Updated April 2007. The most common signs and symptoms of traveler's diarrhea are: Sometimes, people experience moderate to severe dehydration, persistent vomiting, a high fever, bloody stools, or severe pain in the abdomen or rectum. Centers for Disease Control and Prevention. 2023 Healthline Media LLC. Elsevier; 2021.https://www.clinicalkey.com. It can be divided into three basic categories: watery, fatty (malabsorption), and inflammatory. Early ulcerative colitis, distal colitis, and proctitis result in episodes of rectal bleeding, diarrhea, pain, and tenesmus. Pregnancy. It usually affects critically ill people, especially those in an ICU. If youre pregnant, you may also start having sensitivities to particular foods. Nausea and diarrhea can have many causes, two of the most common are stomach virus and food poisoning. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. What should you eat when you have no appetite? But if these issues persist for more than four days or worsen, consult your healthcare provider. Levinson W, et al. Cancer and cancer treatment. How is giardiasis diagnosed? Once inside a host, the cysts dissolve and the parasites are released. This can include foods you eat on a regular basis, resulting in abdominal pain and diarrhea. Several drugs are generally effective against giardia parasites, but not everyone responds to them. But it can cause lingering symptoms and serious complications, especially in infants and children. This content does not have an English version. Don't be afraid to reach out to your healthcare provider, who will be able to help you identify the underlying cause for your symptoms and offer treatment options. headache. Loss of taste or smell. Giardia parasites are found in lakes, ponds, rivers and streams worldwide, as well as in public water supplies, wells, cisterns, swimming pools, water parks and spas. Irritable bowel syndrome (IBS) is a condition often associated with diarrhea, constipation or more frequently alternating diarrhea and constipation. Traveler's diarrhea - Symptoms and causes - Mayo Clinic Also tell your doctor if you have a family history of celiac disease, inflammatory bowel disease (IBD), have unintentional weight loss, fever, abdominal cramping or decreased appetite. Abdominal compartment syndrome is a dangerous medical condition. The giardia parasite can also spread through anal sex. Clues for organic disease are . Bacteria are a common cause of travelers diarrhea. Muscle/body aches. Persistent diarrhea lasts between 2 and 4 weeks. Most cases of acute, watery diarrhea are caused by viruses (viral gastroenteritis). Secretory diarrhea can be distinguished from osmotic and functional diarrhea by virtue of higher stool volumes (greater than 1 L per day) that continue despite fasting and occur at night. Initial dietary choices when refeeding should begin with soups and broth. 20 Causes for Nausea and Diarrhea Medically reviewed by Saurabh Sethi, M.D., MPH Nausea and diarrhea can have many causes, two of the most common are stomach virus and food poisoning. Accessed Nov. 3, 2020. Fatigue. Intestinal and urogenital protozoa. Possible causes of abdominal pain and diarrhea include: stomach flu. Travelers diarrhea: a clinical review. Before the microscopic parasites are passed in stool, they become encased within hard shells called cysts, which allows them to survive outside the intestines for months. (2019). Laxative-induced diarrhea is often osmotic. Apply for Advancement to Fellowship (FACG), The Center for Leadership, Ethics & Equity (The LE&E Center), Visiting Scholar in Equity, Diversity, and Ethical Care, Research, Fellowship Grants and Publishing, Resident Resources Applying to GI Fellowship Programs, The Center for Leadership, Ethics & Equity, Visiting Scholar in Equity, Diversity, & Ethical Care, Established Investigator Bridge Funding Award, ACG/ASGE Epidemiologic Research Award in Gastrointestinal Endoscopy, Directory of Digestive Diseases Organizations for Patients, International Foundation for Functional Gastrointestinal Disorders, National Digestive Diseases Information Clearinghouse, National Institute of Diabetes, Digestive and Kidney Diseases. 