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Digestive Diseases & Disorders

Abdominal Bloating
Abdominal bloating is when the abdomen feels full and tight. It is usually caused by intestinal gas. Common causes are overeating, lactose intolerance and other food intolerances, air swallowing (a nervous habit), Irritable bowel syndrome, partial bowel obstruction, and constipation. Important but uncommon causes of abdominal bloating include ascites and tumors, such as those arising from ovarian cancer.

Abdominal Pain
Abdominal pain is traditionally described by its chronicity (acute or chronic), its progression over time, its nature (sharp, dull, colicky), its distribution (by various methods, such as abdominal quadrant (left upper quadrant, left lower quadrant, right upper quadrant, right lower quadrant)) or other methods that divide the abdomen into nine sections), and by characterization of the factors that make it worse, or alleviate it. Due to the many organ systems in the abdomen, abdominal pain is a concern of general practitioners/family physicians, surgeons, internists, emergency medicine doctors, pediatricians, gastroenterologists, urologists and gynecologists.

Abnormal Liver Tests
An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes in the blood. Under normal circumstances, these enzymes reside within the cells of the liver. But when the liver is injured, these enzymes are spilled into the blood stream signaling liver damage.

Anemia
Anemia is a deficiency of red blood cells or hemoglobin that results in a reduced ability of blood to transfer oxygen to the tissues, causing tissue hypoxia. Since all human cells depend on oxygen for survival, varying degrees of anemia can have a wide range of clinical consequences. Hemoglobin (the oxygen-carrying protein in the red blood cells) has to be present to ensure adequate oxygenation of all tissues and organs. The three main classes of anemia include excessive blood loss (acutely such as a hemorrhage or chronically through low-volume loss), excessive blood cell destruction (hemolysis) or deficient red blood cell production (ineffective hematopoiesis). In menstruating women, dietary iron deficiency is a common cause of deficient red blood cell production. Anemia is the most common disorder of the blood. There are several kinds of anemia, produced by a variety of underlying causes. Anemia can be classified in a variety of ways, based on the morphology of RBCs, underlying etiologic mechanisms, and discernible clinical spectra, to mention a few.

Ascites
Ascites is an accumulation of fluid in the peritoneal cavity. Mild ascites is hard to notice, but severe ascites leads to abdominal distension. Patients with ascites generally will complain of progressive abdominal heaviness and pressure as well as shortness of breath due to mechanical impingement on the diaphragm. Ascites is detected on physical examination of the abdomen by visible bulging of the flanks in the reclining patient ("flank bulging"), "shifting dullness" (difference in percussion note in the flanks that shifts when the patient is turned on the side) or in massive ascites with a "fluid thrill" or "fluid wave" (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen). Other signs of ascites may be present due to its underlying etiology. For instance, in portal hypertension (perhaps due to cirrhosis or fibrosis of the liver) patients may also complain of leg swelling, bruising, gynecomastia, hematemesis, or mental changes due to encephalopathy. Those with ascites due to cancer (peritoneal carcinomatosis) may complain of chronic fatigue or weight loss. Those with ascites due to heart failure may also complain of shortness of breath as well as wheezing and exercise intolerance.

Celiac Disease
Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, found in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in products we use every day, such as stamp and envelope adhesive, medicines, and vitamins. When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging the small intestine. The tiny, fingerlike protrusions lining the small intestine are damaged or destroyed. Called villi, they normally allow nutrients from food to be absorbed into the bloodstream. Without healthy villi, a person becomes malnourished, regardless of the quantity of food eaten. Because the body's own immune system causes the damage, celiac disease is considered an autoimmune disorder. However, it is also classified as a disease of malabsorption because nutrients are not absorbed. Celiac disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy. Celiac disease is a genetic disease, meaning it runs in families. Sometimes the disease is triggered-or becomes active for the first time-after surgery, pregnancy, childbirth, viral infection, or severe emotional stress.

Colitis
Colitis refers to inflammation of the large intestine. Also this is used to refer to inflammation of the small intestine. Although the proper term would be ileitis when speaking of the ileum which is the end of the small intestine, colitis may be due to infections like Salmonella, diseases like ulcerative colitis or Crohn's disease.
Stress-related colitis, also called the irritable bowel syndrome does not truly cause inflammation of the colon, but it does cause the same symptoms.

