tea in the morning
I don't know how that treat the bile problem tho. It treats the IBS and harden the stool. Good nonetheless
I am after more information about PPI’s. How to get off them if on them a long time? Is there a PPI video?
I'm not allowed to make videos with advice about medications. your best bet could be to go through our totally free digestion course because that will walk you through figuring out which aspects of digestion are not working correctly and what steps will help you the most. You can find that free course here: kickitnaturally.com/course
Come back and let us know how it goes.
I dont digest any fat, would tucka help. Xxc
Im thinking if your stomach is not acid enough, it wouldn't trigger bile flow in the duodenum. Likely resulting in some undigested food in the stool. Raw carrots would be something that would show easily in the stool in that case. Of course I still cant figure out why i have weeks of right rib cramps after an episode of what i think was a mild gallbladder attack. No huge pain, just fullness, tightness and cramping under the rib that gradually subsided over several weeks. Yet still have a slight tightness under that rib.
Our video on dealing with gallstones could give you some insights: ua-cam.com/video/qPn_iPkj2Yw/v-deo.html
👍
I have had a bowl ressection at the terminal illium, I also have my gall bladder removed. Had a recent diagnosis of BAM. My gastro doc wants me to take Colesevelam, I can’t see what the advantages are?
Here is our video on BAM: ua-cam.com/video/wgsdzeOGoPo/v-deo.html
Why are they called bile acids when they’re alkaline
damn good question!
My diarrhea greatly improved with betaine HCL, but I still had trouble digesting fats and was constipated. I also got bad diarrhea taking TUDCA on an empty stomach in the morning. What should I try? Thanks!
There can be a variety of issues going on there. your best bet could be to go through our totally free digestion course because that will walk you through figuring out which aspects of digestion are not working correctly and what steps will help you the most. You can find that free course here: kickitnaturally.com/course
Come back and let us know how it goes.
Great video and it made me think differently. Suppose my gallbladder isn't working properly, so there is too much HCl in the intestines, would Colestyramin mask this? In other words they say if you take Colestyramin and it eases your diarrhea, then you have BAM. But is that true alltogether?
Choelestyramine was given to me as a diagnostic medication after 10 years of suffering after the first dose of it in the hospital it was like a miracle, so I would have to say yes.
@@dontdisturbthisgroove8848 Even GI specialists have no knowledge on BAM. It is in the literature that you best try out Cholestiramine right away and see if it helps. I did my own research and sort of embarresed my GI doc by coming up with a diagnose and Cholestyramine. His only diagnose after his was that it would heal in time. Hahaha, that's 3 years ago.
I've been using Oxbile sporadically as my bloating, motility slow down gets worse with higher fat meals. I'm now getting some heartburn symptoms after taking the oxbile (taken 1+ hrs after meal). Why might that be happening?
It could be that the ox bile is now making it so your stomach acid is too low.
Please help if you can. I have had my gallbladder out, hida scan read 0 so they had me have it out. My symptoms have been under my rib cage mostly on the right. I hear gurgling churning under my right rib cage. I feel pressure that makes me feel tired and lethargic which makes me lay down for hours until it has been some what relieved. I have attacks under my ruq like a calf cramp that shoots up my neck and lasts about 3 to 5 mins. Its severe i pace until it subsides, i thought it could be a stroke but none of my doctors know. I at times use the restroom 10 to 20 times a day, incomplete defication. Ive had every type of pooh on the chart. The color varies and does appear to be clay colored when im having bad days. I also do poop blood clots that most times relieves pressure under the center of my rib cage the pressure lasts weeks and i know before i look it will be all blood. My doctors say hemroids but they really dont listen to me or the symtoms. Ive been through the ringer and have had every test multiple times. Im not heard when im telling them about the pain in my ruq or any of my sypmtoms really. They seem puzzled. This is a longshot cry for help or if i could be pointed in the right direction. Hope you can reach back out to me. Thank you.
HI Will. Yeah, we hear stories like this a lot. I don't have a way of knowing for sure what is going on. But I wonder if this video might give you some helpful insights. It might be the video you're looking for: ua-cam.com/video/I4iNJeD7mCQ/v-deo.html
But with all those things going on, your best bet could be to go through our totally free digestion course because that will walk you through figuring out which aspects of digestion are not working correctly and what steps will help you the most. You can find that free course here: kickitnaturally.com/course
and if you get really stuck, this page lists a variety of ways to get help or find your own answers: kickitnaturally.com/get-help/
Come back and let us know how it goes.
Do you think tudca help with Chronic hives to
Here is our new video on hives: ua-cam.com/video/ZjZIw5W1hW8/v-deo.html
TC, Would you say that it would be a waste of time taking liquid complex B vitamins while fixing digestion to absorb it that way in the meantime?
I can't say that would be a waste of time since liquid is easier to assimilate. I don't know if that is right for you, but I don't think it would be a waste in liquid form.
@@KickItNaturally Ok. Thank you
Had high triglycerides when I had my gallbladder removed . What does this mean ?