16th ed. Loss of appetite, referred to by healthcare providers as anorexia, is defined as a reduced desire to eat. The most common signs and symptoms of gastroenteritis are nausea, vomiting, diarrhea, and abdominal pain. Most people improve within 1 to 2 days without treatment and recover completely within a week. Probiotics may help your digestive system heal. Avoid spicy, high fat, and high fiber foods. Medications such as antibiotics and drugs that contain magnesium products are also common offenders. Constipation has a range of causes, including: sudden changes in diet or . Eur J Gastroenterol Hepatol. Other tips that may help decrease your risk of getting sick include: When visiting high-risk areas, keep the following tips in mind: If it's not possible to buy bottled water or boil your water, bring some means to purify water. The doctor will also ask questions about any recent changes in your diet. Accessed May 26, 2021. This content does not have an Arabic version. The duration of diarrhea symptoms can provide a clue to the underlying cause. https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea. These, however, should be avoided in people with high fever or bloody diarrhea as they can worsen severe colon infections and in children because the use of anti-diarrheals can lead to complications of hemolytic uremic syndrome in cases of Shiga-toxin E. coli (E. coli 0157:H7). High-risk destinations for traveler's diarrhea include areas of: Traveling to Eastern Europe, South Africa, Central and East Asia, the Middle East, and a few Caribbean islands also poses some risk. Review/update the In: Review of Medical Microbiology and Immunology. Natural probiotics are found in foods such as yogurt. Evaluation of Chronic Diarrhea | AAFP food poisoning. Lower back pain and diarrhea: Causes and treatment - Medical News Today National Institute of Diabetes and Digestive and Kidney Diseases. National Institute of Diabetes and Digestive and Kidney Diseases. Check out photos of abdominal bloating and read what may be causing your bloating and pain. Infections leading to chronic diarrhea are uncommon, with the exception of parasites. Early symptoms can be subtle, leading to a long delay in diagnosis. Let the water cool naturally and store it in a clean covered container. Advertising revenue supports our not-for-profit mission. Stick to fruits and vegetables that you can peel yourself, such as bananas, oranges and avocados. Bartelt LA. But certain groups of people have a greater risk of developing the condition. The best way to treat abdominal pain and diarrhea depends on the underlying cause. But, it's still possible to get sick even if you follow these rules. Empiric therapy is justified when a specific diagnosis is strongly suspected and follow-up is available. Each year millions of international travelers experience traveler's diarrhea. Use of antibiotics. Bacteria and viruses are often transmitted by the fecal-oral route, so hand washing and hygiene are important to prevent infection. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Bloated stomach, feeling sick, and tired: Causes and what to do It is usually impractical to test and treat the many possible causes of chronic diarrhea. Fatigue The time between infection and the start of symptoms is usually from 1 to 2 weeks. PDF Highlights of Prescribing Information A doctor may order tests and prescribe medications to help diagnose and treat your condition. Verywell Health's content is for informational and educational purposes only. Symptoms that may be associated with diarrhea include: Symptoms that may be associated with loss of appetite include: Diarrhea and a loss of appetite can be due to a number of causes. These including intake of coffee, tea, colas, dietetic foods, gums or mints that contain poorly absorbable sugars. Celiac disease (gluten-sensitive enteropathy), intestinal bypass, mesenteric ischemia, small bowel bacterial overgrowth, Whipple disease, and giardiasis can all cause loss of absorptive capacity. Travelers' diarrhea: Microbiology, epidemiology, and prevention. Both often involve blood and pus in the stool, with onset between 15 and 40 years of age. Advancing gastroenterology, improving patient care, 2023 American College of Gastroenterology. In these cases, discuss symptoms with a doctor. A quick office anoscopy may detect ulcerations or impacted stool. There are also home remedies that are known to help with short-term diarrhea and loss of appetite. Whats Causing My Abdominal Bloating and Abdominal Pain? Abdominal pain is pain that you feel between your chest and pelvis. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Crohn disease typically causes an ileitis but later affects the entire gastrointestinal tract to become exudative. Early cases are often confused with IBS, but symptoms inevitably progress. Shortness of breath/difficulty breathing. Diarrhea | Johns Hopkins Medicine Symptoms of recurrent abdominal pain or discomfort and a marked change in bowel habits for at least six months, with symptoms experienced on at least three days per month for at least three months. If this comes up negative, they may run a more complete analysis of your feces to look for possible digestive disorders. Vomiting lasts more than two days for adults, 24 hours for children under age 2 or 12 hours for infants; You've had bouts of nausea and vomiting for longer than one month; You've experienced unexplained weight loss along with nausea and vomiting; Take self-care measures while you wait for your appointment with your doctor: Take it easy. McGraw Hill; 2018. https://accessmedicine.mhmedical.com. Headache and Nausea: Possible Causes - Verywell Health Persistent diarrhea lasts between 2 and 4 weeks. Giardia infections usually clear up within a few weeks. weight loss, stomach cramps, bloating, increased gas, nausea, fatigue. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Nausea and diarrhea: Causes, treatment, and seeking help We use cookies to ensure that we give you the best experience on our website. Watery diarrhea includes irritable bowel syndrome, which is the most common cause of functional diarrhea. Diarrhea is the most common symptom and may be accompanied by visible blood and mucus. See a doctor if you feel ill, have bloody diarrhea, severe abdominal pain or diarrhea lasting more than 48 hours. Serum peptide concentrations (e.g., gastrin, calcitonin, vasoactive intestinal peptide) and urinary histamine level should be obtained only when these conditions are suspected.1 Neoplastic diarrhea is associated with colon carcinoma, villous adenocarcinoma, and lymphoma. However, you can have multiple episodes of traveler's diarrhea during one trip. Both conditions can be accompanied by symptoms like nausea and unintentional weight loss. Accessed May 26, 2021. Giardia parasites can be spread through food either because food handlers with giardia infection don't wash their hands thoroughly or because raw produce is irrigated or washed with unsafe (contaminated) water. Fecal electrolyte levels can be used to distinguish secretory from osmotic diarrhea. A travel history is essential. If you continue to use this site we will assume that you are happy with it. Last medically reviewed on January 26, 2023. Andrographis might decrease blood pressure and disrupt blood clotting, so it might interact with blood pressure medications and blood thinners by increasing their effects. However, your risk of traveler's diarrhea is generally low in Northern and Western Europe, Japan, Canada, Singapore, Australia, New Zealand, and the United States. other information we have about you. Accessed Nov. 3, 2020. Headaches can be a symptom of dehydration resulting from the gastroenteritis infection itself. Giardia parasites live in the intestines of people and animals. 20th ed. Its important to see a doctor if your symptoms are severe or last longer than a couple of days. The most common small bowel disease in the U.S. is celiac disease, also called celiac sprue. Other common symptoms are bloating, abdominal pain relieved with defecation and a sense of incomplete evacuation. There are many causes of watery diarrhea, including carbohydrate malabsorption such as lactose, sorbitol, and fructose intolerance. Medications like antibiotics may be used to treat infections, and other prescription medications may be used to treat or manage the symptoms of underlying health conditions like Crohn's disease. How are abdominal pain and diarrhea treated? Milk and dairy products should be avoided for 24 to 48 hours as they can make diarrhea worse. It is important to take plenty of fluid with sugar and salt to avoid dehydration. Diarrhea - Symptoms and causes In many cases, nausea and headaches result from lifestyle and dietary choices and underlying health conditions. This can occur by swallowing unsafe water, by eating infected food or through person-to-person contact. Call your healthcare provider if you think you might have COVID-19 and arrange to get tested. (2022). It is suspected that diagnosed celiac disease cases represent only a fraction of patients with this condition.22 Although predominantly a malabsorptive condition, celiac disease can also initially present as a watery diarrhea that may be confusted with IBS. https://www.uptodate.com/contents/search. A doctor may perform a stool culture, in which theyll send a sample of your feces to a lab to check for bacteria, viruses, and parasites. They can help determine the underlying cause and direct you to the appropriate treatment. To provide you with the most relevant and helpful information, and understand which Whats Causing Pain in My Lower Left Abdomen? In: Ferri's Clinical Advisor 2021. Abdomen point tenderness is pain that occurs when