Colon Cancer
Colon cancer is cancer of the large intestine (colon), the lower part of your digestive system. Rectal cancer is cancer of the last 6 inches of the colon. Together, they're often referred to as colorectal cancers. About 112,000 people are diagnosed with colon cancer annually, and about 41,000 new cases of rectal cancer are diagnosed each year, according to the American Cancer Society. Most cases of colon cancer begin as small, noncancerous (benign) clumps of cells called adenomatous polyps. Over time some of these polyps become colon cancers. Polyps may be small and produce few, if any, symptoms. Regular screening tests can help prevent colon cancer by identifying polyps before they become cancerous. If signs and symptoms of colon cancer do appear, they may include changes in bowel habits, blood in your stool, persistent cramping, gas or abdominal pain.

Colon Polyps
As many as 30 percent of middle-aged and older adults have one or more colon polyps - a small clump of cells that forms on the colon lining. Although the great majority of colon polyps are harmless, some may become cancerous over time. Anyone can develop colon polyps, but you're at higher risk if you are 50 or older, are overweight or a smoker, eat a high-fat, low-fiber diet, or have a personal or family history of colon polyps or colon cancer. Sometimes colon polyps can cause signs and symptoms such as rectal bleeding, a change in bowel habits and abdominal pain. But most small colon polyps don't cause problems, which is why experts generally recommend regular screening. Colon polyps that are found in the early stages usually can be removed safely and completely.

Constipation
Constipation is defined as having a bowel movement fewer than three times per week. With constipation stools are usually hard, dry, small in size, and difficult to eliminate. Some people who are constipated find it painful to have a bowel movement and often experience straining, bloating, and the sensation of a full bowel. Some people think they are constipated if they do not have a bowel movement every day. However, normal stool elimination may be three times a day or three times a week, depending on the person. Constipation is a symptom, not a disease. Almost everyone experiences constipation at some point in their life, and a poor diet typically is the cause. Most constipation is temporary and not serious.

Crohn's Disease
Crohn's disease is an ongoing disorder that causes inflammation of the digestive tract, also referred to as the gastrointestinal (GI) tract. Crohn's disease can affect any area of the GI tract, from the mouth to the anus, but it most commonly affects the lower part of the small intestine, called the ileum. The swelling extends deep into the lining of the affected organ. The swelling can cause pain and can make the intestines empty frequently, resulting in diarrhea. Crohn's disease is an inflammatory bowel disease, the general name for diseases that cause swelling in the intestines. Because the symptoms of Crohn's disease are similar to other intestinal disorders, such as irritable bowel syndrome and ulcerative colitis, it can be difficult to diagnose. Ulcerative colitis causes inflammation and ulcers in the top layer of the lining of the large intestine. In Crohn's disease, all layers of the intestine may be involved, and normal healthy bowel can be found between sections of diseased bowel. Crohn's disease affects men and women equally and seems to run in some families. Crohn's disease may also be called ileitis or enteritis.

Diarrhea
Diarrhea is an increase in the frequency of the number of bowel movements in a 24-hour period. People interpret diarrhea differently but the strict definition is as stated: " Diarrhea may be caused by many different disorders ranging from food poisoning, infections, food allergies, malabsorption (not absorbing food properly), medications (prescription and non-prescription) and colitis ". Any persistent diarrhea should come to one's attention and should be addressed by a physician.

Diverticulosis & Diverticulitis
Many people have small pouches in their colons that bulge outward through weak spots, like an inner tube that pokes through weak places in a tire. Each pouch is called a diverticulum. Pouches (plural) are called diverticula. The condition of having diverticula is called diverticulosis. About 10 percent of Americans over the age of 40 have diverticulosis. The condition becomes more common as people age. About half of all people over the age of 60 have diverticulosis. When the pouches become infected or inflamed, the condition is called diverticulitis. This happens in 10 to 25 percent of people with diverticulosis. Diverticulosis and diverticulitis are also called diverticular disease.

