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doi: 10.1053/j.gastro.2022.04.016 62 AchufusiTGOSharmaAZamoraEAManochaD

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where this is particularly severe, nonsurgical methods are unlikely to be sufficient to fully address patient needs, and surgery should be discussed as a potential alternative (with nonsurgical procedures as possible adjuncts)

Given that there are several subtypes of IBS and that the conditions etiology and symptom profiles vary, this is another limitation of the study