Abstract
The digestive system comprises the gastrointestinal track (GI track) and accessory organs/glands. Recent research discoveries prove that in addition to GI track itself, gut microbiota also plays crucial roles in regulating digestive function and other human physiological functionalities as well as pathological processes. We therefore proposed to include gut microbiota into the digestive system, making it now comprise three parts: GI track, digestive glands, and gut microbiota. Gastrointestinal diseases (GI diseases) refer to diseases involving the gastrointestinal tract from mouth through the esophagus, stomach, small intestine, large intestine, and rectum to anus, as well as the accessory organs of digestion, the liver, gallbladder, and pancreas. Gut microbiota are the microorganisms including bacteria, archaea, and microscopic eukaryotes that live in the digestive tracts. This chapter aims to introduce the basics of GI disease and highlight clinical applications of the polypharmacological approaches for the treatment of the GI disease.
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References
Ogobuiro I, Gonzales J, Tuma F. Physiology, gastrointestinal. In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing; 2021 Jan.
Arnold M, Abnet CC, Neale RE, et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology. 2020;159(1):335–49.e15.
Gomaa EZ. Human gut microbiota/microbiome in health and diseases: a review. Antonie Van Leeuwenhoek. 2020;113(12):2019–40.
Adak A, Khan MR. An insight into gut microbiota and its functionalities. Cell Mol Life Sci. 2019;76(3):473–93.
Yamada T, Alpers DH, Kalloo AN, et al. Textbook of gastroenterology. 5th ed. Chichester: Blackwell Pub; 2009. p. 2774–84.
Ralston S, Penman I, Strachan M, et al., editors. Davidson’s principles and practice of medicine. 23rd ed. Edinburgh: Churchill Livingstone/Elsevier; 2018. ISBN: 9780702070280
Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA. 2015;313(9):949–58.
American Gastroenterological Association, Bharucha AE, Dorn SD, Lembo A, et al. American Gastroenterological Association medical position statement on constipation. Gastroenterology. 2013;144(1):211–7.
Moszak M, Szulińska M, Bogdański P. You are what you eat-the relationship between diet, microbiota, and metabolic disorders-a review. Nutrients. 2020;12(4):1096.
Saxena R, Sharma VK. A metagenomic insight into the human microbiome: its implications in health and disease. In: Kumar D, Antonarakis S, editors. Elsevier Science: Medical and Health Genomics; 2016. p. 117.
Quigley EM. Gut bacteria in health and disease. Gastroenterol Hepatol. 2013;9(9):560–9.
Guarner F, Malagelada J. Gut flora in health and disease. Lancet. 2003;361(9356):512–9.
Clarke G, Stilling RM, Kennedy PJ, et al. Minireview: Gut microbiota: The neglected endocrine organ. Mol Endocrinol. 2014;28(8):1221–38.
Gibson GR. Fibre and effects on probiotics (the prebiotic concept). Clin Nutr Suppl. 2004;1(2):25–31.
Hopper CP, De La Cruz LK, Lyles KV, et al. Role of carbon monoxide in host–gut microbiome communication. Chem Rev. 2020;120(24):13273–311.
O’Hara AM, Shanahan F. The gut flora as a forgotten organ. EMBO Rep. 2006;7(7):688–93.
Rajilić-Stojanović M, De Vos WM. The first 1000 cultured species of the human gastrointestinal microbiota. FEMS Microbiol Rev. 2014;38(5):996–1047.
Litou C, Effinger A, Kostewicz ES, et al. Effects of medicines used to treat gastrointestinal diseases on the pharmacokinetics of coadministered drugs: a PEARRL Review. J Pharm Pharmacol. 2019;71(4):643–73.
Longo WE, Vernava AM. Prokinetic agents for lower gastrointestinal motility disorders. Dis Colon Rectum. 1993;36:696–708.
Tonini M. Recent advances in the pharmacology of gastrointestinal prokinetics. Pharmacol Res. 1996;33:217–26.
Cash BD, Lacy BE. Systematic review: FDA-approved prescription medications for adults with constipation. Gastroenterol Hepatol (N Y). 2006;2:736–49.
