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[756] ACIP also cited a large national survey of family medicine and internal medicine physicians assessing barriers to adult hepatitis B vaccination and found that 68% cited patients' non-disclosure of risk factors

Reduced cobalamin availability leads to: Impaired enterocyte regeneration Villous atrophy and barrier dysfunction Increased intestinal permeability Secondary dysbiosis and chronic inflammation Clinically, this manifests as: Persistent anorexia Weight loss Chronic diarrhea Poor response to standard GI or pancreatitis therapy Low vitamin B12 concentrations have also been associated with increased disease severity and poorer prognosis in dogs with chronic enteropathy and inflammatory bowel disease

When physical therapy doesnt work, your doctor might recommend that you start medication therapy

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