your abdomen is pressed in a specific area. Basic blood work may include a complete blood count, albumin level, erythrocyte sedimentation rate, liver function testing, thyroid-stimulating hormone level, and electrolyte levels. Most people occasionally experience abdominal pain and diarrhea for a short time. In patients with mild acute diarrhea, no laboratory evaluation is needed because the illness generally resolves quickly. Diarrheal stools are those that take shape of the container, so they are often described as loose or watery. Consult this list as well as a doctor before traveling abroad. It may be present alone or be associated with other symptoms, such as nausea, vomiting, abdominal pain or weight loss. Malabsorptive and maldigestive diarrhea result from impaired nutrient absorption and impaired digestive function, respectively. In general, its important to stay hydrated by drinking plenty of water. The following list includes a number of potential symptoms, but not all symptoms. Dietary Supplements in the Time of COVID-19 - Consumer Also, see a doctor if diarrhea or back pain occur . Diarrhea, Fatigue, Nausea Or Vomiting And Upset Stomach Anti-diarrheal drug therapy can be helpful to control severe symptoms, and includes bismuth subsalicylate and antimotility agents such as loperamide. You may feel like you need to go to the bathroom frequently. Treatment will depend on the underlying cause, but there are steps people can take at home to cope with diarrhea or a loss of appetite. A patient may not actually have diarrhea, but incontinence occasioned by fecal impaction.4 Stool volume, frequency, and consistency can help categorize the diarrhea, as previously mentioned. We've listed out 20 causes, including symptoms, treatments, and home remedies. A history of travel and antibiotic use is important. Side effects of andrographis include nausea, vomiting, dizziness, skin rashes, diarrhea, and fatigue. Diarrheal Diseases - Acute and Chronic - American College of Dehydration caused by diarrhea can cause serious complications, including organ damage, shock or coma. Although anyone can pick up giardia parasites, some people are especially at risk: Giardia infection is almost never fatal in industrialized countries. stomach pain. Giardia infection (giardiasis) is one of the most common causes of waterborne disease in the United States. Signs and symptoms of dehydration include a very dry mouth, intense thirst, little or no urination, dizziness, or extreme weakness. The most common way to become infected with giardia is after swallowing unsafe (contaminated) water. A more recent article on chronic diarrhea is available. Still, the most practical diagnostic approach is to attempt to categorize the diarrhea by type before testing and treating. Management and Treatment. Giardiasis | Johns Hopkins Medicine Avoid locally made ice cubes or mixed fruit juices made with tap water. Most persons with irritable bowel syndrome meeting Rome III criteria do not require colonoscopy if the condition responds to therapy. Infections or diseases that affect the organs in your abdomen can also cause pain with diarrhea. Chronic diarrhea may be divided into three basic categories: watery, fatty (malabsorption), and inflammatory (with blood and pus). Ginger in gastrointestinal disorders: A systematic review of clinical trials. To get in enough calories, reach for foods that are high in protein and fat like steak, eggs, peanut butter, and cheese. Recent weight loss or lymphadenopathy could result from chronic infection or malignancy. Diarrhea: Causes and How to Treat it - Healthline This content does not have an Arabic version. 1, 2 The prevalence is estimated to be 1% to 5% of the adult population. Common bowel disorders, such as IBS and Crohns disease, can also cause these symptoms. Two histologic patterns are found: lymphocytic colitis (lymphocytic infiltrate of the lamina propria) and collagenous colitis (in which the subepithelial collagen layer is also increased to more than 10 mm).19. You can purchase water-disinfecting tablets containing chlorine, iodine tablets or crystals, or other disinfecting agents at camping stores and pharmacies. Other causes of chronic pancreatitis include cystic fibrosis, hereditary pancreatitis, trauma to the pancreas and pancreatic cancer. He is a partner with Digestive Health Associates of Texas and a medical director at Texas Health Harris Methodist HEB Hospital, Keep a Food Diary to Identify Food Triggers. But eating too much can also cause these symptoms. The exact connection between migraine headaches and diarrhea is not known, although research has found that people