can i take antihistamine before colonoscopy

The colder months are a time when viruses of any kind. Anticoagulants slow blood clotting and can be dangerous to take before the colonoscopy in the event the doctor must remove one or more polyps or take any action that increases the risk for bleeding, states University of Connecticut Medical Center 2. This cookie is set by GDPR Cookie Consent plugin. According to the findings, these types of symptoms can be reduced with antihistamine premedication. I cant cope with my cough, acid, diorhea etc without these meds? Have an edit or suggestion for this page. Other examples of anti-platelet drugs include dipyridamole, pentoxyiflline and tirofiban. Anacin products. Warfarin (Coumadin), MONKEYPOX: UConn Health is NOT currently offering the monkeypox vaccine. Can I Take Vitamins Before a Fasting Blood Test? Can I take my methotrexate and humira pen before the colonoscopy? While we do connect people with vetted, board-certified doctors, we dont provide medical consultations, diagnosis, or advice. Combine an antihistamine with cold medication to relieve symptoms. list of medications for diabetes mellitus. 4-Way Cold Tabs. Other products or supplements may also cause bleeding problems. If you find you are nervous or anxious the night before, you can take an over-the-counter sleep aid. At 4:15 p.m., drink 1 (8-ounce) glass of the mixture. By clicking Accept All, you consent to the use of ALL the cookies. Can I take hydroxyzine before my colonoscopy? if taking phentermine for weight loss how soon to stop before colonoscopy? These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. Please visit the CT DPH website for more information or contact your health provider directly. You want to be cleaned out therefore anything that will make you hold on to your stool should be avoided. You can continue probiotics .BUT talk to your doctor. You may take your antianxiety medications with a small sip of water. COVID-19: Vaccine Program | Testing |Visitor Guidelines | Information for EmployeesMONKEYPOX: UConn Health is NOT currently offering the monkeypox vaccine. The CDC Says Don't Take Antihistamines Before Your Vaccine to Prevent an Allergic Reaction. By using our website, you consent to our use of cookies. Good luck! Can I take vitamin d before mu colonoscopy ? Nevertheless, its better to feel embarrassed or annoyed by reporting they took blood thinner than risk bleeding excessively during a colonoscopy. What medications should you not take before a colonoscopy? Indomethacin (Indocin) Salicylates (sodium salicylate, Magan, Mobidin, Mobogesic, Arthritab, Bayer Select, Doans pills) You may be instructed to take the laxative the night before your colonoscopy, or you may be asked to use the laxative both the night before and the morning of the procedure. Do I need to reschedule my procedure? Opens in a new tab or window. Additionally, analysis was restricted to patients who were on chronic opioids and were undergoing outpatient colonoscopies. It's not the same as hyoscine hydrobromide, which is a different medicine taken to prevent motion sickness.. Buscopan comes as tablets and is available on prescription. Suck on the hard candies to get rid of the flavor. Do not eat or drink solid foods, milk, milk products, or juice with pulp. In general, you can take most medications up to a day before your colonoscopy AND only essential ones like high blood pressure and seizure medications the morning of the procedure. Gastrointest Endosc. Nusrat called for further studies to identify the optimal use of diphenhydramine as an adjunct to standard sedation. I know that often histamine cause problems with sneezing, itching, watery eyes and runny nose. Can I take my duodart capsule today ? It is scheduled for next Tuesday, and I am supposed to take my methotrexate on Friday and my humira shot on Saturday. Good luck! Does Seroquel XR affect the bowel prep process? What meds you can and cannot take preop really differ between procedure being performed, your own medical history, and the specific medication. Medications to Stop Before a Colonoscopy 1 Nonsteroidal Antiinflammatory Drugs. For example, both vitamin E and chamomile may thin the blood and could cause excessive bleeding during the procedure. 