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Gastric acid-reducing medicines such as omeprazole or ranitidine: Long-term use may contribute to vitamin B12 deficiency and may increase the need for supplementation

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Reduced intestinal blood perfusion, mesenteric ischemia, and decreased bowel movements caused by cirrhosis have appeared to change the normal microenvironment to be less suitable for beneficial populations of Bacteroides and Clostridium , resulting in invasion and colonization of opportunistic pathogens, such as Enterobacteriaceae and Veillonella