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12 , 13 Opposite effects are observed in dysbiosis conditions (eg, a low Bacteroidetes to Firmicutes ratio), where high levels of lipopolysaccharides and pro-inflammatory cytokines (eg, interleukin-1, interleukin-6, tumor necrosis factor ) are produced by gut bacteria (Figure 1)

The people most at risk for this condition are those with abnormal lower esophageal sphincter function, gastric emptying disorders, or obesity

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