Esophagitis
Esophagitis is an inflammation of the lining of the esophagus, the tube that carries food from the throat to the stomach. If left untreated, this condition can become very uncomfortable, causing problems with swallowing, ulcers and scarring of the esophagus. In rare instances, a condition known as "Barrett's esophagus" may develop, which is a risk factor for cancer of the esophagus. Esophagitis is caused by an infection or irritation in the esophagus. An infection can be caused by bacteria, viruses, fungi or diseases that weaken the immune system.

Fatty Liver
Fatty liver is the accumulation of fat in liver cells. Simple fatty liver is not a disease, since it does not damage the liver, but is a condition that can be identified by taking a sample of liver tissue (liver biopsy) and examining it under a microscope. Another term often used to describe this condition is fatty infiltration of the liver.

Fissures
An anal fissure is a small split or tear in the anal mucosa that may cause painful bowel movements and bleeding. There may be blood on the outside of the stool or on the toilet tissue following a bowel movement. Anal fissures are extremely common in young infants but may occur at any age. Studies suggest 80% of infants will have had an anal fissure by the end of the first year. Most fissures heal on their own and do not require treatment, aside from good diaper hygiene. However, some fissures may require medical treatment. The incidence of anal fissures decreases rapidly with age. Fissures are much less common among school-aged children than among infants. In adults, fissures may be caused by constipation, the passing of large, hard stools, or by prolonged diarrhea. In older adults, anal fissures may be caused by decreased blood flow to the area. Anal fissures are also common in women after childbirth and people with Crohn's disease.


Fistulas - An abnormal passageway in the body. The fistula may go from the body surface into a blind pouch or into an internal organ or go between two internal organs. For a common example, an anal fistula has an opening in the skin near the anus that leads into a blind pouch or may connect through a tunnel with the rectal canal. For a rare example, a gastropericardial fistula is a passageway between the stomach and the pericardial sac (that surrounds the heart). There are numerous types of fistulas and they are usually designated by the organs or parts they connect.

Gallstones
Gallstones are pieces of solid material that form in the gallbladder. Gallstones form when substances in the bile, primarily cholesterol and bile pigments, form hard, crystal-like particles. Cholesterol stones are usually white or yellow in color and account for about 80 percent of gallstones. They are made primarily of cholesterol. Pigment stones are small, dark stones made of bilirubin and calcium salts that are found in bile. They account for the other 20 percent of gallstones. Risk factors for pigment stones include cirrhosis, biliary tract infections, and hereditary blood cell disorders, such as sickle cell anemia. Gallstones vary in size and may be as small as a grain of sand or as large as a golf ball. The gallbladder may develop a single, often large, stone or many smaller ones, even several thousand.

Gas (excessive)
Perhaps the most frequent gastrointestinal complaint, intestinal gas is one of the more embarrassing symptoms for which patients seek assistance. Aside from causing embarrassment, too much gas in the digestive system can result in considerable pain, bloating, and discomfort - symptoms that may appear on their own or in conjunction with functional dyspepsia or irritable bowel syndrome. There are only two ways for gas to originate. Either you swallow it (aerophagia), or it's manufactured in the gut (producing flatus). Flatus, also known as flatulence, describes gas that escapes from the rectum. The gas is mostly the by-product of the fermentation of undigested food by bacteria in the colon. It contains carbon dioxide, hydrogen, and, in some people, methane. Tiny amounts of volatile chemicals produced by bacterial metabolism of residual fats and proteins are responsible for the distinctive foul odor of flatus. Gas that escapes from the far end of the GI tract may be natural, but nowhere is it an accepted part of society. The average human intestine holds 100-200 milliliters of gas, but researchers have found that in 24 hours, production of flatus averages 2 liters. This gas originates in the intestine, and its quantity and composition depend largely on the foods you eat. Studies using hydrogen breath testing have found that up to one-fifth of the complex carbohydrates eaten by average, healthy individuals is turned into gas.