See other comment I just left you
I have bam after being diagnosed with a sehcat scan, it causes me stomach and gut pains 😢
your best bet could be to go through our totally free digestion course because that will walk you through figuring out which aspects of digestion are not working correctly and what steps will help you the most. You can find that free course here: kickitnaturally.com/course
Come back and let us know how it goes.
hi doc, what is the problem if the poop comes out but looks like it didn't digest properly?
is it bile not enough or the acid from the stomach? i stopped using ppi for my gastric ulcer but i don't know if this is one of the reasons. thanks doc. God bless you.
Not a doc, but it could be either or both sides when you're seeing undigested food. your best bet could be to go through our totally free digestion course because that will walk you through figuring out which aspects of digestion are not working correctly and what steps will help you the most. You can find that free course here: kickitnaturally.com/course
Come back and let us know how it goes.
Dysbiosis maybe low stomach acid for sure imo - get a holistic coach like him
I had surgery in my small intestines, and doctor told me that he removed around 50 cm off my small bowel, I did 3 years and a half with bam and maybe was better to be dead than living like this!!
Thank you
You're welcome
Can you have too much hcl causing the BAD?
I have green vomit! Also burning in my stomach.
I have my gall bladder-- I will watch the other video.
We're not allowed to give advice on specific situations in video comments, but With burning in your stomach, our video on gastritis might give you some insights: ua-cam.com/video/XM10QB10vK0/v-deo.html
and if you get stuck, this page lists a variety of ways to get help or find your own answers: kickitnaturally.com/get-help/
What is the cause for yellow liquid diarrhea on a fast?
This video explains light or yellow colored stool in any circumstance: ua-cam.com/video/P_HfYxOsr4I/v-deo.html
I seem to get diahhrea especially bad when losing weight. Could the body be reacting to stored toxins that are now released from fat cells and sending water down to flush these toxins out?
I feel like that could be possible, but it could also be other things going on. You really want to look at your chemistry and how your body is working so you don't have to guess. your best bet could be to go through our totally free digestion course because that will walk you through figuring out which aspects of digestion are not working correctly and what steps will help you the most. You can find that free course here: kickitnaturally.com/course
Come back and let us know how it goes.
@@KickItNaturally - Thank you so much!!
I’m trying to wrap my head around my GI doctor prescribing a bile acid sequestrant (which I have seen some success with) yet refusing to call it BAM or BAD and insists it’s ibs. I have no gallbladder, and suddenly got BAM 10 years later after a few rounds of antibiotics. I have been housebound for 10 months and am on full time disability. But it’s just ibs 🙄
Second opinion?
You do not take any bile acid sequestrate? I had my gall bladder removed and could not hold food in me it was so bad I would chew food and have to run to the bathroom. Finally last year my intestines were so irritated that they diagnosed me with colitis in the hospital, a doc came in and gave me Colestyramine packet and mixed it with my applesauce. After one dose it worked like a miracle.
@@dontdisturbthisgroove8848 i wrote that I take sequestrants with some success. Cholestyramine did not work for me. Colesevelam has worked better but still struggling.
I just had my gal stones removed. Am I prone to this too?
Here is our video about gallbladder removal: ua-cam.com/video/jJ_30UK_G0E/v-deo.html
Did you have just the stones removed or the gallbladder ?
The test showed that I'm dealing with a high bile acid problem, which is irritating my small intestine after I consume more dietary fat. I need some clarification. What is the correct solution for this? Does that mean I have too little bile, which cannot neutralize the acid from my stomach? Would supplementing more oxbile help fix the high bile acid problem or worsen it?Thank you!
I'm not allowed to give specific advice in video comments. your best bet could be to go through our totally free digestion course because that will walk you through figuring out which aspects of digestion are not working correctly and what steps will help you the most. So you can better understand what both sides are doing and that could help you make adjustments as you test things out. You can find that free course here: kickitnaturally.com/course
Come back and let us know how it goes.
If your bile is too high, try supplementing with betaine HCL so the stomach acid is increased. That should help to match the high bile in the small intestine.
Can problems with bile and gallbladder cause also problems with pancreas in long run?
We talk about that in this video: ua-cam.com/video/Dqg6RhWATk0/v-deo.html
Ox bile made my gastritis worse. Why is that ?
This video on bile acid gastritis might give you the insights on why: ua-cam.com/video/FyRL1_xSK3s/v-deo.html
@KickItNaturally i had a hida scan done and they said my gallbladder is emptying too fast and have had bloating and gastritis for years. Apple cider vinger and betaine hcl also makes my gastritis worse I have no clue what to do
my poop is yellow all the time. is this a sign of this ?
This is the video that usually helps that situation if a person still has their gallbladder: ua-cam.com/video/mBdV6ZT9woQ/v-deo.html
Please make hindi channel also for indian
That would be pretty cool
Betaine HCL causes insominia
Something is going wrong if that is the case. your best bet could be to go through our totally free digestion course because that will walk you through figuring out which aspects of digestion are not working correctly and what steps will help you the most. It will also help you figure out any imbalances that could be contributing to the insomnia. You can find that free course here: kickitnaturally.com/course
Come back and let us know how it goes.
Why call the bile fluid an acid if it is alkaline? Wouldn’t it be more accurate to call it an alkali? Shouldn’t the condition be called “bile alkali diarrhea?”
bile acids are contained in the bile itself. and this is not the only name in science that is confusing. :)
Voice dubbing
Good tip. I didn't think about that.
One word you are using wrong. Bile is not acid. It is alkaline. Bile reflux.