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Recent studies suggest that ghrelin may play an important role in the pathogenesis of upper GI functional diseases

The reduction in lean mass accounted for approximately 65% of total weight loss (9) which is notably higher than the typical 2030% range observed with standard hypocaloric diets (31), and primarily involved loss of skeletal muscle mass

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Patients should be educated to recognise the pattern and document episodes, including timing relative to meals, food consumed, and symptom severity

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The pages linked below present the evidence without reduction