Tack J, et al. Diagnosis and treatment of chronic constipation – a European perspective. Neurogastroenterol Motil. 2011;23:697–710.
Andresen V, et al. Effect of 5 days linaclotide on transit and bowel function in females with constipation-predominant irritable bowel syndrome. Gastroenterology. 2007;133:761–8.
Ippoliti C. Antidiarrheal agents for the management of treatment-related diarrhea in cancer patients. Am J Health Syst Pharm. 1998;55:1573–80.
Blanton WP, Wolfe MM. Proton pump inhibitors. In: Wolfe MM, Lowe RC, editors. Pocket Guide to Gastrointestinal Drugs. Chichester, UK: Wiley; 2014. p. 15–30.
Sugano K. Histamine H2-receptor antagonists. In: Wolf MM, Lowe RC, editors. Pocket Guide to Gastrointestinal Drugs. Chichester, UK: Wiley; 2014. p. 31–43.
Fröhlich EE, et al. Cognitive impairment by antibiotic-induced gut dysbiosis: analysis of gut microbiota–brain communication. Brain Behav Immun. 2016;56:140–55.
Sullivan A, et al. Effect of antimicrobial agents on the ecological balance of human microflora. Lancet Infect Dis. 2001;1:101–14.
Edlund C, Nord CE. Effect on the human normal microflora of oral antibiotics for treatment of urinary tract infections. J Antimicrob Chemother. 2000;46(Suppl 1):41–8. discussion 63–5
Beaugerie L, Petit J-C. Antibiotic-associated diarrhoea. Best Pract Res Clin Gastroenterol. 2004;18:337–52.
Orlicka K, et al. Prevention of infection caused by immunosuppressive drugs in gastroenterology. Ther Adv Chronic Dis. 2013;4:167–85.
Zenlea T, Peppercorn MA. Immunosuppressive therapies for inflammatory bowel disease. World J Gastroenterol. 2014;20:3146–52.
Scaldaferri F, et al. Use and indications of cholestyramine and bile acid sequestrants. Intern Emerg Med. 2013;8:205–10.
Wedlake L, et al. Effectiveness and tolerability of colesevelam hydrochloride for bile-acid malabsorption in patients with cancer: a retrospective chart review and patient questionnaire. Clin Ther. 2009;31:2549–58.
Odunsi-Shiyanbade ST, et al. Effects of chenodeoxycholate and a bile acid sequestrant, colesevelam, on intestinal transit and bowel function. Clin Gastroenterol Hepatol. 2010;8:159–165.e5.
Stephen AM, Cummings JH. The microbial contribution to human faecal mass. J Med Microbiol. 1980;13(1):45–56.
Sommer F, Bäckhed F. The gut microbiota—masters of host development and physiology. Nat Rev Microbiol. 2013;11(4):227–38.
Segata N, Boernigen D, Tickle TL, et al. Computational meta’omics for microbial community studies. Mol Syst Biol. 2013;9:666.
Faderl M, Noti M, Corazza N, et al. Kee** bugs in check: the mucus layer as a critical component in maintaining intestinal homeostasis. IUBMB Life. 2015;67(4):275–85.
Gibson GR. Fibre and effects on probiotics (the prebiotic concept). Clin Nutrition Supplements. 2004;1(2):25–31.
Yatsunenko T, Rey FE, Manary MJ, et al. Human gut microbiome viewed across age and geography. Nature. 2012;486(7402):222–7.
McNamara MP, Singleton JM, Cadney MD, et al. Early-life effects of juvenile Western diet and exercise on adult gut microbiome composition in mice. J Exp Biol. 2021;224(4):jeb.239699.
Yeh M-C, Glick-Bauer M. The health advantage of a vegan diet: Exploring the gut microbiota connection. Nutrients. 2014;6(11):4822–38.
David LA, Maurice CF, Carmody RN, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2013;505(7484):559–63.
Jeffery I, O’Toole P. Diet-microbiota interactions and their implications for healthy living. Nutrients. 2013;5(1):234–52.
De Filippo C, Cavalieri D, Di Paola M, et al. Impact of diet in sha** gut microbiota revealed by a comparative study in children from Europe and rural Africa. Pro Nat Acad Sci. 2010;107(33):14691–6.
