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Other concerning symptoms include: Signs of dehydration (decreased urination, dizziness, extreme thirst) Persistent diarrhea lasting more than 48 hours Blood in stool or vomit Unexplained weight loss beyond expected therapeutic effects Severe constipation unresponsive to standard measures New or worsening heartburn or reflux symptoms Symptoms of gallbladder disease (right upper abdominal pain, especially after meals, fever, or jaundice) Signs of possible bowel obstruction or ileus (severe abdominal distension, inability to pass gas or stool) Before starting digestive enzyme supplements or any over-the-counter products, patients should discuss this decision with their healthcare provider or pharmacist

A.WoodsC.O'ConnellJ.et al (2014)

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