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In these vulnerable populations, administering probiotics carries a risk of serious adverse events, most notably systemic infections
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Additionally, new or worsening constipation accompanied by unexplained weight loss (beyond expected therapeutic weight reduction), persistent changes in stool caliber, or alternating constipation and diarrhea warrants evaluation to exclude structural or neoplastic causes, particularly in patients age 45 or older or those with family history of colorectal cancer
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