Jonkers DMAE. Microbial perturbations and modulation in conditions associated with malnutrition and malabsorption. Best Pract Res Clin Gastroenterol. 2016;30(2):161–72.
Million M, Diallo A, Raoult D. Gut microbiota and malnutrition. Microb Pathog. 2017;106:127–38.
Khanna S, Tosh PK. A clinician’s primer on the role of the microbiome in human health and disease. Mayo Clin Proc. 2014;89(1):107–14.
Hutkins RW, Krumbeck JA, Bindels LB, et al. Prebiotics: why definitions matter. Curr Opin Biotechnol. 2016;37:1–7.
Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995;125(6):1401–12.
Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14(8):491–502.
Slavin J. Fiber and prebiotics: mechanisms and health benefits. Nutrients. 2013;5(4):1417–35.
Lamsal BP. Production, health aspects and potential food uses of dairy prebiotic galactooligosaccharides. J Sci Food Agricul. 2012;92(10):2020–8.
Rajendran SR, Okolie CL, Udenigwe CC, et al. Structural features underlying prebiotic activity of conventional and potential prebiotic oligosaccharides in food and health. J Food Biochem. 2017;41(5):e12389.
Pokusaeva K, Fitzgerald GF, van Sinderen D. Carbohydrate metabolism in Bifidobacteria. Genes Nutrition. 2011;6(3):285–306.
Zaman SA, Sarbini SR. The potential of resistant starch as a prebiotic. Crit Rev Biotechnol. 2015;36(3):578–84.
Gómez B, Gullón B, Remoroza C, et al. Purification, characterization, and prebiotic properties of pectic oligosaccharides from orange peel wastes. J Agricul Food Chem. 2014;62(40):9769–82.
Arena MP, Caggianiello G, Fiocco D, et al. Barley β-glucans-containing food enhances probiotic performances of beneficial bacteria. Int J Mol Sci. 2014;15(2):3025–39.
Linares-Pasten JA, Aronsson A, Karlsson EN. Structural considerations on the use of endo-xylanases for the production of prebiotic Xylooligosaccharides from biomass. Curr Protein Peptide Sci. 2017;19(1):48–67.
Delcour JA, Aman P, Courtin CM, et al. Prebiotics, fermentable dietary fiber, and health claims. Advances in Nutrition. 2016;7(1):1–4.
Pandey KR, Naik SR, Vakil BV. Probiotics, prebiotics and synbiotics- a review. J Food Sci Technol. 2015;52(12):7577–87.
Coxam V. Current data with inulin-type fructans and calcium, targeting bone health in adults. J Nutrition. 2007;137(Suppl11):S2527–33.
Seifert S, Watzl B. Inulin and oligofructose: review of experimental data on immune modulation. J Nutrition. 2007;137(Suppl11):S2563–7.
Wilson B, Whelan K. Prebiotic inulin-type fructans and galacto-oligosaccharides: definition, specificity, function, and application in gastrointestinal disorders. J Gastroenterol Hepatol. 2017;32(Suppl1):64–8.
Prebiotics. Food-Info.net. Wageningen University.
Byrne CS, Chambers ES, Morrison DJ, et al. The role of short chain fatty acids in appetite regulation and energy homeostasis. Int J Obesity. 2015;39(9):1331–8.
Mack DR. Probiotics: mixed messages. Can Fam Physician. 2005;51(11):1455–7.
Gareau MG, et al. Probiotics and the gut microbiota in intestinal health and disease. Nat Rev Gastroenterol Hepatol. 2010;7:503–14.
Guidelines for the evaluation of probiotics in food report. Joint FAO/WHO Working Group report on drafting guidelines for the evaluation of probiotics in food. 2002. Available at: http://www.who.int/foodsafety/fs_management/en/probiotic_guidelines.pdf. Accessed 5 Sept 2021.
Westendorf AM, et al. Intestinal immunity of Escherichia coli NISSLE 1917: a safe carrier for therapeutic molecules. FEMS Immunol Med Microbiol. 2005;43:373–84.