who suffer from migraines are also more likely to have gastrointestinal (GI) disorders such as irritable bowel syndrome (IBS), celiac disease, and inflammatory bowel disease (IBD). The best method of prevention is to avoid eating and drinking contaminated or raw foods and beverages. Giardia, the most common of these, is best diagnosed with fecal antigen testing.1 Brainerd diarrhea is an epidemic form of long-lasting secretory diarrhea associated with consumption of unpasteurized milk or contaminated water. A new hypervirulent C. difficile strain (NAP1/BI/027) produces a binary toxin in addition to the usual A and B toxins.27 Outbreaks are characterized by severe watery diarrhea, often complicated by toxic megacolon. Antimotility agents such as loperamide are the most effective agents for the treatment of chronic diarrhea. Parasitic diarrhea may be caused by Cryptosporidium, Cyclospora, Entamoeba, Giardia, Microsporida, and Strongyloides. 1 Common causes . (2016). Bodagh MN, et al. However, not all chronic diarrhea is strictly watery, malabsorptive, or inflammatory, because some categories overlap. Traveler's diarrhea is a digestive tract disorder that commonly causes loose stools and abdominal cramps. Accessed Nov. 3, 2020. If we combine this information with your protected One small study found that giving 600 mg NAC twice a day for 2 weeks . With the right diagnosis and treatment plan, you can find relief. You can also chemically disinfect water with iodine or chlorine. Some children may have trouble telling the difference between when theyre hungry and when theyre full. This condition is more common in African-Americans and Asian-Americans. The most common ones in children are rotavirus and in adults are norovirus (this is sometimes called cruise ship diarrhea due to well publicized epidemics). Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. They can also cause unpleasant side effects, such as skin rashes, skin reactions to the sun and vaginal yeast infections. Your chances of getting traveler's diarrhea are mostly determined by your destination. Short-term (acute) diarrhea lasts 1 or 2 days. If washing isn't possible, use an alcohol-based hand sanitizer with at least 60% alcohol to clean your hands before eating. Giardia and Cryptosporidium infections are easily missed on routine ova and parasite examination, although stool acid-fast staining identifies Cryptosporidium. Mayo Clinic on Incontinence - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Abrupt onset of passage of three or more looser watery stools a day, Signs of being unusually sleepy, drowsy or unresponsive, Decreased volume of urine, including fewer wet diapers in infants. Abdominal pain is pain that originates between the chest and the pelvis. Eat foods that are well cooked and served hot. If you have chronic diarrhea, your doctor will want to further assess etiologic factors or complications of diarrhea by obtaining several tests. . Chronic Diarrhea: What It Is, Causes & Treatment Options This can cause digestive trouble. You can get infected with giardia if your hands become dirty with feces parents changing a child's diapers are especially at risk. See permissionsforcopyrightquestions and/or permission requests. ncbi.nlm.nih.gov/pmc/articles/PMC6341159/, onlinelibrary.wiley.com/doi/10.1111/apt.14519, niddk.nih.gov/health-information/digestive-diseases/diarrhea/definition-facts, niddk.nih.gov/health-information/digestive-diseases/diarrhea/diagnosis, niddk.nih.gov/health-information/digestive-diseases/diarrhea/eating-diet-nutrition, ncbi.nlm.nih.gov/pmc/articles/PMC6751351/, niddk.nih.gov/health-information/digestive-diseases/diarrhea/symptoms-causes, niddk.nih.gov/health-information/digestive-diseases/diarrhea/treatment, ncbi.nlm.nih.gov/pmc/articles/PMC9277355/. If your symptoms are caused by stress or need to be managed, home remedies can help. Copyright 2023 American Academy of Family Physicians. Chronic diarrhea lasts longer than 4 weeks. