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However, only the injectable form has been available because peptide drugs are usually not suitable for administration via the oral route, as they present low oral bioavailability, are inactivated when they reach the gastrointestinal tract, and have low rates of diffusion into the cell [31, 32]

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Clinical presentation Patients with melanosis coli may be asymptomatic or present with non-specific gastrointestinal complaints, such as altered bowel habits, abdominal discomfort, or bloating

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Although not definitively proven, this risk has been a significant concern, particularly with long-term use