1998-2023 Baylor College of Medicine | One Baylor Plaza, Houston, Texas 77030 | (713)798-4951Have an edit or suggestion for this page? Anticholinergics, such as the Transderm Scop patch, may also help with dizziness. Do I need to stop both? https://www.ncbi.nlm.nih.gov/pubmed/23222289/, Three Colonoscopy Videos You Need to See Before Your Test, [Video] How to make colonoscopy prep more tolerable, How to prepare for gastroenterologist GI procedures, When to start screening for colorectal cancer. However to simply answer your question, yes you can take the antihistamines like zyrtec . I am 5 days out from my colonoscopy. The question we really need to answer here is: is the nipple at the correct position above the inframammary fold. Fenoprofen (Nalfon) Warfarin (Coumadin)is usually stopped 5-7 days before your colonoscopy. J Community Hosp Intern Med Perspect. If you follow the diet instruction and do the split dose regimen, you should be alright with your plan. Other oral anticoagulation medications like Eliquis and Xarelto can be stopped 2-3 days before colonoscopy. I can't take any more of my colonoscopy prep medicine! You may take DRAMAMINE if nausea develops while taking prep. You can continue to take these important medications. You may need to start your bowel prep 1 to 2 days before your colonoscopy, or the night before. Patients rated their pain on 10-point scales (1=no pain; 10=severe pain) and amnesia (1=complete memory; 10=no memory) the following day. Can I take the following drugs Claritin D contains a decongestant which Allegra (as opposed to Allegra D does not). Share on Facebook. These cookies ensure basic functionalities and security features of the website, anonymously. Follow your instructions. I take one duodart capsule at 5.00 PM each day to lessen the effects of benign enlarged prostate. These cookies will be stored in your browser only with your consent. Talk to your doctor if you take any of these medications and ask if you need to stop or continue them. The arrival of COVID booster shots can give many of us peace of mind that our immune systems are bolstered against COVID-19 this winter. Flonase is a steroid spray that acts on the area where is sprayed (i.e the nose). Actually you CAN take a non sedating antihistamine before a colonoscopy however you should NOT take it atleast 4 hours before the procedure itself as that can cause problems in visualizing the colonoscopy. Good luck! Click list of medications for diabetes mellitus. What kind of decongestant can a 3 year old take? Follow the specific instruction of your doctor. There are 2 main types of medications-insulin and non-insulin medications. Cilostazol (Pletal) Some doctors recommend stopping all vitamin and herbal supplements for a week before the procedure, rather than singling out vitamins or supplements by name. Most people can safely take antihistamines. My colonoscopy is in 2 days. You need to stop your anti-coagulation medications before your colonoscopy. Im taking Valacyclovir 1000 mg TID. Good luck! Generally taking over the counter allergy medications is safe prior to your Breast Augmentation. Ibuprofen (Advil, Motrin) - stop 1 week prior to surgery Naprosyn (Aleve) - stop 1 week prior to surgery Plavix - discuss this with the prescriber as to the best time to stop this medication before surgery Some over-the-counter herbs can also effect bleeding. BATHING INSTRUCTIONS Leave jewelry and other valuables at home. How long does it take to move bowels after a colonoscopy? Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. Its been rescheduled 2x before by the doc already. Opens in a new tab or window, Share on LinkedIn. Nonsteroidal anti-inflammatory medications NSAIDs (generic name in italics): Diclofenac (Cataflam, Voltaren, Arthrotec) Call today to schedule an appointment or fill out an online request form. It should not affect your colonoscopy. Talk to your doctor. (adsbygoogle = window.adsbygoogle || []).push({}); Your email address will not be published. Sulindac (Clinoril) Thanks! However, follow the specific instruction of your physician because these medications may affect some of your colonoscopy findings. Blood pressure medications are essential medicines. How to use your bowel cleansing agents for colonoscopy. 3 Can I take a sleeping pill the night after a colonoscopy? Medically reviewed by Drugs.com. What is a station drug? can you tell me what vermifuge herbs i can take before colonscopy that wont stain intestines and make it hard to see. Arrange for someone to drive you home and stay with you after your procedure. They should be stopped 1 week before your colonoscopy. thanks! Antihistamines prevent histamine from binding to receptors that trigger symptoms in both conditions. Food affects bowel prep. Yes, you may take your prescription sleep medication and or muscle relaxants as prescribed by your physician. There are 2 types of diabetes mellitus. Talk to your doctor. Last updated on Feb 6, 2023. your colon needs to be cleaned out. Will one pill impact my colonoscopy? Good luck! Depending on the patient's breast