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Main exclusion criteria included recent gastrointestinal discomfort (e.g., abdominal pain or diarrhea) within the previous month, recent use of antibiotics, use of probiotics or prebiotics within the previous month, and advanced chronic kidney disease or other metabolic disorders (thyroid dysfunction, Cushing syndrome, acromegaly, and pheochromocytoma)

Additionally, if household members or dining companions develop similar symptoms simultaneously, this strongly suggests a foodborne illness rather than medication effects

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