Resta-Lenert SC, Barrett KE. Modulation of intestinal barrier properties by probiotics: role in reversing colitis. Ann N Y Acad Sci. 2009;1165:175–82.
Probiotics. National Health Service. 27 November 2018.
Probiotics: What you need to know. National Center for Complementary and Integrative Health, US National Institutes of Health. 1 August 2019. Retrieved 10 November 2021.
Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis. 2015;60(Suppl2):S129–34.
Singhi SC, Kumar S. Probiotics in critically ill children. F1000Res. 2016;5:407.
Durchschein F, Petritsch W, Hammer HF. Diet therapy for inflammatory bowel diseases: The established and the new. World J Gastroenterol. 2016;22(7):2179–94.
Brown AC, Valiere A. Probiotics and medical nutrition therapy. Nutr Clin Care. 2004;7(2):56–68.
King CK, Glass R, Bresee JS, et al. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep. 2003;52(RR–16):1–16.
Collinson S, Deans A, Padua-Zamora A, et al. Probiotics for treating acute infectious diarrhea. Cochrane Database Syst Rev. 2020;12:CD003048.
Saez-Lara MJ, Gomez-Llorente C, Plaza-Diaz J, et al. The role of probiotic lactic acid bacteria and bifidobacteria in the prevention and treatment of inflammatory bowel disease and other related diseases: A systematic review of randomized human clinical trials. Biomed Res Int. 2015;2015:1–15.
Probiotics and prebiotics. World Gastroenterology Organisation Global Guidelines. World Gastroenterology Organisation. October 2011. Archived (PDF) from the original on 9 August 2016. Retrieved 1 November 2021.
Ghouri YA, Richards DM, Rahimi EF, et al. Systematic review of randomized controlled trials of probiotics, prebiotics, and synbiotics in inflammatory bowel disease. Clin Exp Gastroenterol. 2014;7:473–87.
Moayyedi P, Ford AC, Talley NJ, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2010;59(3):325–32.
Islam MA, Yun CH, Choi YJ, et al. Microencapsulation of live probiotic bacteria. J Microbiol Biotechnol. 2010;20(1367–1377):1367–77.
Timmerman HM, Koning CJ, Mulder L, et al. Monostrain, multistrain and multispecies probiotics – a comparison of functionality and efficacy. Int J Food Microbiol. 2004;96(3):219–33.
Williams EA, Stimpson J, Wang D, et al. Clinical trial: a multistrain probiotic preparation significantly reduces symptoms of irritable bowel syndrome in a double-blind placebo-controlled study. Aliment Pharmacol Ther. 2008;29(1):97–103.
Rijkers GT, de Vos WM, Brummer RJ, et al. Health benefits and health claims of probiotics: Bridging science and marketing. Brit J Nutrition. 2011;106(9):1291–6.
Bee P. Probiotics, not so friendly after all? The Times. London. 2008. Archived from the original on 11 May 2015. Retrieved 18 May 2021.
Cooperative Oesophageal Group. Combination of cimetidine and alginic acid: an improvement in the treatment of oesophageal reflux disease. Gut. 1991;32(7):819–22.
Tytgat GNJ. Medical therapy of reflux esophagitis. In: Siewart JR, Hoelscher AH (eds). Diseases of the esophagus. Berlin, Springer Verlag. 1988: pp1137–47.
Temple JG, Bradby GVH, O’Connor F, et al. Cimetidine and metoclopramide in oesophageal reflux disease. BMJ. 1983;286:1863–4.
Bennett JR, Buckton GK, Martin HD, et al. The effect of adding cimetidine to alginate–antacid in treating gastrooesophageal reflux. In: Siewert JR, Hoelscher AH, editors. Diseases of the esophagus. Berlin: Springer Verlag; 1988. p. 1111–5.
Eriksen CA, Cheadle WG, Cranford CA, et al. Combined cimetidine-alginate antacid therapy versus single agent treatment for reflux oesophagitis: results of prospective double-blind randomised clinical trial. Ann Chir Gynaecol. 1988;77(4):133–7.
Connell AM. Combination drugs in gastroenterology. Am J Gastroenterol. 1986;81(5):392–6.