shape, size, and chest structure we may decide to place the implants over or under the muscle. Use the split dose regimen. As of December 28, 2020, at least 10 allergic reactions to the Pfizer/BioNTech and two allergic reactions to Moderna vaccines have been reported. These are sometimes referred to as blood thinners. I am having breast augmentation surgery 3/26/15. Key Statistics for Colorectal Cancer. Generally, patients should stop these drugs four days before the colonoscopy, but they should ask the prescribing doctor how many days before the procedure they should stop taking them. hb```f``Jd`e`ff@ a+.cu& -HJ8Z>Uc^bp $X\yH@BHxuse%rg"l70s&2Ag8f@ [K5 endstream endobj 28 0 obj <> endobj 29 0 obj <> endobj 30 0 obj <>stream 7 What medications should you not take before a colonoscopy? This is called bowel prep or colon prep. On December 9, 2020, it was reported that two patients in the U.K. had an allergic reaction after getting the COVID-19 vaccine. All patients used chronic opioids (defined as at least 5 mg of morphine or its equivalent at least 3 days per week for more than 3 months) and were scheduled to undergo colonoscopy. If not I can get the 1000mg pull which is white. For medications used to treat arthritis (regular dose aspirin or nonsteroidal anti-inflammatory drugs, also known as NSAIDs), there is little or no risk to stopping these, but you may have more arthritis pain or swelling. This cookie is set by GDPR Cookie Consent plugin. He indicated that it was ok. Thank you. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Finesteride? The above information is an educational aid only. Plus 50mcg clonidine. Ive been prescribed 500 mg pills x 2 per dose. Why do I need to stop taking lansaprazole and ranitidine a week before my colonoscopy and endoscopy? Once the vomiting subsides, make sure you drink plenty of clear fluids. Thank you for your question. Colonoscopy is booked for Tuesday. Get up and walk around. A day before your colonoscopy, your physician will put you on either a clear liquid diet or a low fiber diet. Created for people with ongoing healthcare needs but benefits everyone. Fexofenadine with other medicines. You should consult your doctor about this in order to be safe. In addition, they can prevent any artery from getting blockedlike arteries in the leg. Learn how we can help 4.2k views Reviewed >2 years ago Thank Dr. Ronald Krauser and another doctor agree 8 thanks I finished my prep with success. Those who. When histamine, a chemical created by your immune system, overreacts to an allergen such as pollen and pet dander, it can cause symptoms such as coughing, sneezing and watery eyes. Doctors recommend patients stop taking Blood Thinners *, and Ibuprofen, including Advil, 7 days prior to your colonoscopy exam. Your doctor wants you alert to consent (if not already done) and examine before the procedure. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Can you take oxybutnin before a colonoscopy. Please visit the, Some medications (prescription and over-the-counter) can reduce your bodys ability to form blood clots and taking these before GI endoscopy procedures may increase your risk of bleeding during and after these tests. It is safe to take acetaminophen (Tylenol) before an endoscopy for arthritis pain or headaches. Blood thinners may need to be stopped 7 to 14 days before a colonoscopy to prevent bleeding. If so, then they should ask their physician whether they should stop taking the drug before the colonoscopy. Having any active infection before surgery can increase you chances of complications after surgery. Taking a decongestant can lead to hypertension or both have decongestants in them so I would not. Sedating antihistamines, in particular, may not be suitable for some people. Opens in a new tab or window, Visit us on TikTok. Some medications (prescription and over-the-counter) can reduce your bodys ability to form blood clots and taking these before GI endoscopy procedures may increase your risk of bleeding during and after these tests. Follow all other instructions. Very little information about the cause of these reactions are known . Can I take decongestant before a colonoscopy, Can I take ibuprofen before a colonoscopy, Can I take claritin d and nyquil together, Can I take claritin D and dayquil together. For the first 24 hours after your procedure: Do not make important decisions or sign any legal papers. What experience do you need to become a teacher? To learn more, please visit our, You can check with your physician to be certain but I dont see this is a problem. It may make it easier for you. Is it possible for me to take a decongestant with claritand? 