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Beware of sliced fruit that may have been washed in contaminated water. A positive celiac panel, typically consisting of immunoglobulin A (IgA) antigliadin, antiendomysium, and antitissue transglutaminase antibodies, is usually followed by duodenal biopsy for confirmation.24 IgA antiendomysium and antitissue transglutaminase antibodies have much better accuracy than native gliadin antibodies (IgA antigliadin antibodies).22 The deamidated gliadin peptide antibody test is a more accurate second-generation IgA antigliadin antibody test but is not yet routinely included in panels.25 It should be noted that use of gluten-free diets before testing can give false-negative results, as can IgA deficiency or age younger than two years.22, Testing should be expanded to include all patients with unexplained chronic diarrhea, IBS, iron deficiency anemia, chronic fatigue, weight loss, infertility, and elevated liver transaminase levels. These can include a blood count to look for anemia and infections, an electrolyte and kidney function panel to assess for electrolyte abnormalities and renal insufficiency, and albumin to assess your nutritional status. Learn about what causes stomach pains and dizziness and how to treat or manage your symptoms. Your doctor may perform stool tests for bacteria and parasites if your diarrhea is severe or bloody or if you traveled to an area where infections are common. Giardiasis: Epidemiology, clinical manifestations, and diagnosis. Eating, diet, & nutrition for diarrhea. Traveler's diarrhea may begin abruptly during your trip or shortly after you return home. Other symptoms that warrant a visit to the doctor include vomiting, fever, blood in the stool, and sudden weight loss. Abdominal pain and diarrhea can take a toll on your daily life. Iron deficiency anemia may be an indicator of celiac disease and warrants screening.6 A minimal stool assessment should include a fecal leukocyte level and fecal occult blood test, with further testing as indicated. What You Should Know About Abdominal Tenderness. Be aware that alcohol in a drink won't keep you safe from contaminated water or ice. Frequent, constant, or severe abdominal pain and diarrhea may indicate a disease or a more serious medical issue. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. Abdominal bloating. Two or more of the following must apply: Onset of pain is related to a change in frequency of stool, Onset of pain is related to a change in appearance of stool, Magnesium-containing antacids and laxatives, Antibiotics (e.g., amoxicillin/clavulanate [Augmentin]), Nonsteroidal anti-inflammatory drugs (may contribute to microscopic colitis), Prostaglandins (e.g., misoprostol [Cytotec]), Stimulant laxatives (e.g., bisacodyl [Dulcolax], senna), Acarbose (Precose; carbohydrate malabsorption), Antibiotics (e.g., amoxicillin, cephalosporins, clindamycin, fluoroquinolones), Chronic malabsorptive diarrhea, fatigue, iron deficiency anemia, weight loss, dermatitis herpetiformis, family history, Often florid inflammatory diarrhea with weight loss, Recent history of antibiotic use, evidence of colitis, fever, May not resolve with discontinuation of antibiotics, Osmotic (e.g., magnesium, phosphates, sulfates, sorbitol), hypermotility (stimulant laxatives), or malabsorption (e.g., acarbose [Precose], orlistat [Xenical]), Secretory diarrhea or increased motility (hyperthyroidism), Infectious enteritis or colitis (diarrhea not associated with, Inflammatory diarrhea, nausea, vomiting, fever, abdominal pain, History of travel, camping, infectious contacts, or day care attendance, Inflammatory bowel disease: Crohn disease, ulcerative colitis, Bloody inflammatory diarrhea, abdominal pain, nausea, vomiting, loss of appetite, family history, eye findings (e.g., episcleritis), perianal fistulae, fever, tenesmus, rectal bleeding, weight loss, Stool mucus, crampy abdominal pain, altered bowel habits, watery functional diarrhea after meals, exacerbated by emotional stress or eating, History of vascular disease; pain associated with eating, Watery, secretory diarrhea affecting older persons, Nonsteroidal anti-inflammatory drug association possible, No response to fasting; nocturnal symptoms. Ultrasound and CT scan of the abdomen can be helpful to evaluate the bowel, pancreas and other intra-abdominal organs. Seek medical help if youre having abdominal pain and diarrhea that last for more than 2 days, if the pain grows increasingly worse over a 24-hour period, or if its accompanied by any of these symptoms: Diarrhea can be more dangerous for infants, older adults, and people with weakened immune systems. Elsevier; 2021. https://www.clinicalkey.com. IBS is a symptom complex of crampy abdominal pain accompanied by altered bowel habits, either with diarrhea or constipation. All rights reserved. Fever and cough are the most common. https://www.uptodate.com/contents/search. The type of medical treatment youll receive for your abdominal pain and diarrhea depends on the underlying condition causing your symptoms. We avoid using tertiary references. This gram-positive anaerobic bacillus is easily spread through ingestion of spores, rapidly colonizing the colon following antibiotic therapy.
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