Gastroesophageal Reflux Disease (GERD)
When you swallow, food passes down your throat and through your esophagus to your stomach. A muscle called the lower esophageal sphincter controls the opening between the esophagus and the stomach, and remains tightly closed except when you swallow food. When this muscle fails to close, the acid-containing contents of the stomach can travel back up into the esophagus. This backward movement is called reflux. When stomach acid enters the lower part of the esophagus, it can produce a burning sensation, commonly referred to as heartburn. Several factors might explain why this reflux action occurs and might offer some clues for relief. The most important are the position of your body after eating (An upright posture helps prevent reflux.) ,the size of the meal (Smaller meals reduce reflux.), the nature of foods you consume (Certain substances that irritate the esophagus or weaken the sphincter can cause reflux.)

GI Bleeding
The many causes of gastrointestinal (GI) bleeding are classified into upper or lower, depending on their location in the GI tract. Upper GI bleeding originates in the first part of the GI tract-the esophagus, stomach, or duodenum (first part of the intestine). Bleeding can come from ingestion of caustic poisons or stomach cancer. Most often, upper GI bleeding is caused by Peptic ulcers, Gastritis, Esophageal varices, or Mallory-Weiss tears. Lower GI bleeding originates in the portions of the GI tract farther down the digestive system-the segment of the small intestine farther from the stomach, large intestine, rectum, and anus. Diverticular disease, angiodysplasia, polyps, hemorrhoids, and anal fissures most commonly cause the bleeding. Blood in the stool can result from cancers, inflammatory bowel disease, and infectious diarrhea.

Heartburn
Heartburn is a burning sensation in the center of the chest that often occurs after eating, bending over, with exercise, and sometimes at night when lying down. Approximately one in 10 adults has heartburn at least once a week and one in three monthly. Some pregnant women experience heartburn almost daily as a result of increased pressure on the abdomen and hormonal changes. Although its name implies otherwise, heartburn has nothing to do with your heart. Rather, these symptoms indicate a condition called gastroesophageal reflux disease, or GERD.

Helicobacter Pylori (Stomach Infection)
This unusual name identifies a specific bacteria that can cause infection of the stomach. This infection can contribute to the development of diseases, such as dyspepsia (heartburn, bloating and nausea), gastritis (inflammation of the stomach), and ulcers in the stomach and duodenum. But even though the bacteria can cause these illnesses, experts believe that most H. pylori infections are "silent" and produce no symptoms. The bacteria are found everywhere in the world, but especially in developing countries, where up to 10% of children and 80% of adults can have laboratory evidence of an H. pylori infection - usually without having any symptoms. In industrialized countries, the infection is rare in children, and only about 40% of adults are infected. The risk of infection is higher for those who live in overcrowded or unsanitary conditions.

Hemochromatosis
Hemochromatosis is the most common form of iron overload disease. Primary hemochromatosis, also called hereditary hemochromatosis, is an inherited disease. Secondary hemochromatosis is caused by anemia, alcoholism, and other disorders. Hemochromatosis causes the body to absorb and store too much iron. The extra iron builds up in the body's organs and damages them. Without treatment, the disease can cause the liver, heart, and pancreas to fail. Healthy people usually absorb about 10 percent of the iron contained in the food they eat, which meets normal dietary requirements. People with hemochromatosis absorb up to 30 percent of iron. Over time, they absorb and retain between five to 20 times more iron than the body needs. Because the body has no natural way to rid itself of the excess iron, it is stored in body tissues, specifically the liver, heart, and pancreas.

Hepatitis
The word hepatitis simply means an inflammation of the liver without pinpointing a specific cause. Someone with hepatitis may have one of several disorders, including viral or bacterial infection of the liver , a liver injury caused by a toxin (poison), have liver damage caused by interruption of the organ's normal blood supply, be experiencing an attack by his or her own immune system through an autoimmune disorder or have experienced trauma to the abdomen in the area of the liver.  Hepatitis is most commonly caused by one of three viruses, the hepatitis A virus, the hepatitis B virus and the hepatitis C virus. In some rare cases, the Epstein Barr Virus (which causes mononucleosis) can also result in hepatitis because it can cause inflammation of the liver.  Other viruses and bacteria that also can cause hepatitis include hepatitis D and E, varicella (chickenpox), and cytomegalovirus (CMV).