2009;69(7):1201-9. doi:10.1016/j.gie.2009.01.035, Arora G, Mannalithara A, Singh G, Gerson LB, Triadafilopoulos G. Risk of perforation from a colonoscopy in adults: a large population-based study. If requested before 2 p.m. you will receive a response today. Opens in a new tab or window, Visit us on YouTube. Around 60% of all people with asthma have allergic asthma. The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. Do not take oral diabetic medications or short-acting insulin on the day of your colonoscopy. Sounds like both are ok to take. For aspirin (81 or 325 mg daily) used to prevent heart problems, this is usually safe to stop for seven (7) days prior to any procedure. Start Your Bowel Preparation. As of this writing, 7 days left before my scheduled colonoscopy. This cookie is set by GDPR Cookie Consent plugin. Thank you for your question. We comply with the HONcode standard for trustworthy health information. Diabetes and colonoscopy. Can i list my meds and please tell me what to stop and when? Decongestants are medicines that help relieve a congested (stuffy) nose. Can I take that? Those who were pregnant, had a history of colon resection, or severe cardiopulmonary disease were excluded. Colorectal Cancer Facts & Figures 2017-2019. Do not drink clear liquids that are blue, red, or purple. Itching, anxiety, nausea, vomiting, allergies? Most people are placed on a clear liquid diet a day before colonoscopy. Yes a klonopin can be taken the day before a colonoscopy so long as it has been prescribed by a doctor. The researchers reported no financial disclosures of interest. Shower or bathe to minimize the chance of infection and wear loose, comfortable clothing. 3 Anti-Platelet Drugs. The researchers found that diphenhydramine improved patient scores for pain (mean 2.05 with diphenhydramine versus 3.09 for placebo) and amnesia (7.8 versus 6.5, respectively; P=0.047 for both comparisons), although the categorical assessment showed no significant difference between groups. Apheresis blood donation (double red cells, platelets, plasma) takes about 1 1/2-2 hours. Opens in a new tab or window, Visit us on LinkedIn. Below is a list of many medications (but not all) that fall into these categories. It is ok to take allergy medications before and after surgery. Piroxicam (Feldene) In this video, Dr. Gelrud and Dr. Echavarria explain which medications should be continued, which ones should be adjusted in dosage, and which ones should be stopped before your colonoscopy. No need to take on the morning of your colonoscopy. Can I take diphenhydramine before surgery? You will need to stop taking medicines that contain aspirin or iron for 7 days before your colonoscopy. Be sure to tell your doctor well ahead of your colonoscopy about any regularly prescribed medications you are taking and any health conditions or allergies, as this information needs to be shared when you . Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features. You may take acetaminophen (Tylenol) as needed for minor aches and pains. No need to cancel your procedures. Second-generation H1 antihistamines and H2 blockers can typically be taken at any time of the day. You can even take it on the day of your colonoscopy with sips of water. You will probably feel much better taking them than not! However, in most cases, you can take Tylenol before and after your screening unless there are unusual circumstances. Is it ok to take cold medicine just for the decongestant effects? Colonoscopy: A colonoscopy (koe-lun-OS-kuh-pee) is an exam used to detect changes or abnormalities in the large intestine (colon) and rectum. 2. Etodolac (Lodine) It can also help bladder cramps and period pain.. Buscopan contains the active ingredient hyoscine butylbromide. There are no interactions between then but remember that the D part of Claritin d can increase blood pressure.you can look up interactions at drugs.co and sympathomimetics don't interact well and can cause arrhythmias, Cornea, Cataract, & Refractive (LASIK & PRK) Surgery. An antihistamine, like Claritin should help block the release of histamine from mast cells, decreasing mucous production. 