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Zygote (2014) 23:5867

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Patients should be counselled to respond promptly to the urge to defecate rather than delaying, avoid straining or spending excessive time on the toilet, and consider using a footstool to elevate the knees above hip level, which facilitates easier bowel movements

Since there is limited evidence for central ghrelin synthesis, circulating ghrelin needs to be transported into the brain for central action on GHS-R1a