Alter MJ, Margolis HS, Krawczynski K, et al. The natural history of community-acquired hepatitis C in the United States: the sentinel counties chronic non-A, non-B hepatitis study team. N Engl J Med. 1992;327(27):1899–905.
Thomas DL, Astemborski J, Rai RM, et al. The natural history of hepatitis C virus infection: host, viral, and environmental factors. JAMA. 2000;284(4):450–6.
Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups. Lancet. 1997;349(9055):825–32.
Wiley TE, McCarthy M, Breidi L, Layden TJ. Impact of alcohol on the histological and clinical progression of hepatitis C infection. Hepatology. 1998;28(3):805–9.
Graham CS, Baden LR, Yu E, et al. Influence of human immunodeficiency virus infection on the course of hepatitis C virus infection: a meta-analysis. Clin Infect Dis. 2001;33(4):562–9.
Thein HH, Yi Q, Dore GJ, Krahn MD. Natural history of hepatitis C virus infection in HIV-infected individuals and the impact of HIV in the era of highly active antiretroviral therapy: a meta-analysis. AIDS. 2008;22(15):1979–91.
Pellicelli A, Messina V, Giannelli V, et al. High efficacy and safety of flat-dose ribavirin plus sofosbuvir/daclatasvir in genotype 3 cirrhotic patients. Gut Liver. 2020;14(3):357–67.
Kawaguchi Y, Mizuta T. Interaction between hepatitis C virus and metabolic factors. World J Gastroenterol. 2014;20:2888–901.
Kanwal F, Kramer JR, Ilyas J, et al. HCV genotype 3 is associated with an increased risk of cirrhosis and hepatocellular cancer in a national sample of U.S. Veterans with HCV. Hepatology. 2014, 60:98–105.
Leroy V, Angus P, Bronowicki JP, et al. Daclatasvir, sofosbuvir, and ribavirin for hepatitis C virus genotype 3 and advanced liver disease: a randomized phase III study (ALLY-3+). Hepatology. 2016;63:1430–41.
Lontok E, Mani N, Harrington PR, Miller V. Closing in on the target: sustained virologic response in hepatitis C virus genotype 1 infection response-guided therapy. Clin Infect Dis. 2013;56:1466–70.
Nelson DR, Cooper JN, Lalezari JP, et al. All-oral 12-week treatment with daclatasvir plus sofosbuvir in patients with hepatitis C virus genotype 3 infection: ALLY-3 phase III study. Hepatology. 2015;61:1127–35.
Zeuzem S, Dusheiko GM, Salupere R, et al. Sofosbuvir and ribavirin in HCV genotypes 2 and 3. N Engl J Med. 2014;370:1993–2001.
Feld JJ, Maan R, Zeuzem S, et al. Effectiveness and safety of sofosbuvir-based regimens for chronic HCV genotype 3 infection: results of the HCV-TARGET study. Clin Infect Dis. 2016;63:776–83.
Cornberg M, Petersen J, Schober A, et al. Real-world use, effectiveness and safety of anti-viral treatment in chronic hepatitis C genotype 3 infection. Aliment Pharmacol Ther. 2017;45:688–700.
European Association for Study of Liver. EASL clinical practice guidelines: management of hepatitis C virus infection. J Hepatol. 2014;60:392–420.
Alonso S, Riveiro-Barciela M, Fernandez I, et al. Effectiveness and safety of sofosbuvir-based regimens plus an NS5A inhibitor for patients with HCV genotype 3 infection and cirrhosis: results of a multicenter real-life cohort. J Viral Hepat. 2017;24:304–11.
Herzer K, Welzel TM, Spengler U, et al. Real-world experience with daclatasvir plus sofosbuvir ± ribavirin for post-liver transplant HCV recurrence and severe liver disease. Transpl Int. 2017;30:243–55.
Hézode C, Lebray P, De Ledinghen V, et al. Daclatasvir plus sofosbuvir, with or without ribavirin, for hepatitis C virus genotype 3 in a French early access programme. Liver Int. 2017;37:1314–24.