6 Can I take diphenhydramine before surgery? The following are general guidelines: Diabetic medicines may need to be stopped or their dose changed, on the day of your colonoscopy. Can i take claritin-d and nasacort (triamcinolone) at the same time? It is important that you get a good nights sleep before your surgery. This has not been validated by other studies. Meloxicam (Mobic) A: Yes. How to Take Antihistamines It has minimal effects on the rest of the body. Adprin-B products. You may continue to take aspirin if your doctor recommended you ordinarily take it. What does your doctor need to know before a colonoscopy? Nabumetone (Relafen) I have a colonoscopy and endoscopy this wed morning. Doctors typically provide answers within 24 hours. The following are examples of clear liquids: Copyright Merative 2022 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Quality of sedation was then assessed both categorically (inadequate, adequate, over-sedated) and quantitatively on a seven-point scale (spanning no effect to optimal sedation) separately by a physician and a nurse. Whole blood donation takes about 45-60 minutes. The congestion can be caused by a cold virus or by the flu, sinusitis, or allergies. If you are already on a nerve medication, e.g., diazepam, please contact your primary care doctor for instructions. Can I take Mucinex DM and Tylenol 1-4 days before colonoscopy? 4. Adamec is coauthor of "The Encyclopedia of Diabetes," "Fibromyalgia for Dummies" and many other books. Medpage Today is among the federally registered trademarks of MedPage Today, LLC and may not be used by third parties without explicit permission. Anti-platelet medications are used to prevent stroke and heart attack. You do not need to stop these medications 1 week before your colonoscopy/egd. This question came to me and my resident team at McMaster University and we decided to pursue an answer from the surgical literature. Can i take claritin d with vyvanse (lisdexamfetamine)? If you have tested positive for Covid-19 or been exposed to someone who has the illness, you should not go to the vaccination site to get your shot until your symptoms and isolation period have. Will a station drug affect a colonoscopy? Can I take a sleep aid the night before a colonoscopy? At 4:30 p.m., drink 1 (8-ounce) glass of the mixture. He knew when Id be having the procedures, but I forgot to mention that the GI Dr said to stop. Take one-half of the bowel prep in the evening as instructed If you have diabetes and take Lantus take only your typical dose. You can also take an anti-nausea medication if you have one at home, such as Phenergan or Reglan. [08Q(n& TA]2FQpR b JX Vt Most medications can be continued as usual if you're getting a colonoscopy, but some medications can interfere with the preparation or the examination. This is true even if they already had the induced-diarrhea from the bowel preparation and feel as if they should just go ahead with the procedure anyway. But opting out of some of these cookies may affect your browsing experience. You can resume your usual medication unless you are taking a You never want to take more medication than you need. 2015;5(5):29147. doi:10.3402/jchimp.v5.29147, Amornyotin S. Sedation-related complications in gastrointestinal endoscopy. At Mayo Clinic donor centers, you'll have access to wireless internet, a television and movies during the donation process. Naproxen (Naprosyn, Naprelan, Anaprox, Aleve) Anti-platelet drugs should be avoided about seven days before the colonoscopy, because they could increase the risk for bleeding during the procedure, notes University of Connecticut Medical Center 2. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Antihistamines are available over the counter (OTC) and prescription as tablets, capsules, liquid gels, eye drops, and nasal sprays. Take a break from drinking liquids and prep. Can You Take Vitamin B-6 if Taking Warfarin? Do not take any sedatives, tranquilizers, sleeping pills, or medicines that make you drowsy. Antihistamines treat these allergy symptoms: Congestion, runny nose, sneezing, or itching Swelling of the nasal passages Hives and other skin rashes Itchy, runny eyes Treating symptoms can help you or your child to feel better during the day and sleep better at night. If not what cold medicine can be take ? Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. "Our results showed that, though the use of diphenhydramine did not decrease the dose of conventional sedative used, it did improve the quality of sedation as rated by the patient, nurses and the physicians," stated Nusrat. And for the eletriptan as not eating sufficiently to prepare for the test may trigger a headache and no otc medication works. bismuth-subsalicylate: blackish stools and changes in tongue . Atlanta: American Cancer Society; 2017. Q: Can I take my antianxiety medications the morning of my procedure? 