Hepatitis A
The most common form of hepatitis is hepatitis A (also called infectious hepatitis). This form is caused by the hepatitis A virus (HAV), which lives in the stools (feces or poop) of infected individuals. Infected stool can be present in small amounts in food and on objects (from doorknobs to diapers). The hepatitis A virus is spread when someone ingests anything that's contaminated with HAV-infected stool (this makes it easy for the virus to spread in overcrowded, unsanitary living conditions) in water, milk, and foods, especially in shellfish. Because hepatitis A can be a mild infection, it's possible for some people to be unaware that they have had the illness. In fact, although medical tests show that about 40% of urban Americans have had hepatitis A, only about 5% recall being sick. Although the hepatitis A virus can cause prolonged illness up to 6 months, it typically only causes short-lived illnesses and it does not cause chronic liver disease.

Hepatitis B
Hepatitis B (also called serum hepatitis) is caused by the hepatitis B virus (HBV). HBV can cause a wide spectrum of symptoms ranging from general malaise to chronic liver disease that can lead to liver cancer. The hepatitis B virus spreads through infected body fluids, such as blood, saliva, semen, vaginal fluids, tears, and urine, a contaminated blood transfusion (uncommon in the United States), shared contaminated needles or syringes for injecting drugs, sexual activity with an HBV-infected person, and transmission from HBV-infected mothers to their newborn babies.

Hepatitis C
The hepatitis C virus (HCV) is spread by direct contact with an infected person's blood. The symptoms of the hepatitis C virus can be very similar to those of the hepatitis A and B viruses. However, infection with the hepatitis C virus can lead to chronic liver disease and is the leading reason for liver transplant in the United States. The hepatitis C virus can be spread by sharing drug needles, getting a tattoo or body piercing with unsterilized tools, blood transfusions (especially ones that occurred before 1992; since then the U.S. blood supply has been routinely screened for the disease), transmission from mother to newborn , sexual contact (although this is less common). Hepatitis C is also a common threat in kidney dialysis centers. Rarely, people living with an infected person can contract the disease by sharing items that might contain that person's blood, such as razors or toothbrushes.

Irritable Bowel Syndrome
Irritable bowel syndrome is a disorder characterized most commonly by cramping, abdominal pain, bloating, constipation, and diarrhea. IBS causes a great deal of discomfort and distress, but it does not permanently harm the intestines and does not lead to a serious disease, such as cancer. Most people can control their symptoms with diet, stress management, and prescribed medications. For some people, however, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances. As many as one in five Americans, have symptoms of IBS, making it one of the most common disorders diagnosed by doctors. It occurs more often in women than in men, and it begins before the age of 35 in about 50 percent of people.

Jaundice
Jaundice is a symptom of liver disease and manifests as yellow discoloration of the skin and sclera (whites of the eyes). Usually when one is jaundiced the urine is very dark in color and the stool very light. Jaundice can be caused by a number of things such as liver inflammation (hepatitis) of many causes (medication, viruses, alcohol, etc.) blockage of the tube leading out of the liver (Bile Duct) or blood disorders. Jaundice is often temporary and if not, is very often treated either with medication or surgery.

Lactose Intolerance
Lactose intolerance is the inability to digest significant amounts of lactose, the predominant sugar of milk. This inability results from a shortage of the enzyme lactase, which is normally produced by the cells that line the small intestine. Lactase breaks down milk sugar into simpler forms that can then be absorbed into the bloodstream. When there is not enough lactase to digest the amount of lactose consumed, the results, although not usually dangerous, may be very distressing. While not all persons deficient in lactase have symptoms, those who do are considered to be lactose intolerant. Common symptoms include nausea, cramps, bloating, gas, and diarrhea, which begin about 30 minutes to 2 hours after eating or drinking foods containing lactose. The severity of symptoms varies depending on the amount of lactose each individual can tolerate.
Some causes of lactose intolerance are well known. For instance, certain digestive diseases and injuries to the small intestine can reduce the amount of enzymes produced. In rare cases, children are born without the ability to produce lactase. For most people, though, lactase deficiency is a condition that develops naturally over time. After about the age of 2 years, the body begins to produce less lactase. However, many people may not experience symptoms until they are much older. Between 30 and 50 million Americans are lactose intolerant. Certain ethnic and racial populations are more widely affected than others. As many as 75 percent of all African-Americans and Native Americans and 90 percent of Asian-Americans are lactose intolerant. The condition is least common among persons of northern European descent.