Curry MP, Charlton M. Sofosbuvir and velpatasvir for patients with HCV infection. N Engl J Med. 2016;374:1688.
Pianko S, Flamm SL, Shiffman ML, et al. Sofosbuvir plus velpatasvir combination therapy for treatment-experienced patients with genotype 1 or 3 hepatitis C virus infection: a randomized trial. Ann Intern Med. 2015;163:809–17.
European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C 2018. J Hepatol. 2018;69:461–511.
Wyles D, Poordad F, Wang S, et al. Glecaprevir/pibrentasvir for hepatitis C virus genotype 3 patients with cirrhosis and/or prior treatment experience: a partially randomized phase 3 clinical trial. Hepatology. 2018;67:514–23.
Reig M, Mariño Z, Perelló C, et al. Unexpected high rate of early tumor recurrence in patients with HCV-related HCC undergoing interferon-free therapy. J Hepatol. 2016;65:719–26.
Cabibbo G, Petta S, Calvaruso V, et al. Is early recurrence of hepatocellular carcinoma in HCV cirrhotic patients affected by treatment with direct-acting antivirals? A prospective multicentre study. Aliment Pharmacol Ther. 2017;46:688–95.
Chinchilla-López P, Qi X, Yoshida EM, et al. The direct-acting antivirals for hepatitis C virus and the risk for hepatocellular carcinoma. Ann Hepatol. 2017;16:328–30.
Kumari R, Nguyen MH. Fixed-dose combination of sofosbuvir and ledipasvir for the treatment of chronic hepatitis C genotype 1. Expert Opin Pharmacother. 2015;16(5):739–48.
Dehghan Manshadi SA, Merat S, et al. Single-pill sofosbuvir and daclatasvir for treating hepatis C in patients co-infected with human immunodeficiency virus. Int J Clin Pract. 2021;75(8):e14304.
Madisch A, Vinson BR, Abdel-Aziz H, et al. Modulation of gastrointestinal motility beyond metoclopramide and domperidone: pharmacological and clinical evidence for phytotherapy in functional gastrointestinal disorders. Wien Med Wochenschr. 2017;167(7–8):160–8.
Ottillinger B, Storr M, Malfertheiner P, et al. STW 5 (Iberogast®)―a safe and effective standard in the treatment of functional gastrointestinal disorders. Wien Med Wochenschr. 2013;163(3–4):65–72.
Vinson B. Development of Iberogast: clinical evidence for multicomponent herbal mixtures. In: Cooper R, Kronenberg F (eds). Botanical medicine: from bench to bedside. New Rochelle, Mary Ann Liebert. 2009; pp167–89.
Wagner H. Multitarget therapy: the future of treatment for more than just functional dyspepsia. Phytomedicine. 2006;13(Suppl. 5):122–99.
Wegener T, Wagner H. The active components and the pharmacological multi-target principle of STW 5 (Iberogast). Phytomedicine. 2006;13(Suppl. 5):20–35.
Bundesinstitut für Arzneimittel und Medizinprodukte. Abwehr von Gefahren durch Arzneimittel, Stufe II. Metoclopramid-haltige Arzneimittel: Wirksamkeits- und Sicherheitsbedenken (hinsichtlich neurologischer und kardiovaskulärer Ereignisse). Bonn 2. Jan. 2012.
Arzneimittelkommission der deutschen Ärzteschaft UAW-News International. Ventrikuläre Arrhythmien und plötzlicher Herztod im Zusammenhang mit Domperidon. Deutsches Ärzteblatt. 2012;109(35/36):A1779–80.
Heidelbaugh JJ, Kim AH, Chang R. Overutilization of proton-pump inhibitors: what the clinician needs to know. Ther Adv Gastroenterol. 2012;5(4):219–32.
Malfertheiner P, Holtmann G, Peitz U. Guidelines of the German society of metabolic and digestive diseases for the therapy of dyspepsia. Z Gastroenterol. 2001;39(11):937–56.
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Wang, Z., Yang, B. (2022). Polypharmacology in Clinical Applications: Gastrointestinal Polypharmacology. In: Polypharmacology. Springer, Cham. https://doi.org/10.1007/978-3-031-04998-9_8
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