2 Can you take an antihistamine before a colonoscopy? Talk to your healthcare provider before you stop or change any of your medicines. Preferably not because it can cause drowsiness and interact with other medications you will be given. Aspirin is one example of an anti-platelet drug and it becomes important to note that many drugs contain aspirin--so check the bottle if a medication is an OTC drug. I take 50mg of vyvanse in the morning. Background: Intravenous benzodiazepines in combination with opiates are used to achieve moderate sedation for colonoscopy. Since it causes drowsiness, you may hold it on the day of your colonoscopy. Gastroenterology. 2009;69(3 Pt 2):654-64. doi:10.1016/j.gie.2008.09.008. Have any allergies. Please make sure to review with your doctor all medicines and supplements that you are taking. Medications likeImodium, Lomotil, and Pecto Bismol should be stopped about 1 week before your colonoscopy. No. Some people recommend you stop this drug 5-7 days before colonoscopy. Can I take Phenergan before a colonoscopy? Why people hate colonoscopy and what to do about it. Welcome to JA and thanks for this question. Gastrointest Endosc. There were no statistical differences in induction time, procedure duration, or recovery time between the diphenhydramine and placebo groups. I had my pre op today and told my doctor I have been taking Flonase and Allegra for the last few days. Ibuprofen (Motrin, Advil, Motrin IB, Nuprin) "Patient tolerance is important for successful and safe completion of colonoscopy and results in increased compliance and willingness to undergo repeat procedure," he said. As always, talk to your doctor. Although effective, these agents have potential adverse effects, such as respiratory depression and hypotension. Wait Until After Children for Breast Augmentation? Can I take a sleeping pill the night after a colonoscopy? Do not eat or drink solid foods, milk, milk products, or juice with pulp. Some medications may cause you to bleed more during or after colonoscopy. Things to consider before taking antihistamines. All rights reserved. Low Molecular Weight Heparins (Fragmin, Lovenox, Danaparoid) How to take your medications before colonoscopy. How do we find the inframammary fold? You should continue your blood pressure medications. Non-essential medications can be used after the procedure. I had an Avastin treatment and will have a Colonoscopy and an Endoscopy 3 weeks later. Your bowel movements should look yellow to light brown and be liquid. Every medicine can cause allergies in some people. diltiazem, Letrozole, levothyroxine., fosinopril sodium. Forms: Both drugs come in a variety of OTC forms. can I take dextromethorphan before my colonoscopy. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. 5 Supplements. For this reason, it is generally recommended to withhold certain drugs if you are scheduled to have one of these procedures performed. If you experience any signs of infection or fever, please call your plastic surgeons office to inform them. This site uses Akismet to reduce spam. Day of your Colonoscopy Do not eat any solid food until after the colonoscopy. About 40 minutes: An UGI endoscopy usually takes 10 min while a colonoscopy wihtout polypectomy or other procedure, usually takes about 30 minutes. Take care! This is particularly true if some form of therapeutic procedures (biopsies, dilation, polypectomy) are performed during colonoscopy. Aspirin is one example of an anti-platelet drug and it becomes important to note that many drugs contain aspirin--so check the bottle if a medication is an OTC drug. My GI Dr told me to stop 10 days before, but my primary care Dr had told me to keep taking Vitron Iron supplements 2 per day because my blood test said still wasnt normal, even though I was feeling much better. Clear liquids before a colonoscopy: Your healthcare provider may tell you to drink only clear liquids 1 to 2 days before your colonoscopy. Place a pen under your breast where your breast meets your chest. Some people recommend you stop this drug 5-7 days before colonoscopy. I was using cbd oil until last night but wasnt sure so i stopped last night. You should not have solids in your bowel movements. As always, discuss with your doctor. Staff Writer, MedPage Today "Many allergy sufferers know that antihistamines work for their symptoms but also make them . Many people take prescribed or over-the-counter medications they must stop using before a colonoscopy. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. Best of luck. My procedures are in 36 hours, and I did take them each of the last 3 days. Have a fever. what do you recommend? But speak to a pharmacist or GP for advice if you: are pregnant or breastfeeding are looking for a medicine for a young child are taking other medicines have an underlying health condition, such as heart disease , liver disease, kidney disease or epilepsy

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