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Additionally, patients with inflammatory bowel disease, severe gastroesophageal reflux disease, or other significant gastrointestinal disorders should be monitored closely if treatment is initiated, as the gastrointestinal effects of semaglutide may worsen their underlying condition

Fortunately, such reactions are extremely infrequent

Pernicious anemia is associated with an increased incidence of carcinoma of the stomach, but this is believed to be related to the underlying pathology and not to treatment with cyanocobalamin

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