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This does not mean the clinicians are unqualifiedbut it does mean that many online patients are not receiving care from those with formal expertise in obesity care

Melena strongly suggests, and hematemesis confirms, that bleeding is of upper gastrointestinal originPeptic ulcer, the most common cause of gastrointestinal hemorrhage, should be pursued through questions about epigastric distress, the relationship of symptoms to food intake, and a history of peptic ulcer disease

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