Liver Diseases
Liver disease is categorized both by the cause and the effect it has on the liver. Causes may include infection, injury, exposure to drugs or toxic compounds, an autoimmune process, or a genetic defect (such as hemochromatosis). These causes can lead to hepatitis, cirrhosis, stones that develop and form blockages, fatty liver, and in rare instances liver cancer. Genetic defects can prevent vital liver functions and lead to the deposition and build-up of damaging substances, such as iron or copper.

Pancreas Disease
The pancreas is called the "hidden organ" because it is located deep in the abdomen behind the stomach. About six to eight inches long in the adult, the organ contains thin tubes that come together like the veins of a leaf. These tubes join to form a single opening into the intestine that is located just beyond the stomach. The pancreas produces juices and enzymes that flow through these tubes into the intestine, where they mix with food. The enzymes digest fat, protein, and carbohydrates so they can be absorbed by the intestine. Pancreatic juices, therefore, play an important role in maintaining good health. The pancreas also produces insulin, which is picked up by the blood flowing through the organ. Insulin is important in regulating the amount of sugar or glucose in the blood. A number of problems can occur in the pancreas. These include Diabetes mellitus, Acute pancreatitis, Chronic pancreatitis, Pancreatic enzyme deficiency, and Pancreas tumor.

Pancreatitis
Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum. The duodenum is the upper part of the small intestine. The pancreas secretes digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest fats, proteins, and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it takes from food for energy. Normally, digestive enzymes do not become active until they reach the small intestine, where they begin digesting food. But if these enzymes become active inside the pancreas, they start "digesting" the pancreas itself.
Acute pancreatitis occurs suddenly and lasts for a short period of time and usually resolves. Chronic pancreatitis does not resolve itself and results in a slow destruction of the pancreas. Either form can cause serious complications. In severe cases, bleeding, tissue damage, and infection may occur. Pseudocysts, accumulations of fluid and tissue debris, may also develop. And enzymes and toxins may enter the bloodstream, injuring the heart, lungs, and kidneys, or other organs.

Peptic Ulcer Disease
An ulcer is an open sore in the lining of the stomach or intestine, much like mouth or skin ulcers. Peptic ulcers are eventually caused by acid and pepsin, a digestive stomach enzyme. These ulcers can occur in the stomach, where they are called gastric ulcers. Or they can occur in the first portion of the intestine. These are called duodenal ulcers. "Peptic Ulcer" is the term used to describe either or both of these two types of ulcers. In the end, it is acid that causes the injury to the stomach or bowel lining. However, a revolutionary and startling recent discovery is that most peptic ulcers result from a stomach infection caused by the bacteria, Helicobacter pylori. Peptic ulcer disease (PUD) is a very common ailment, affecting one out of eight persons in the United States.


Ulcerative Colitis
Ulcerative colitis is a disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. Ulcers form where inflammation has killed the cells that usually line the colon, then bleed and produce pus. Inflammation in the colon also causes the colon to empty frequently, causing diarrhea. Ulcerative colitis, an inflammatory bowel disease (IBD) that causes chronic inflammation of the digestive tract, is characterized by abdominal pain and diarrhea. Like Crohn's disease, another common IBD, ulcerative colitis can be debilitating and sometimes can lead to life-threatening complications. Ulcerative colitis usually affects only the innermost lining of your large intestine (colon) and rectum. It occurs only through continuous stretches of your colon, unlike Crohn's disease, which occurs in patches anywhere in the digestive tract and often spreads deep into the layers of affected tissues. There's no known cure for ulcerative colitis, but therapies are available that may dramatically reduce the signs and symptoms of ulcerative colitis and even bring about a long-term remission.

IMPORTANT REMINDER:
The preceding information is intended only to provide general information and not as a definitive basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific condition.

 

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